TY - JOUR
T1 - Interobserver reliability of coronoid fracture classification: two-dimensional versus three-dimensional computed tomography
AU - Lindenhovius, Anneluuk
AU - Karanicolas, Paul Jack
AU - Bhandari, Mohit
AU - van Dijk, Niek
AU - Ring, David
AU - AUTHOR GROUP
AU - Allan, Christopher
AU - Anglen, Jeffrey
AU - Axelrod, Terry
AU - Baratz, Mark
AU - Beingessner, Daphne
AU - Brink, Peter
AU - Cassidy, Charles
AU - Coles, Chad
AU - Conflitti, Joe
AU - Crist, Brett
AU - Della Rocca, Gregory
AU - Dijkstra, Sander
AU - Elmans, L. H. G. J.
AU - Feibel, Roger
AU - Flores, Luis
AU - Frihagen, Frede
AU - Gosens, Taco
AU - Goslings, J. C.
AU - Greenberg, Jeffrey
AU - Grosso, Elena
AU - Harness, Neil
AU - van der Heide, Huub
AU - Jeray, Kyle
AU - Kalainov, David
AU - van Kampen, Albert
AU - Kawamura, Sumito
AU - Kloen, Peter
AU - McKee, Michael
AU - Nork, Sean
AU - Page, Richard
AU - Pesantez, Rodrigo
AU - Peters, Anil
AU - Poolman, Rudolf
AU - Prayson, Michael
AU - Richardson, Martin
AU - Seiler, John
AU - Swiontkowski, Marc
AU - Thomas, George
AU - Trumble, Tom
AU - van Vugt, Arie
AU - Wright, Thomas
AU - Zalavras, Charalampos
AU - Zura, Robert
PY - 2009
Y1 - 2009
N2 - This study tests the hypothesis that 3-dimensional computed tomography (CT) reconstructions improve interobserver agreement on classification and treatment of coronoid fractures compared with 2-dimensional CT. A total of 29 orthopedic surgeons evaluated 10 coronoid fractures on 2 occasions (first with radiographs and 2-dimensional CT and then with radiographs and 3-dimensional CT), separated by a minimum of 2 weeks. Surgeons classified fractures according to the classifications of Regan and Morrey and of O'Driscoll et al., identified specific characteristics, recommended the most appropriate treatment approach, and made treatment recommendations. The kappa multirater measure (kappa) was calculated to estimate agreement between observers. Regardless of the imaging modality used, there was fair to moderate agreement for most of the observations. Three-dimensional CT improved interobserver agreement in Regan and Morrey's classsication (kappa(3-dimensional) = 0.51 vs kappa(2-dimensional) = 0.40; p <.001) and O'Driscoll et al.'s classifications (kappa(3-dimensional) = 0.48 vs kappa(2-dimensional) = 0.42; p = .009). There were trends toward better reliability for 3-dimensional reconstruction in recognition of coronoid tip fractures (kappa(3-dimensional) = 0.19, kappa(2-dimensional) = 0.03; p = .268), comminution (kappa(3-dimensional) = 0.41 vs kappa(2-dimensional) = 0.29; p = .133), and impacted fragments (kappa(3-dimensional) = 0.39 vs kappa(2-dimensional) = 0.27; p = .094), and in surgeons' opinions on the need for something other than screws or plate for surgical fixation (kappa(3-dimensional) = 0.31 vs kappa(2-dimensional) = 0.15; p = .138). Interobserver agreement on treatment approach was better with 2-dimensional CT (kappa(3-dimensional) = 0.27, kappa(2-dimensional) = 0.32; p = .015). Three-dimensional CT reconstructions improve interobserver agreement with respect to fracture classification compared with 2-dimensional CT. Diagnostic III
AB - This study tests the hypothesis that 3-dimensional computed tomography (CT) reconstructions improve interobserver agreement on classification and treatment of coronoid fractures compared with 2-dimensional CT. A total of 29 orthopedic surgeons evaluated 10 coronoid fractures on 2 occasions (first with radiographs and 2-dimensional CT and then with radiographs and 3-dimensional CT), separated by a minimum of 2 weeks. Surgeons classified fractures according to the classifications of Regan and Morrey and of O'Driscoll et al., identified specific characteristics, recommended the most appropriate treatment approach, and made treatment recommendations. The kappa multirater measure (kappa) was calculated to estimate agreement between observers. Regardless of the imaging modality used, there was fair to moderate agreement for most of the observations. Three-dimensional CT improved interobserver agreement in Regan and Morrey's classsication (kappa(3-dimensional) = 0.51 vs kappa(2-dimensional) = 0.40; p <.001) and O'Driscoll et al.'s classifications (kappa(3-dimensional) = 0.48 vs kappa(2-dimensional) = 0.42; p = .009). There were trends toward better reliability for 3-dimensional reconstruction in recognition of coronoid tip fractures (kappa(3-dimensional) = 0.19, kappa(2-dimensional) = 0.03; p = .268), comminution (kappa(3-dimensional) = 0.41 vs kappa(2-dimensional) = 0.29; p = .133), and impacted fragments (kappa(3-dimensional) = 0.39 vs kappa(2-dimensional) = 0.27; p = .094), and in surgeons' opinions on the need for something other than screws or plate for surgical fixation (kappa(3-dimensional) = 0.31 vs kappa(2-dimensional) = 0.15; p = .138). Interobserver agreement on treatment approach was better with 2-dimensional CT (kappa(3-dimensional) = 0.27, kappa(2-dimensional) = 0.32; p = .015). Three-dimensional CT reconstructions improve interobserver agreement with respect to fracture classification compared with 2-dimensional CT. Diagnostic III
U2 - https://doi.org/10.1016/j.jhsa.2009.07.009
DO - https://doi.org/10.1016/j.jhsa.2009.07.009
M3 - Article
C2 - 19833449
SN - 0363-5023
VL - 34A
SP - 1640
EP - 1646
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 9
ER -