Lozoya Sergio Charles, Báez Joaquín Darío Treviño, Flores Jesús María Rangel, Ventura Jesús Miguel Brizuela, Topete Omar Araiza, Juárez Andrea Alcázar
Specialized Orthopedics and Traumatology Unit, Hospital de Traumatología y Ortopedia No. 21 del instituto Mexicano del Seguro Social, Monterrey, NL, Mexico.
High-Speciality, Medical Unit No. 23 del instituto Mexicano del Seguro Social, Monterrey, NL, Mexico.
Acta Ortop Bras. 2018;26(4):218-221. doi: 10.1590/1413-785220182604191367.
The aim of this study is to estimate the inter- and intra-observer agreement of the Weiss and Milch classification systems in radiological studies of fractures of the lateral humeral condyle in pediatric patients.
An agreement study was performed with non-probability sampling of consecutive cases with a sample size of a hundred radiological studies, which were evaluated by three experienced orthopedic surgeons and three resident physicians; following a thorough comparison of both inter- and intra-observer agreements over a six-week period based on the Fleiss' kappa, which was used to determine the inter- and intra-observer agreement rates of both classifications.
The overall reliability of the entire group of evaluators for the Milch classification in the inter-observer evaluation was κ = 0.13, 95% CI, 0.08-0.18, and the intra-observer evaluation was κ = 0.08, 95% CI, 0.06-0.11. For the Weiss classification, the overall evaluation had an inter-observer agreement of κ = 0.53, 95% CI, 0.50-0.57, and an intra-observer agreement of κ = 0.22, 95% CI, 0.20 -0.24.
In the present study, the Weiss classification system demonstrated greater agreement than the Milch classification; however, the latter may require complementary studies, such as an arthrography to enhance classification accuracy.
本研究旨在评估小儿肱骨外侧髁骨折放射学研究中Weiss和Milch分类系统的观察者间及观察者内一致性。
采用非概率抽样的连续病例进行一致性研究，样本量为100份放射学研究，由三名经验丰富的骨科外科医生和三名住院医师进行评估；在六周内基于Fleiss kappa彻底比较观察者间及观察者内一致性，用于确定两种分类的观察者间及观察者内一致性率。
在观察者间评估中，Milch分类的全体评估者的总体可靠性为κ = 0.13，95% CI为0.08 - 0.18，观察者内评估为κ = 0.08，95% CI为0.06 - 0.11。对于Weiss分类，总体评估的观察者间一致性为κ = 0.53，95% CI为0.50 - 0.57，观察者内一致性为κ = 0.22，95% CI为0.20 - 0.24。
在本研究中，Weiss分类系统比Milch分类表现出更高的一致性；然而，后者可能需要补充研究，如关节造影以提高分类准确性。
