Alexandropoulos Christos, Tsourvakas Stefanos, Papachristos John, Tselios Athanasios, Soukouli Paraskevi
Orthopaedic Department, Trikala General Hospital,Trikala, Greece.
Acta Orthop Belg. 2010 Aug;76(4):521-5.
The interobserver variability and the ability of the Lauge-Hansen, A.O. and Broos-Bisschop classification systems to encompass all the ankle fracture patterns were investigated in a study of the radiographs of 293 patients with a total of 294 malleolar fractures. Three different orthopaedic surgeons independently evaluated the sets of ankle radiographs. The examiners classified the ankle fractures using the Lauge-Hansen, A.O. and Broos-Bisschop systems. The overall percentage of unclassified fracture patterns was 0.7% with the Broos-Bisschop system, 10% with the Lauge-Hansen system and 8.7% with the A.O. system. The concordance rate using Kappa coefficient ranged from 0.327 to 0.408 for the Broos-Bisschop system, from 0.174 to 0.476 for the Lauge-Hansen system and from 0.397 to 0.483 for the A.O. system. These results show that these three classification systems have in common a considerable interobserver variability deficiency which restricts their validity in selection of treatment options, prognosis and comparison between different materials.
在一项对293例患者共294处踝关节骨折的X线片研究中，调查了观察者间的变异性以及Lauge-Hansen、AO和Broos-Bisschop分类系统涵盖所有踝关节骨折类型的能力。三位不同的骨科医生独立评估了踝关节X线片。检查者使用Lauge-Hansen、AO和Broos-Bisschop系统对踝关节骨折进行分类。Broos-Bisschop系统未分类骨折类型的总体百分比为0.7%，Lauge-Hansen系统为10%，AO系统为8.7%。使用Kappa系数的一致性率，Broos-Bisschop系统为0.327至0.408，Lauge-Hansen系统为0.174至0.476，AO系统为0.397至0.483。这些结果表明，这三种分类系统都存在相当大的观察者间变异性不足，这限制了它们在治疗方案选择、预后以及不同材料比较方面的有效性。
