Doornberg Job, Elsner Andreas, Kloen Peter, Marti René K, van Dijk C Niek, Ring David
Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA 02116, USA.
J Shoulder Elbow Surg. 2007 Sep-Oct;16(5):603-8. doi: 10.1016/j.jse.2006.10.015. Epub 2007 Apr 19.
The purpose of this study was to measure the prevalence and reliability of the radiographic diagnosis of displacement of apparently isolated partial articular radial head fractures and use these factors to assess treatment considerations. Among 119 radiographically visible partial fractures of the radial head not associated with other wrist, forearm, or elbow injury, 101 were classified as Mason type 1 (85%), 11 as borderline between Mason type 1 and Mason type 2 fractures (9%), and 7 as Mason type 2 fractures (6%) according to Broberg and Morrey's modification of the Mason classification. The intraobserver reliability of the classification of Mason type 1 and type 2 fractures was excellent (mean kappa, 0.85), but the interobserver reliability was only moderate (multirater kappa, 0.45). Because apparently isolated, stable partial fractures of the radial head are infrequently displaced and observers have moderate disagreement regarding the diagnosis of displacement, it is likely that displacement is overdiagnosed.
本研究的目的是测量明显孤立的部分关节面桡骨头骨折移位的影像学诊断的患病率和可靠性，并利用这些因素评估治疗考量。在119例影像学可见的桡骨头部分骨折中，这些骨折未伴有其他腕部、前臂或肘部损伤，根据布罗伯格和莫里对梅森分类法的改良，101例被归类为梅森1型（85%），11例为梅森1型和梅森2型骨折之间的临界类型（9%），7例为梅森2型骨折（6%）。梅森1型和2型骨折分类的观察者内可靠性极佳（平均卡帕值，0.85），但观察者间可靠性仅为中等（多评估者卡帕值，0.45）。由于明显孤立、稳定的桡骨头部分骨折很少发生移位，且观察者在移位诊断方面存在中度分歧，因此移位很可能被过度诊断。
