Observer variation in the radiographic classification of ankle fractures

Abstract

We recorded inter-and infra-observer variations in the classification of ankle fractures by the Lauge

Classification of thoracic and lumbar spine fractures: problems of reproducibility

“…In a multi-layer classification scheme it is expected that the agreement rates decrease in subsequent levels, as observed for the AO classification of peripheral fractures [1,2,3,5,10,11,13,14,20,21,27,29,31]. This does not seem to be the case in the classification scheme we studied.…”

Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures

“…Despite Yde's work, multiple studies have since challenged the validity of the Lauge-Hansen classification system [5,6,17,19,22,25]. Interobserver and intraobserver reliabilities are fair at best for the Lauge-Hansen classification.…”

“…The poor interobserver reliability of the Lauge-Hansen, Danis-Weber, and AO/OTA classifications indicates that orthopaedic surgeons interpret these classifications differently, suggesting these systems are an ineffective means for physician-to-physician communication [3,16,19,22,25]. One of the keys to the Lauge-Hansen classification is the geometry of the medial malleolus fracture.…”

“…Lauge-Hansen's classification, which was published in a 1950 issue of Archives of Surgery, has become one of the most widely used ankle fracture classification systems [12]. Although still considered a landmark work regarding the biomechanics and deforming forces of ankle fractures, the quality, validity, and reproducibility of the Lauge-Hansen classification have been challenged [17,19,22,25].…”

AO-classification of thoracic and lumbar fractures—reproducibility utilizing radiographs and clinical information

“…Appendicular skeleton classification systems have been shown to have a poor to moderate intra-observer reproducibility and interobserver reliability [1,2,7,9,11,15,16,18,19]. There are relatively few studies assessing the reproducibility of thoracolumbar fracture classification systems [3,17].…”