Heal J, Bould M, Livingstone J, Blewitt N, Blom A W
Avon Orthopaedic Centre, Southmead Hospital, Bristol, United Kingdom.
J Orthop Surg (Hong Kong). 2007 Apr;15(1):12-4. doi: 10.1177/230949900701500104.
To evaluate the intra- and inter-observer reproducibility of the Gartland radiographic classification for supracondylar humeral fractures in children.
Anteroposterior and lateral radiographs of 50 supracondylar humeral fractures in children were graded on 2 separate occasions by 4 orthopaedic surgeons according to the Wilkins modification of the Gartland classification. Data were analysed by calculating the Kappa values for intra- and inter-observer agreement to indicate the reproducibility of the classification.
There was moderate inter-observer agreement, except for poor agreement over type I fractures. Type II fractures only showed fair to moderate agreement. Type III fractures and the flexion group showed good to very good agreement. Intra-observer agreement was good to very good.
Surgeons should treat paediatric supracondylar humeral fractures based on an assessment of the degree of displacement rather than by employing the Gartland classification.
评估儿童肱骨髁上骨折的Gartland放射学分类在观察者内和观察者间的可重复性。
4位骨科医生根据Wilkins对Gartland分类法的修订，在两个不同时间对50例儿童肱骨髁上骨折的前后位和侧位X线片进行分级。通过计算观察者内和观察者间一致性的Kappa值来分析数据，以表明分类的可重复性。
观察者间一致性为中等，I型骨折的一致性较差。II型骨折仅显示出一般到中等的一致性。III型骨折和屈曲型骨折组显示出良好到非常好的一致性。观察者内一致性为良好到非常好。
外科医生应根据移位程度评估来治疗儿童肱骨髁上骨折，而不是采用Gartland分类法。
