Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/654
Title: Interobserver agreement of Neer and AO classifications for proximal humeral fractures.
Epworth Authors: van Bavel, Dirk
Richardson, Martin
Other Authors: Papakonstantinou, Maritsa
Hart, Melissa
Farrugia, Richard
Gabbe, Belinda
Moaveni, Afshin
Page, Richard
Keywords: Proximal Humeral Fractures
Humerus
Shoulder Fractures
Neer Classification
AO Classification
Classification
X-Rays
Interobserver Agreement
Observer Variation
Department of Orthopaedics, The Epworth Hospital, Melbourne, Victoria, Australia
Issue Date: Apr-2016
Publisher: Wiley
Citation: ANZ J Surg. 2016 Apr;86(4):280-4
Abstract: BACKGROUND: The classification of proximal humeral fractures remains challenging. The two main classification systems used, the Neer and the AO classification, have both been shown to have less than ideal interobserver agreement. Agreement in classification is required, however, to guide fracture management. METHOD: Data from the Victorian Orthopaedic Trauma Outcomes Registry were collected and the X-rays of 104 proximal humeral fractures were reviewed by three orthopaedic consultants. They classified the fractures according to the Neer and AO classifications, as well as their simplified versions. Interobserver agreement was then assessed using kappa statistics. RESULTS: Interobserver agreement was better overall in the Neer classification, which was moderate (kappa = 0.40-0.58), than the AO classification, which was fair to moderate (kappa = 0.31-0.54). When simplified, the Neer and AO classification interobserver agreement remained similar. CONCLUSION: The classification of proximal humeral fractures with both the Neer and the AO systems remains difficult with minimal improvements seen when reducing the number of categories in each classification system. From these results, the Neer classification system would appear slightly more useful in clinical practice to guide treatment.
URI: http://hdl.handle.net/11434/654
DOI: 10.1111/ans.13451
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/26887373
ISSN: 1445-2197
Journal Title: ANZ Journal of Surgery
Type: Journal Article
Affiliated Organisations: Department of Orthopaedics, St Vincent's Hospital, Melbourne, Victoria, Australia
Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), Melbourne, Victoria, Australia
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Orthopaedics, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
Department of Orthopaedics, The Alfred Hospital, Melbourne, Victoria, Australia
Department of Orthopaedics, University Hospital, Geelong, Victoria, Australia
School of Medicine, Deakin University, Geelong, Victoria, Australia
Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Validation Study
Appears in Collections:Musculoskeletal

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