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Classification and treatment of proximal humerus fractures: inter-observer reliability and agreement across imaging modalities and experience.肱骨近端骨折的分类和治疗：不同影像学方法和经验的观察者间可靠性和一致性。
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J Shoulder Elbow Surg. 2011 Oct;20(7):1125-32. doi: 10.1016/j.jse.2011.01.020. Epub 2011 Apr 9.
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The reliability and reproducibility of the Neer classification system--digital radiography (PACS) improves agreement.Neer 分类系统的可靠性和可重复性——数字射线照相术（PACS）提高了一致性。
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Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee.《骨折与脱位分类概要 - 2007》：骨科创伤协会分类、数据库与结果委员会
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The epidemiology of proximal humeral fractures.肱骨近端骨折的流行病学
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计算机断层扫描及其三维重建能否提高肱骨近端骨折分类的可重复性？

Do computed tomography and its 3D reconstruction increase the reproducibility of classifications of fractures of the proximal extremity of the humerus?

作者信息

Matsushigue Thaís, Pagliaro Franco Valmir, Pierami Rafael, Jun Sugawara Tamaoki Marcel, Archetti Netto Nicola, Hide Matsumoto Marcelo

机构信息

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Bras Ortop. 2014 Mar 27;49(2):174-7. doi: 10.1016/j.rboe.2014.03.016. eCollection 2014 Mar-Apr.

DOI:10.1016/j.rboe.2014.03.016
PMID:26229795
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4511748/
Abstract

OBJECTIVE

to determine whether 3D reconstruction images from computed tomography (CT) increase the inter and intraobserver agreement of the Neer and Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification systems.

METHODS

radiographic images and tomographic images with 3D reconstruction were obtained in three shoulder positions and were analyzed on two occasions by four independent observers.

RESULTS

the radiographic evaluation demonstrated that using CT improved the inter and intraobserver agreement of the Neer classification. This was not seen with the AO classification, in which CT was only shown to increase the interobserver agreement.

CONCLUSION

use of 3D CT allows better evaluation of fractures with regard to their component parts and their displacements, but nevertheless the intraobserver agreement presented is less than ideal.

摘要

目的

确定计算机断层扫描（CT）的三维重建图像是否能提高Neer和骨科学内固定研究学会（AO）分类系统在观察者间及观察者自身的一致性。

方法

在三个肩部位置获取X线图像和具有三维重建的断层图像，并由四名独立观察者分两次进行分析。

结果

X线评估表明，使用CT可提高Neer分类在观察者间及观察者自身的一致性。AO分类则未出现这种情况，在AO分类中，CT仅显示能提高观察者间的一致性。

结论

使用三维CT能够更好地评估骨折的组成部分及其移位情况，不过观察者自身的一致性仍不尽如人意。