Department of Orthopedics and Traumatology, Universidade Federal de São Paulo -- Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
BMC Musculoskelet Disord. 2009 Oct 1;10:120. doi: 10.1186/1471-2474-10-120.
Fractures of the proximal radius need to be classified in an appropriate and reproducible manner. The aim of this study was to assess the reliability of the three most widely used classification systems.
Elbow radiographs images of patients with proximal radius fractures were classified according to Mason, Morrey, and Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF) classifications by four observers with different experience with this subject to assess their intra- and inter-observer agreement. Each observer analyzed the images on three different occasions on a computer with numerical sequence randomly altered.
We found that intra-observer agreement of Mason and Morrey classifications were satisfactory (kappa = 0.582 and 0.554, respectively), while the AO/ASIF classification had poor intra-observer agreement (kappa = 0.483). Inter-observer agreement was higher in the Mason (kappa = 0.429-0.560) and Morrey (kappa = 0.319-0.487) classifications than in the AO/ASIF classification (kappa = 0.250-0.478), which showed poor reliability.
Inter- and intra-observer agreement of the Mason and Morey classifications showed overall satisfactory reliability when compared to the AO/ASIF system. The Mason classification is the most reliable system.
桡骨近端骨折需要以适当且可重复的方式进行分类。本研究旨在评估三种最广泛使用的分类系统的可靠性。
由四位具有不同专业背景的观察者按照 Mason、Morrey 和 Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation（AO/ASIF）分类系统对桡骨近端骨折的肘部 X 光片进行分类，以评估他们的组内和组间一致性。每位观察者在计算机上三次不同的场合对图像进行分析，随机改变数字序列。
我们发现 Mason 和 Morrey 分类的组内一致性令人满意（kappa 值分别为 0.582 和 0.554），而 AO/ASIF 分类的组内一致性较差（kappa 值为 0.483）。在 Mason（kappa 值为 0.429-0.560）和 Morrey（kappa 值为 0.319-0.487）分类中，观察者间的一致性高于 AO/ASIF 分类（kappa 值为 0.250-0.478），后者显示出较差的可靠性。
与 AO/ASIF 系统相比，Mason 和 Morey 分类的组内和组间一致性显示出总体上令人满意的可靠性。Mason 分类是最可靠的系统。
