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Title: Scapula fractures: interobserver reliability of classification and treatment.
Epworth Authors: Richardson, Martin
Other Authors: Neuhaus, Valentin
Bot, Arjan G.
Guitton, Thierry G.
Ring, David C.
Keywords: Department of Orthopaedics, Epworth HealthCare, Melbourne, Victoria, Australia.
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Computerized Tomography, X Ray
Tomography, X-Ray Computed
Computer-Assisted Three-Dimensional Imaging
Imaging, Three-Dimensional, Computer Assisted
Three-Dimensional Imaging, Computer Generated
Fractures, Bone
Bone Fractures
Observer Variation
Issue Date: Mar-2014
Publisher: Wolters Kluwer
Citation: J Orthop Trauma. 2014 Mar;28(3):124-9.
Abstract: OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. DESIGN: Web-based reliability study. SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. MAIN OUTCOME MEASUREMENTS: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.
DOI: 10.1097/BOT.0b013e31829673e2
PubMed URL:
ISSN: 0890-5339
Journal Title: Journal of Orthopaedic Trauma
Type: Journal Article
Type of Clinical Study or Trial: Reproducibility of Results
Appears in Collections:Musculoskeletal

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