Carrerra Eduardo da Frota, Wajnsztejn Andre, Lenza Mario, Netto Nicola Archetti
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2012 Oct-Dec;10(4):473-9. doi: 10.1590/s1679-45082012000400014.
To propose a new system for classifying proximal humeral neck fractures, and to evaluate intra- and interobserver agreement using the Neer system that is the most commonly used in the area and the Arbeit Gemeinschaft für Osteosynthesefragen system created by an European group, and a new classification system proposed by the authors of this study.
A total of 56 patients with proximal humeral fractures were selected, and submitted to digitized simple radiography in antero-posterior shoulder and scapular profile. Radiographs were analyzed by three observers at time one, and then three and six weeks later. The kappa coefficient modified by Fleiss was used for the analysis.
The mean intra-observer Kappa agreement index (k = 0.687) of the new classification, was higher than both the Neer classification (k = 0.362) and the Arbeit Gemeinschaft für Osteosynthesefragen (k = 0.46). The mean interobserver Kappa agreement index (0.446) of the new classification, also had better results than both the Neer classification (k = 0.063) and the Arbeit Gemeinschaft für Osteosynthesefragen (k = 0.028).
the new classification considering bone compression had higher results for intra- and interobserver compared to the Neer system, and the Arbeit Gemeinschaft für Osteosynthesefragen system.
提出一种用于肱骨近端骨折分类的新系统，并使用该领域最常用的Neer系统、欧洲一个小组创建的AO（Arbeit Gemeinschaft für Osteosynthesefragen）系统以及本研究作者提出的新分类系统，评估观察者内和观察者间的一致性。
共选取56例肱骨近端骨折患者，对其进行肩部前后位和肩胛骨侧位数字化X线平片检查。三位观察者在第一次、然后在三周和六周后对X线片进行分析。采用Fleiss修正的kappa系数进行分析。
新分类系统的观察者内kappa一致性指数均值（k = 0.687）高于Neer分类系统（k = 0.362）和AO系统（k = 0.46）。新分类系统的观察者间kappa一致性指数均值（0.446）也比Neer分类系统（k = 0.063）和AO系统（k = 0.028）的结果更好。
与Neer系统和AO系统相比，考虑骨压缩情况的新分类系统在观察者内和观察者间的一致性方面具有更高的结果。
