基于稳定性的踝关节骨折分类的可重复性

Reproducibility of the stability-based classification for ankle fractures.

作者信息

Viberg Bjarke, Haidari Tamim A, Stork-Hansen Jesper, Knudsen Roland, Bech Rune Dueholm

机构信息

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.

Department of Orthopaedic Surgery and Traumatology, Kolding Hospital - part of Hospital Lillebaelt, Kolding, Denmark.

出版信息

Eur J Orthop Surg Traumatol. 2019 Jul;29(5):1125-1129. doi: 10.1007/s00590-019-02404-8. Epub 2019 Feb 21.

DOI:10.1007/s00590-019-02404-8

PMID:30790049

Abstract

BACKGROUND

Classification of ankle fracture is important when deciding for operative or conservative treatment. This study rates the reproducibility of ankle stability assessment and compares it with the classification by Lauge-Hansen and Arbeitsgemeinschaft für Osteosyntesefragen (AO) in adult patients with primary ankle fractures.

METHODS

A total of 496 consecutive ankle fractures were included, and the X-ray images were reviewed 2 times by 2 medical students, 2 residents, and 1 consultant in orthopedic traumatology. The raters were blinded to each other and to their own results. Unweighted Kappa statistics were used to assess reproducibility.

RESULTS

Overall mean (95% CI) interrater Kappa results were 0.65 (0.64; 0.68) for Lauge-Hansen, 0.62 (0.60; 0.63) for AO and 0.61 (0.57; 0.62) for the stability assessment. The intrarater results ranged from a mean Kappa of 0.64-0.80 for the medical students, 0.65-0.81 for the residents and 0.82-0.84 for the consultant.

CONCLUSION

The stability assessment has substantial to almost-perfect agreement which is comparable to the Lauge-Hansen and AO classifications.

摘要

背景

在决定采用手术治疗还是保守治疗时，踝关节骨折的分类很重要。本研究评估了踝关节稳定性评估的可重复性，并将其与Lauge-Hansen和骨科内固定协会（AO）对原发性踝关节骨折成年患者的分类进行比较。

方法

共纳入496例连续性踝关节骨折患者，由2名医学生、2名住院医师和1名骨科创伤顾问对X线图像进行2次复查。评分者彼此之间以及对自己的结果均不知情。采用非加权Kappa统计量评估可重复性。

结果

Lauge-Hansen分类的评分者间Kappa总体均值（95%CI）为0.65（0.64；0.68），AO分类为0.62（0.60；0.63），稳定性评估为0.61（0.57；0.62）。医学生的评分者内结果均值Kappa范围为0.64 - 0.80，住院医师为0.65 - 0.81，顾问为0.82 - 0.84。