Scapula fractures: interobserver reliability of classification and treatment.

Autor:	Neuhaus V; Orthopaedic Hand Service, Massachusetts General Hospital, Boston, MA., Bot AG, Guitton TG, Ring DC, 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 MB, Boyer M, Brilej D, Brink PR, Brunton LM, Buckley R, Cagnone JC, Calfee RP, Campinhos LA, Cassidy C, Catalano L 3rd, 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 JD, Fernandes CH, Fischer TJ, Fischmeister M, Forigua Jaime E, Getz CL, Gilbert RS, Giordano V, Glaser DL, Gosens T, Grafe MW, Filho JE, Gray RR, Gulotta LV, Gummerson NW, Hammerberg EM, Harvey E, Haverlag R, Henry PD, 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 FT, 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 CG, 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 MP, van der Heide H, van de Sande MA, van Eerten PV, Verbeek DO, Hoffmann DV, Vochteloo AJ, Wagenmakers R, Wall CJ, Wallensten R, Wascher DC, Weiss L, Wiater JM, Wills BP, Wint J, Wright T, Young JP, Zalavras C, Zura RD, Zyto K
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic trauma [J Orthop Trauma] 2014 Mar; Vol. 28 (3), pp. 124-9.
DOI:	10.1097/BOT.0b013e31829673e2
Abstrakt:	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.
Databáze:	MEDLINE
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