Gartland classification concordance of supracondylar fractures among pediatric emergency medicine physicians, radiologists, and orthopedic surgeons.

Autor: Schultz RJ; Department of Orthopedics Surgery, Texas Children's Hospital (Texas Medical Center), Mark Wallace Tower, 6Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA. fz5534@wayne.edu.; Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA. fz5534@wayne.edu., Amaral JZ; Department of Orthopedics Surgery, Texas Children's Hospital (Texas Medical Center), Mark Wallace Tower, 6Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA., Bridges CS; Department of Orthopedics Surgery, Texas Children's Hospital (Texas Medical Center), Mark Wallace Tower, 6Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA., Allen JY; Division of Emergency Medicine, Texas Children's Hospital, Houston, TX, USA.; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA., Bih ES; Department of Radiology, Texas Children's Hospital (Texas Medical Center), West Tower, 4Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Radiology, Baylor College of Medicine, Houston, TX, USA., Cruz AT; Divisions of Emergency Medicine and Infectious Diseases, Baylor College of Medicine, Houston, TX, USA., Gladstein AZ; Department of Orthopedics Surgery, Texas Children's Hospital (Texas Medical Center), Mark Wallace Tower, 6Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA., Henkel EB; Division of Emergency Medicine, Texas Children's Hospital, Houston, TX, USA.; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA., Kraus SJ; Department of Radiology, Texas Children's Hospital (Texas Medical Center), West Tower, 4Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Radiology, Baylor College of Medicine, Houston, TX, USA., Smith BG; Department of Orthopedics Surgery, Texas Children's Hospital (Texas Medical Center), Mark Wallace Tower, 6Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA., Wall JC Jr; Department of Orthopedics Surgery, Texas Children's Hospital (Texas Medical Center), Mark Wallace Tower, 6Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA.; Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA., Kan JH; Department of Radiology, Texas Children's Hospital (Texas Medical Center), West Tower, 4Th Floor, 6621 Fannin Street, Houston, TX, 77030, USA. jhkan@texaschildrens.org.; Department of Radiology, Baylor College of Medicine, Houston, TX, USA. jhkan@texaschildrens.org.
Jazyk: angličtina
Zdroj: Pediatric radiology [Pediatr Radiol] 2024 Jun; Vol. 54 (7), pp. 1180-1186. Date of Electronic Publication: 2024 May 02.
DOI: 10.1007/s00247-024-05935-3
Abstrakt: Background: The modified Gartland classification is the most widely accepted grading method of supracondylar humeral fractures among orthopedic surgeons and is relevant to identifying fractures that may require surgery.
Objective: To assess the interobserver reliability of the modified Gartland classification among pediatric radiologists, pediatric orthopedic surgeons, and pediatric emergency medicine physicians.
Materials and Methods: Elbow radiographs for 100 children with supracondylar humeral fractures were retrospectively independently graded by two pediatric radiologists, two pediatric orthopedic surgeons, and two pediatric emergency medicine physicians using the modified Gartland classification. A third grader of the same subspecialty served as a tie-breaker as needed to reach consensus. Readers were blinded to one another and to the medical record. The modified Gartland grade documented in the medical record by the treating orthopedic provider was used as the reference standard. Interobserver agreement was assessed using kappa statistics.
Results: There was substantial interobserver agreement (kappa = 0.77 [95% CI, 0.69-0.85]) on consensus fracture grade between the three subspecialties. Similarly, when discriminating between Gartland type I and higher fracture grades, there was substantial interobserver agreement between specialties (kappa = 0.77 [95% CI, 0.66-0.89]). The grade assigned by pediatric radiologists differed from the reference standard on 15 occasions, pediatric emergency medicine differed on 19 occasions, and pediatric orthopedics differed on 9 occasions.
Conclusion: The modified Gartland classification for supracondylar humeral fractures is reproducible among pediatric emergency medicine physicians, radiologists, and orthopedic surgeons.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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