Alencar Neto Jonatas Brito, Osório Neto Ernane Bruno, Souza Clodoaldo José Duarte de, da Rocha Pedro Henrique Messias, Cavalcante Maria Luzete Costa, Lopes Márcio Bezerra Gadelha
Departamento de Ortopedia e Traumatologia, Instituto Doutor José Frota, Fortaleza, CE, Brasil.
Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Aug;56(4):459-462. doi: 10.1055/s-0040-1713388. Epub 2020 Oct 2.
To evaluate the interobserver agreement of two classifications for floating knee: Fraser and Blake & McBryde. Thirty-two observers, subdivided according to the degree of titration (26 resident physicians and 6 orthopedic physicians specialized in orthopedic trauma), classified 15 fractures of the ipsilateral femur and tibia. Interobserver agreement was evaluated by using the Kappa coefficient When evaluating the agreement between the 9 R1, a Kappa index of 0.58 was obtained for the Fraser classification and of 0.46 for the Blake & McBryde classification. Among the 7 R2, a rate of 0.59 was obtained for the Fraser rating and 0.51 for the Blake & McBryde rating. Among the 10 R3, the agreement index was higher for both classifications: 0.72 for the Fraser and 0.71 for the Blake & McBryde classification. Considering the 3 groups (R1, R2, R3) as one large group, the general Kappa index was calculated, which resulted in 0.63 for the Fraser classification and 0.56 for the Blake & McBryde classification. In the group of trauma and orthopedic knee specialists, in turn, an agreement of 0.597 was obtained for the Blake and McBryde classification and of 0.843 for the Fraser classification. Comparatively, the two classifications presented a weak to moderate degree of agreement. Fraser classification had better agreement in both groups. The agreement was higher when evaluating orthopedic trauma physicians.
为评估两种浮膝分类方法（弗雷泽分类法和布莱克与麦克布赖德分类法）的观察者间一致性。32名观察者，根据经验程度进行细分（26名住院医师和6名骨科创伤专科骨科医生），对15例同侧股骨和胫骨骨折进行分类。采用Kappa系数评估观察者间一致性。在评估9名R1时，弗雷泽分类法的Kappa指数为0.58，布莱克与麦克布赖德分类法的Kappa指数为0.46。在7名R2中，弗雷泽分级的比率为0.59，布莱克与麦克布赖德分级的比率为0.51。在10名R3中，两种分类法的一致性指数均较高：弗雷泽分类法为0.72，布莱克与麦克布赖德分类法为0.71。将3组（R1、R2、R3）视为一个大组，计算总体Kappa指数，结果弗雷泽分类法为0.63，布莱克与麦克布赖德分类法为0.56。在创伤和骨科膝关节专科医生组中，布莱克与麦克布赖德分类法的一致性为0.597，弗雷泽分类法的一致性为0.843。相比之下，两种分类法的一致性程度为弱到中度。弗雷泽分类法在两组中具有更好的一致性。评估骨科创伤医生时一致性更高。
