Proximal humeral fracture classification systems revisited

Majed, Addie; MacLeod, Iain; Bull, Anthony M.J.; Zyto, Karol; Resch, Herbert; Hertel, R.; Reilly, Peter; Emery, Roger

doi:10.1016/j.jse.2011.01.020

Cited by 118 publications

(91 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9 The validity of the classification has also been studied in various bone segments, but specific results of the classifications used for humeral shaft fractures are scarce. [10][11][12][13][14][15][16] Johnstone et al…”

Section: Discussionmentioning

confidence: 99%

Reliability and Reproducibility of the OTA/AO Classification for Humeral Shaft Fractures

Mahabier

Lieshout

Schaaf

et al. 2017

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

Objectives: This study aimed to determine inter-observer reliability and intra-observer reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. Patients of 16 years and older were included. Periprosthetic, recurrent, and pathological fractures were excluded. Radiographs were provided in random order, and observers were blinded to clinical information. To determine intra-observer agreement, radiographs were reviewed again after two months in a different random order. Agreement was assessed using kappa statistics.Results: Inter-observer agreement for the three fracture types was moderate (κ=0.60; 0.59-0.61). It was substantial for type A (κ=0.77; 0.70-0.84), and moderate for type B (κ= 0.52; 0.46-0.58) and type C fractures (κ=0.46; 0.42-0.50). Inter-observer agreement for the nine fracture groups was moderate (κ=0.48; 95% CI 0.48-0.48). Orthopedic trauma surgeons had better overall agreement for fracture types, and general orthopedic surgeons had better overall agreement for fractures groups. Observers classified 64% of fractures identically in both rounds. Intra-observer agreement was substantial for the three types (κ=0.80; 0.77-0.81) and nine groups (κ=0.80; 0.77-0.82). Intra-observer agreement showed no differences between surgical disciplines. Conclusions:The OTA/AO classification for humeral shaft fractures has a moderate interobserver and substantial intra-observer agreement for fracture types and groups.10

show abstract

Section: Discussionmentioning

confidence: 99%

Reliability and Reproducibility of the OTA/AO Classification for Humeral Shaft Fractures

Mahabier

Lieshout

Schaaf

et al. 2017

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

show abstract

“…Aufgrund der hohen Re-liabilität setzte sich für den klinischen Alltag die ursprüngliche Codman-Klassifikation durch. Häufig ist das Frakturmuster allerdings von höherer Komplexität, und die klassischen 4 Teile des Humerus liegen nicht in der von Codman [17] beschriebenen vereinfachten Form vor [47].…”

Section: Klassifikationen Der Proximalen Humerusfrakturunclassified

Frakturen des Humeruskopfs

Imrecke

Katthagen

Voigt

et al. 2014

Trauma Berufskrankh

View full text Add to dashboard Cite

“…Past studies [2,[6][7][8] using proximal humeral fracture radiographs have shown poor-to-moderate inter and intraobserver agreement in classifying these fractures. Most of these studies have used a relatively small number of observers.…”

mentioning

confidence: 99%

“…Also in question is the intra and interobserver reliability [2,7,8] in determining the amount of fracture displacement and therefore our ability to classify these fractures. The implication is that if the ability to determine the degree of fracture displacement is questionable, then recommendations for surgical intervention based on radiographic findings may be unreliable.…”

mentioning

confidence: 99%