Alencar Jonatas Brito DE, Souza Clodoaldo JosÉ Duarte DE, Coelho Pedro Rafael Reis, Freitas Pedro Gomes DE, Lopes MÁrcio Bezerra Gadelha, Pinto Francisco JosÉ Maia
Instituto Dr. José Frota, Orthopedics and Traumatology Service, Fortaleza, CE, Brazil.
Hospital Geral de Fortaleza, Orthopedics and Traumatology Service, Fortaleza, CE, Brazil.
Acta Ortop Bras. 2020 Sep-Oct;28(5):216-220. doi: 10.1590/1413-785220202805228092.
To verify inter- and intra-observer agreement of three classification systems for tibial plateau fractures - Schatzker, AO/ASIF, and Luo's - among orthopedic surgery residents.
This cross-sectional study was conducted with 29 observers. Radiographic and tomographic imaging of the knee of 15 patients presenting with fractures were evaluated. After six weeks, the test was reapplied. The level of agreement was calculated by the Kappa index.
In test 1, inter-observer agreement of all residents, according to the Kappa index, for Schatzker classification was 0.226, for AO 0.431, and Luo's 0.319. In test 2, values were 0.316, 0.333, and 0.347, respectively ( < 0.001). Regarding intra-observer analysis, the mean Kappa indexes of 1-year residents were: Schatzker, 0.20; AO, 0.32; and Luo's, 0.3. For 2-year residents, means were: 0.51, 0.58, and 0.38, respectively. As for 3-year, results were 0.42, 0.42, and 0.41, respectively ( < 0.001).
AO/ASIF showed a better reproducibility than other classifications, with substantial inter- and intra-observer agreement. We also found a stronger agreement among 2- and 3-year residents.
验证骨科住院医师对胫骨平台骨折的三种分类系统（Schatzker、AO/ASIF和罗氏分类法）在观察者间和观察者内的一致性。
本横断面研究纳入了29名观察者。对15例骨折患者的膝关节进行了X线和断层扫描成像评估。六周后，重复进行测试。通过Kappa指数计算一致性水平。
在测试1中，根据Kappa指数，所有住院医师对Schatzker分类法的观察者间一致性为0.226，对AO分类法为0.431，对罗氏分类法为0.319。在测试2中，相应的值分别为0.316、0.333和0.347（<0.001）。关于观察者内分析，1年住院医师的平均Kappa指数分别为：Schatzker分类法0.20；AO分类法0.32；罗氏分类法0.3。2年住院医师的平均值分别为：0.51、0.58和0.38。3年住院医师的结果分别为0.42、0.42和0.41（<0.001）。
AO/ASIF分类法比其他分类法具有更好的可重复性，在观察者间和观察者内具有较高的一致性。我们还发现2年和3年住院医师之间的一致性更强。
