Reproducibility of the AO/ASIF and Gartland classifications for supracondylar fractures of the humerus in children

Abstract

ObjectiveTo evaluate the reproducibility of the radiographic classifications of Gartland and the Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) for supracondylar fractures of the humerus in children.MethodsOn two occasions, 50 radiographs in anteroposterior and lateral views were evaluated by three pediatric orthopedists in accordance with the Gartland and AO/ASIF pediatric classifications. Their responses were subjected to statistical analysis consisting of calculation of the κ coefficient to assess the intra- and interobserver concordance, in both classifications.ResultsThe strength of the intraobserver concordance was high or near perfect for the three examiners in the two classification systems. The strength of the interobserver concordance was high in the two systems, with κ coefficients of 0.756 for the Gartland classification and 0.766 for the AO/ASIF classification.ConclusionThe Gartland and AO/ASIF classification systems showed similar reproducibility and performance. High strength of concordance was seen in the intra- and interobserver analyses.

Assessing the reliability of the modified Gartland classification system for extension-type supracondylar humerus fractures

“…A more recent study from Brazil between three paediatric orthopaedic surgeons found substantial interobserver agreement overall, excellent interobserver agreement for type I fractures, moderate interobserver agreement for type II fractures, substantial interobserver agreement for type III fractures and excellent intraobserver agreement overall. 8 Finally, a study by Leung et al 9 between five USA-based surgeons found moderate interobserver agreement overall and substantial intraobserver agreement overall. They questioned the utility of the Wilkins-modified classification system in guiding clinical decision-making, particularly for type II fractures where the reliability of classification between surgeons is low.…”

Comparison of Functional Outcomes of above Elbow Backslab Versus Close Reduction and Percutaneous Pinning in Supracondylar Humerus Fracture in Kids

“…In children Supracondylar fracture of the humerus is the most common fracture around the elbow [9]. Type I (Gartland) fractures can be adequately managed by immobilization in an above elbow cast [10]. However, controversy exists regarding the optimal treatment for displaced supracondylar fracture (Gartland type II & type III).…”

Fixed Time and Fixed Angle External Fixation in the Treatment of Gartland Type III Supracondylar Humerous Fractures in Children

“…The Gartland classification system categorizes SHF into 3 categories based on severity of displacement. Specifically, type I SHF is not displaced; type II is angulated with the posterior cortex intact; type III is completely displaced with no cortical contact [6,7]. Bone displacement in Gartland type III SHF is difficult to correct by manipulative reduction as the realigned fractured ends have minimal contact and poor stability, making splint and plaster external fixation extremely difficult.…”