Tibia Plateau Fractures Inter Observer Reliability Analysis Between Orthopedics and Traumatology Residents and Specialist Physicians According to Schatzker and AO / OTA classification systems

Year 2019, Volume: 52 Issue: 2, 145 - 148, 31.07.2019

Mehmet Yücens , Ahmet Nadir Aydemir

Abstract

ABSTRACT

Purpose:
The aim of this study was to investigate the reliability  of the Schatzker and AO / OTA classifications between
Orthopedics and Traumatology specialists and residents.

Material
methods: Twelve observers, six of them Orthopedics and Traumatology residents,
six of them Orthopedics and Traumatology specialist were participated to the
study. 60 tibial plateau fractures radiographs were sent via e-mail to the
observers. They were asked to classify anteroposterior and lateral radiographs
according to Schatzker and AO / OTA classification systems.

Results:
In this study according to Schatzker and AO / OTA classifications reliability,
only the Schatzker classification was observed to be moderate among the Orthopedics
and Traumatology specialist. The AO / OTA classification was found to be fair
reliability among the specialist physicians, residents and all physicians.

Conclusion:
Schatzker classification system compared with the AO / OTA classification
system, it is observed that the interobserver consistency is higher.

Keywords

Tibial plateau fractures, AO / OTA classification system, Schatzker classification system

Tibia Plato Kırıklarında Schatzker ve AO / OTA sınıflandırma sistemlerine göre Ortopedi ve Travmatoloji Asistan ve Uzman Hekimler Arasındaki Güvenirlik Analizi

Abstract

ÖZET

Amaç:
Bu çalışmadaki amacımız Schatzker ve AO / OTA sınıflamalarının Ortopedi ve
Travmatoloji uzmanları ve asistanları arasındaki güvenilirliği incelemektir.

Gereç
yöntem: Çalışmaya altısı Ortopedi ve Travmatoloji asistanı, altısı ise Ortopedi
ve Travmatoloji uzmanı olmak üzere oniki gözlemci katıldı. Gözlemcilerden elektronik
posta yoluyla gönderilen 60 tibia plato kırığı olan hastanın anteroposterior ve
lateral radyografilerinin bulunduğu standart formları Schatzker ve AO / OTA
sınıflandırma sistemlerine göre sınıflamaları istendi.

Bulgular:
Bu çalışmada Schatzker ve AO / OTA sınıflandırmalarına göre yapılan gözlemciler
arası uyumda sadece Schatzker sınıflaması uzman hekimler tarafından
değerlendirildiğinde gözlemciler arası uyumun orta düzeyde olduğu olduğu
görülmüştür. AO / OTA sınıflamasının uzman hekimler arası, asistan hekimler
arası ve tüm hekimler arasında uyumunun düşük düzeyde kaldığı görülmüştür.

Sonuç: Schatzker sınıflandırma sistemi AO / OTA
sınıflandırma sistemi ile karşılaştırıldığında gözlemciler arası uyumunun daha
yüksek olduğu görülmektedir.

Keywords

Tibia plato kırıkları, AO / OTA sınıflaması, Schatzker sınıflaması

References

• Salduz A, Birisik F, Polat G, Bekler B, Bozdag E, Kilicoglu O. The effect of screw thread length on initial stability of Schatzker type 1 tibial plateau fracture fixation: a biomechanical study. J Orthop Surg Res [Internet]. 2016 Nov 22 [cited 2018 Nov 21];11(1):146. Available from: http://josr-online.biomedcentral.com/articles/10.1186/s13018-016-0484-9
• Mthethwa J, Chikate A. A review of the management of tibial plateau fractures. Musculoskelet Surg. 2018;102(2):119–27.
• Taskeşen A, Demirkale I, Okkaoğlu MC, Özdemir M, Bilgili MG, Altay M, et al. The pivotal role of the coronal fracture line for a new three-dimensional CT-based fracture classification of bicondylar proximal tibial fractures. Int Orthop [Internet]. 2017;41(6):944–9. Available from: http://dx.doi.org/10.1016/j.injury.2017.06.019
• Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, Mavrogenis AF, Korres DS, Soucacos PN. Complications after tibia plateau fracture surgery. Injury [Internet]. 2006 Jun [cited 2018 Nov 21];37(6):475–84. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16118010
• Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968-1975. Clin Orthop Relat Res. 1979.
• Müller ME, Nazarian S KP. Müller AO Classification of Fractures—Long Bones. AO Found. 1987;
• Limb D. Fractures in adults (Rockwood and Green’s). Curr Orthop. 1998;
• Luo C-F, Sun H, Zhang B, Zeng B-F. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma [Internet]. 2010 Nov [cited 2018 Nov 27];24(11):683–92. Available from: https://insights.ovid.com/crossref?an=00005131-201011000-00005
• Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics [Internet]. 1977 Mar [cited 2018 Dec 3];33(1):159–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/843571
• Gwet KL. Computing inter-rater reliability and its variance in the presence of high agreement. Br J Math Stat Psychol. 2008;61(1):29–48.
• Charalambous CP, Tryfonidis M, Alvi F, Moran M, Fang C, Samarji R, et al. Inter- and intra-observer variation of the Schatzker and AO/OTA classifications of tibial plateau fractures and a proposal of a new classification system. Ann R Coll Surg Engl [Internet]. 2007 May [cited 2018 Nov 21];89(4):400–4. Available from: http://publishing.rcseng.ac.uk/doi/10.1308/003588407X187667
• Harish S, Roberts C, Blundell C, Walton NP. AO or Schatzker? How reliable is classification of tibial plateau fractures? Arch Orthop Trauma Surg [Internet]. 2003 Oct 1 [cited 2018 Nov 27];123(8):396–8. Available from: http://link.springer.com/10.1007/s00402-003-0573-1
• Mellema JJ, Doornberg JN, Molenaars RJ, Ring D, Kloen P, Babis GC, et al. Interobserver reliability of the Schatzker and Luo classification systems for tibial plateau fractures. Injury. 2016;47(4):944–9.
• Zhu Y, Hu C-F, Yang G, Cheng D, Luo C-F. Inter-observer reliability assessment of the Schatzker, AO/OTA and three-column classification of tibial plateau fractures. J Trauma Manag Outcomes [Internet]. 2013 Dec 11 [cited 2018 Nov 21];7(1):7. Available from: http://traumamanagement.biomedcentral.com/articles/10.1186/1752-2897-7-7
• Gicquel T, Najihi N, Vendeuvre T, Teyssedou S, Gayet L-E, Huten D. Tibial plateau fractures: Reproducibility of three classifications (Schatzker, AO, Duparc) and a revised Duparc classification. Orthop Traumatol Surg Res [Internet]. 2013 [cited 2018 Nov 27];99:805–16
• Taskeşen A, Demirkale I, Okkaoğlu MC, Özdemir M, Bilgili MG, Altay M. Intraobserver and interobserver reliability assessment of tibial plateau fracture classification systems. Eklem Hast ve Cerrahisi. 2017;28(3):177–81.
• Millán-Billi A, Gómez-Masdeu M, Ramírez-Bermejo E, Ibañez M, Gelber PE. What is the most reproducible classification system to assess tibial plateau fractures? Int Orthop. 2017;41(6):1251–6.
• Martínez-Rondanelli A, Escobar-González SS, Henao-Alzate A, Martínez-Cano JP. Reliability of a four-column classification for tibial plateau fractures. Int Orthop. 2017;41(9):1881–6.