TY - JOUR
T1 - Tibial Plateau Fracture Characteristics: Reliability and Diagnostic Accuracy
AU - Mellema, Jos J.
AU - Doornberg, Job N.
AU - Molenaars, Rik J.
AU - Ring, David
AU - Kloen, Peter
AU - AUTHOR GROUP
AU - Babis, George C.
AU - Jeray, Kyle J.
AU - Prayson, Michael J.
AU - Pesantez, Rodrigo
AU - Acacio, Ramos
AU - Verbeek, Diederik O.
AU - Melvanki, Parag
AU - Kreis, Barbara E.
AU - Mehta, Samir
AU - Meylaerts, S.
AU - Wojtek, S.
AU - Yeap, Ewe J.
AU - Haapasalo, Heidi
AU - Kristan, Anže
AU - Coles, Chad
AU - Marsh, J. Lawrence
AU - Mormino, Matthew
AU - Memon, Matthew
AU - Tyllianakis, Minos
AU - Schandelmaier, Peter
AU - Jenkinson, R. J.
AU - Neuhaus, Valentin
AU - Shahriar, Chegini M. H.
AU - Belangero, William D.
AU - Leonidovich, Golovakha M.
AU - Davenport, J. H.
AU - Kabir, Koroush
AU - Althausen, Peter L.
AU - Weil, Yoram
AU - Toom, Alar
AU - Sa da Costa, Daniel
AU - Koukoulias, Nikolaos
AU - Manidakis, Nikolaos
AU - van den Bogaert, Max
AU - Patczai, Balázs
AU - Grauls, Anthony
AU - Kurup, Harish
AU - van den Bekerom, Michel P.
AU - Lansdaal, Joris R.
AU - Vale, Mário
AU - Ousema, Paul
AU - Barquet, Antonio
AU - Cross, Brian J.
AU - Haverkamp, Daniel
AU - Schepers, T.
PY - 2016
Y1 - 2016
N2 - The purpose of this study was to assess the interobserver reliability and diagnostic accuracy for 2-dimensional (2D) and 3-dimensional (3D) computed tomography (CT)-based evaluation of tibial plateau fracture characteristics. We hypothesized that recognition of specific tibial plateau fracture characteristics is equally reliable and accurate in 2DCT and 2D- and 3DCT. Eighty-one orthopedic trauma surgeons and residents were randomized to either 2DCT or 2D- and 3DCT evaluation of 15 complex tibial plateau fractures using web-based platforms to recognize 4 tibial plateau fracture characteristics: (1) a posteromedial component, (2) a lateral component, (3) a tibial tubercle component, and (4) a tibial spine (central) component. Interobserver reliability was evaluated by Siegel and Castellan's multirater kappa measure and kappa values were interpreted according to the categorical rating by Landis and Koch. Diagnostic accuracy was calculated according to standard formulas. Interobserver reliability of tibial plateau fracture characteristics ranged from "fair" to "substantial". The addition of 3DCT reconstructions did not improve agreement between observers or diagnostic accuracy, because kappa values and diagnostic accuracy were significantly better for evaluation of tibial plateau fractures using 2DCT alone. Diagnostic accuracy of fracture characteristics ranged from 70% to 89% and was better for more frequently encountered components (ie, the posteromedial and lateral component). The recognition of tibial plateau fracture characteristics prove accurate and reliable on CT-based evaluation in this study and may be useful besides current classification systems, which do not account for all fracture components, in daily practice to help clinical decision making. Further research is needed to evaluate whether the use of distinct fracture components helps preoperative planning of surgical approach and specific fixation techniques
AB - The purpose of this study was to assess the interobserver reliability and diagnostic accuracy for 2-dimensional (2D) and 3-dimensional (3D) computed tomography (CT)-based evaluation of tibial plateau fracture characteristics. We hypothesized that recognition of specific tibial plateau fracture characteristics is equally reliable and accurate in 2DCT and 2D- and 3DCT. Eighty-one orthopedic trauma surgeons and residents were randomized to either 2DCT or 2D- and 3DCT evaluation of 15 complex tibial plateau fractures using web-based platforms to recognize 4 tibial plateau fracture characteristics: (1) a posteromedial component, (2) a lateral component, (3) a tibial tubercle component, and (4) a tibial spine (central) component. Interobserver reliability was evaluated by Siegel and Castellan's multirater kappa measure and kappa values were interpreted according to the categorical rating by Landis and Koch. Diagnostic accuracy was calculated according to standard formulas. Interobserver reliability of tibial plateau fracture characteristics ranged from "fair" to "substantial". The addition of 3DCT reconstructions did not improve agreement between observers or diagnostic accuracy, because kappa values and diagnostic accuracy were significantly better for evaluation of tibial plateau fractures using 2DCT alone. Diagnostic accuracy of fracture characteristics ranged from 70% to 89% and was better for more frequently encountered components (ie, the posteromedial and lateral component). The recognition of tibial plateau fracture characteristics prove accurate and reliable on CT-based evaluation in this study and may be useful besides current classification systems, which do not account for all fracture components, in daily practice to help clinical decision making. Further research is needed to evaluate whether the use of distinct fracture components helps preoperative planning of surgical approach and specific fixation techniques
U2 - https://doi.org/10.1097/BOT.0000000000000511
DO - https://doi.org/10.1097/BOT.0000000000000511
M3 - Article
C2 - 27101164
SN - 0890-5339
VL - 30
SP - e144-e151
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 5
ER -