Reliability and reproducibility of radiographic interpretation of proximal humeral fracture pathoanatomy.


Journal Article

Recent studies have demonstrated inconsistencies in the use of certain images for classifying proximal humerus fractures. Our purpose was to determine whether three-dimensional computed tomography or the level of expertise of the observers would improve the reliability and reproducibility of identifying specific anatomic fragments in proximal humerus fractures. Two groups of observers, nonexperts and experts in shoulder surgery, were asked to review the radiographs and three-dimensional computed tomography scans of 12 patients with proximal humerus fractures. Observers were asked to identify displaced fracture fragments, dislocation, and articular surface fractures. Both groups of observers displayed suboptimal reliability for the identification of displaced fracture fragments. The addition of three-dimensional computed tomography scans did not improve the reliability or reproducibility. Poor agreement for the purpose of classification seems to occur at the most fundamental level, the pathoanatomic description of the fracture. Inconsistencies may have been due to imprecise identification and measurement of individual fracture fragments, differing interpretations of the pathoanatomy, or both.

Full Text

Duke Authors

Cited Authors

  • Sallay, PI; Pedowitz, RA; Mallon, WJ; Vandemark, RM; Dalton, JD; Speer, KP

Published Date

  • January 1997

Published In

Volume / Issue

  • 6 / 1

Start / End Page

  • 60 - 69

PubMed ID

  • 9071684

Pubmed Central ID

  • 9071684

International Standard Serial Number (ISSN)

  • 1058-2746

Digital Object Identifier (DOI)

  • 10.1016/s1058-2746(97)90072-0


  • eng

Conference Location

  • United States