利希特曼（Lichtman）分类法对99例月骨无菌性坏死（Kienböck病）的可靠性研究
Reliability of Lichtman's classification for Kienböck's disease in 99 subjects.
作者信息
Shin Masaki, Tatebe Masahiro, Hirata Hitoshi, Koh Shukuki, Shinohara Takaaki
机构信息
Department of Hand Surgery, Nagoya University School of Medicine, Nagoya 466-8550, Japan.
出版信息
Hand Surg. 2011;16(1):15-8. doi: 10.1142/S0218810411005035.
PURPOSE
The objective of this research was to investigate the reliability of Lichtman's classification for Kienböck's disease.
METHODS
Interobserver reliability and intraobserver reproducibility were investigated by interpreting both anteroposterior and lateral X-rays of the wrist joint twice in 99 patients with Kienböck's disease using the modified Lichtman's classification system. Observers comprised three orthopaedic surgeons, and no information was exchanged between observers either before or during the study.
RESULTS
Intraobserver reliability was moderate (0.313-0.628), and interobserver reliability was fair (Siegel's kappa = 0.228).
CONCLUSION
Low values were obtained regarding interobserver reliability for the modified Lichtman's classification of Kienböck's disease. This classification is thus inadequate for use in clinical settings. A new classification should be established.
目的
本研究的目的是调查利希特曼（Lichtman）分类法对月骨无菌性坏死（Kienböck病）的可靠性。
方法
采用改良的利希特曼分类系统，对99例月骨无菌性坏死患者的腕关节前后位和侧位X线片进行两次解读，以此来研究观察者间的可靠性和观察者自身的可重复性。观察者包括三名骨科医生，在研究前和研究过程中观察者之间均未交流信息。
结果
观察者自身的可靠性为中等（0.313 - 0.628），观察者间的可靠性为尚可（西格尔kappa系数 = 0.228）。
结论
改良的利希特曼分类法用于月骨无菌性坏死时，观察者间可靠性的值较低。因此，这种分类法不适用于临床。应建立一种新的分类法。
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