TY - JOUR
T1 - Radiographic loss of contact between radial head fracture fragments is moderately reliable
AU - Bruinsma, Wendy E.
AU - Guitton, Thierry
AU - Ring, David
AU - AUTHOR GROUP
AU - Eng, Kevin
AU - Jokhi, Vispi
AU - Oloruntoba, David O.
AU - Jain, Sanjev
AU - Melvanki, Parag
AU - Frihagen, Frede
AU - McGraw, Iain
AU - Lenzlinger, Philipp
AU - Ponsen, K. J.
AU - Schmidt, Andrew
AU - Ciritsis, Bernhard
AU - Conflitti, Joseph M.
AU - Turina, Matthias
AU - Poolman, Rudolf W.
AU - Liem, Ronald
AU - Gulve, R. S.
AU - Wagg, James
AU - Kloen, Peter
AU - Grosso, Elena
AU - Mormino, Matt
AU - Choudhari, Pradeep
AU - Zura, Robert D.
AU - Pesantez, Rodrigo
AU - Thomas, George
AU - Brink, Peter
AU - Swiontkowski, Marc
AU - Beingessner, Daphne
AU - Schep, Niels
AU - Kanakaris, Nikolaos
AU - Peters, R. W.
AU - Andrew, J.
AU - Trenholm, I.
AU - Mica, Ladislav
AU - Verhofstad, M. H. J.
AU - Taitsman, Lisa
AU - Hernandez, Daniel
AU - Harris, Ian
AU - Egol, Kenneth
AU - Jeray, Kyle
AU - Borris, Lars C.
AU - Barquet, Antonio
AU - Kellam, James
AU - Marsh, John L.
AU - Hobby, Jonathan L.
AU - Eygendaal, Denise
AU - Goslings, J. C.
AU - Kleinlugtenbelt, I. J. V.
PY - 2014
Y1 - 2014
N2 - Loss of contact between radial head fracture fragments is strongly associated with other elbow or forearm injuries. If this finding has adequate interobserver reliability, it could help examiners identify and treat associated ligament injuries and fractures (eg, forearm interosseous ligament injury or elbow dislocation). (1) What is the interobserver agreement on radiographic loss of contact between radial head fracture fragments? (2) Are there factors associated with the observer such as location of practice or subspecialization that increase interobserver reliability? Fully trained practicing orthopaedic and trauma surgeons from around the world evaluated 27 anteroposterior and lateral radiographs of radial head fractures on a web-based platform for the following characteristics: (1) loss of contact between at least one radial head fracture fragment and the remaining radial head and neck; (2) a gap between fragments of 2 mm or greater; (3) anticipated fracture instability (mobility) on operative exposure; (4) anticipated associated ligament injuries; and (5) recommendation for treatment. Agreement among observers was measured using the multirater kappa measure. Kappas for various observer characteristics were compared using 95% confidence intervals. The overall interobserver agreement was moderate (range, 0.49-0.55) for each question except associated ligament injury, which was fair (0.33). Shoulder and elbow surgeons had substantial agreement (range, 0.51-0.61) in many areas, but kappas were generally in the moderate range (0.41-0.59) based on number of years in practice, radial head fractures treated per year, and trainee supervision. Radiographic signs of radial head fracture instability such as loss of contact have moderate reliability. This characteristic seems clinically useful, because loss of contact between at least one radial head fracture fragment and the remaining radial head and neck is strongly associated with associated ligament injury or other fractures. Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence
AB - Loss of contact between radial head fracture fragments is strongly associated with other elbow or forearm injuries. If this finding has adequate interobserver reliability, it could help examiners identify and treat associated ligament injuries and fractures (eg, forearm interosseous ligament injury or elbow dislocation). (1) What is the interobserver agreement on radiographic loss of contact between radial head fracture fragments? (2) Are there factors associated with the observer such as location of practice or subspecialization that increase interobserver reliability? Fully trained practicing orthopaedic and trauma surgeons from around the world evaluated 27 anteroposterior and lateral radiographs of radial head fractures on a web-based platform for the following characteristics: (1) loss of contact between at least one radial head fracture fragment and the remaining radial head and neck; (2) a gap between fragments of 2 mm or greater; (3) anticipated fracture instability (mobility) on operative exposure; (4) anticipated associated ligament injuries; and (5) recommendation for treatment. Agreement among observers was measured using the multirater kappa measure. Kappas for various observer characteristics were compared using 95% confidence intervals. The overall interobserver agreement was moderate (range, 0.49-0.55) for each question except associated ligament injury, which was fair (0.33). Shoulder and elbow surgeons had substantial agreement (range, 0.51-0.61) in many areas, but kappas were generally in the moderate range (0.41-0.59) based on number of years in practice, radial head fractures treated per year, and trainee supervision. Radiographic signs of radial head fracture instability such as loss of contact have moderate reliability. This characteristic seems clinically useful, because loss of contact between at least one radial head fracture fragment and the remaining radial head and neck is strongly associated with associated ligament injury or other fractures. Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence
U2 - https://doi.org/10.1007/s11999-014-3592-z
DO - https://doi.org/10.1007/s11999-014-3592-z
M3 - Article
C2 - 24711128
SN - 0009-921X
VL - 472
SP - 2113
EP - 2119
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
IS - 7
ER -