Scapula fractures: interobserver reliability of classification and treatment.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Neuhaus, V; Bot, AGJ; Guitton, TG; Ring, DC; Science of Variation Group, ; Abdel-Ghany, MI; Abrams, J; Abzug, JM; Adolfsson, LE; Balfour, GW; Bamberger, HB; Barquet, A; Baskies, M; Batson, WA; Baxamusa, T; Bayne, GJ; Begue, T; Behrman, M; Beingessner, D; Biert, J; Bishop, J; Alves, MBO; Boyer, M; Brilej, D; Brink, PRG; Brunton, LM; Buckley, R; Cagnone, JC; Calfee, RP; Campinhos, LAB; Cassidy, C; Catalano, L; Chivers, K; Choudhari, P; Cimerman, M; Conflitti, JM; Costanzo, RM; Crist, BD; Cross, BJ; Dantuluri, P; Darowish, M; de Bedout, R; DeCoster, T; Dennison, DG; DeNoble, PH; DeSilva, G; Dienstknecht, T; Duncan, SF; Duralde, XA; Durchholz, H; Egol, K; Ekholm, C; Elias, N; Erickson, JM; Esparza, JDE; Fernandes, CH; Fischer, TJ; Fischmeister, M; Forigua Jaime, E; Getz, CL; Gilbert, RS; Giordano, V; Glaser, DL; Gosens, T; Grafe, MW; Filho, JEGR; Gray, RRL; Gulotta, LV; Gummerson, NW; Hammerberg, EM; Harvey, E; Haverlag, R; Henry, PDG; Hobby, JL; Hofmeister, EP; Hughes, T; Itamura, J; Jebson, P; Jenkinson, R; Jeray, K; Jones, CM; Jones, J; Jubel, A; Kaar, SG; Kabir, K; Kaplan, FTD; Kennedy, SA; Kessler, MW; Kimball, HL; Kloen, P; Klostermann, C; Kohut, G; Kraan, GA; Kristan, A; Loebenberg, MI; Malone, KJ; Marsh, L; Martineau, PA; McAuliffe, J; McGraw, I; Mehta, S; Merchant, M; Metzger, C; Meylaerts, SA; Miller, AN; Wolf, JM; Murachovsky, J; Murthi, A; Nancollas, M; Nolan, BM; Omara, T; Omid, R; Ortiz, JA; Overbeck, JP; Castillo, AP; Pesantez, R; Polatsch, D; Porcellini, G; Prayson, M; Quell, M; Ragsdell, MM; Reid, JG; Reuver, JM; Richard, MJ; Richardson, M; Rizzo, M; Rowinski, S; Rubio, J; Guerrero, CGS; Satora, W; Schandelmaier, P; Scheer, JH; Schmidt, A; Schubkegel, TA; Schulte, LM; Schumer, ED; Sears, BW; Shafritz, AB; Shortt, NL; Siff, T; Silva, DM; Smith, RM; Spruijt, S; Stein, JA; Pemovska, ES; Streubel, PN; Swigart, C; Swiontkowski, M; Thomas, G; Tolo, ET; Turina, M; Tyllianakis, M; van den Bekerom, MPJ; van der Heide, H; van de Sande, MAJ; van Eerten, PV; Verbeek, DOF; Hoffmann, DV; Vochteloo, AJH; Wagenmakers, R; Wall, CJ; Wallensten, R; Wascher, DC; Weiss, L; Wiater, JM; Wills, BPD; Wint, J; Wright, T; Young, JP; Zalavras, C; Zura, RD; Zyto, K

Published Date

  • March 2014

Published In

Volume / Issue

  • 28 / 3

Start / End Page

  • 124 - 129

PubMed ID

  • 23629469

Pubmed Central ID

  • 23629469

Electronic International Standard Serial Number (EISSN)

  • 1531-2291

Digital Object Identifier (DOI)

  • 10.1097/BOT.0b013e31829673e2

Language

  • eng

Conference Location

  • United States