Stirma Guilherme Augusto, Secundino Armando Romani, Gonzalez Guilherme Ferreira Garcia, Sola Wilson Carlos, de Souza Geovanna Andrade Labres, Dau Leonardo
Universidade Federal do Paraná, Hospital do Trabalhador, Department of Orthopedic Surgery, Curitiba, PR, Brazil.
Acta Ortop Bras. 2020 Jan-Feb;28(1):36-39. doi: 10.1590/1413-785220202801215063.
The use of images in 3D reconstruction is an instrument that facilitates the interpretation of the fracture, observations of deviations, rotations and articular surface.
To evaluate the inter-observer and intra-observer reliability of the Neer x AO proximal humerus fracture classification on radiographs versus computed tomography with three-dimensional reconstruction (3D).
We evaluated the digital radiographs (anteroposterior and profile) and computerized tomography with 3D reconstruction of patients presenting with a proximal humerus fracture, surgically treated at an Orthopedics and Traumatology Service. All radiographs and computed tomography were classified (Neer and AO) by eight (8) orthopedic surgeons, specialists in the upper limb and sent, following the pre-established numeration by the author, in a spreadsheet to the author of the study.
The Neer and AO scores were more reproducible when determined by computed tomography with 3D reconstruction, mainly in fractures of greater complexity (Neer 4 parts and AO group C). However, in absolute values, inter and intra-observer reproducibility and concordance still remain low.
Computed tomography with 3D reconstruction allows a better analysis of fractures of group C and Neer 4 parts. However, the inter and intra-observer agreement does not increase significantly in comparison to the radiographs.
三维重建中图像的使用是一种有助于解释骨折、观察移位、旋转和关节面的工具。
评估在X线片与三维重建计算机断层扫描（3D）上，Neer x AO肱骨近端骨折分类在观察者间和观察者内的可靠性。
我们评估了在骨科和创伤科接受手术治疗的肱骨近端骨折患者的数字化X线片（前后位和侧位）以及三维重建计算机断层扫描。所有X线片和计算机断层扫描均由八位上肢专科骨科医生按照Neer和AO分类法进行分类，并按照作者预先设定的编号，以电子表格形式发送给该研究的作者。
通过三维重建计算机断层扫描确定Neer和AO评分时，再现性更高，主要体现在更复杂的骨折（Neer 4部分骨折和AO C组）中。然而，就绝对值而言，观察者间和观察者内的再现性及一致性仍然较低。
三维重建计算机断层扫描能够更好地分析C组骨折和Neer 4部分骨折。然而，与X线片相比，观察者间和观察者内的一致性并未显著提高。
