Department of Orthopaedics and Trauma Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
Department of Orthopaedics and Trauma Surgery, Hospital Univesitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
Arch Orthop Trauma Surg. 2023 Aug;143(8):5001-5006. doi: 10.1007/s00402-023-04823-z. Epub 2023 Mar 11.
Two of the most commonly used classifications for the posterior malleolus fracture are Haraguchi and Bartoníček. Both classifications are based on the morphology of the fracture. This study makes an inter- and intra-observer agreement analysis of the mentioned classifications.
39 patients with ankle fractures who met inclusion criteria were selected. All the fractures were analyzed and classified twice by each of the 20 observers using Bartoníček and Haraguchi's classifications, with a window period of at least 30 days between the two rounds.
Analysis was made by Kappa coefficient (ƙ). The global intraobserver value was ƙ = 0.627 in the Bartoníček classification and ƙ = 0.644 in the Haraguchi one. The first round global interobserver ƙ = 0.589 (0.574-0.604) on the Bartoníček classification and ƙ = 0.534 (0.517-0.551) on the Haraguchi one. Second round coefficients were ƙ = 0.601 (0.585-0.616) and ƙ = 0.536 (0.519-0.554), respectively. The best agreement was when there was involvement of the posteromedial malleolar zone with ƙ = 0.686 and ƙ = 0.687 in Haraguchi II and ƙ = 0.641 and ƙ = 0.719 in Bartoníček III. No differences were observed in Kappa values when an experience-based analysis was made.
Bartoníček and Haraguchi classifications of the posterior malleolus fracture have both substantial intraobserver agreement but moderate to substantial agreement in interobserver analysis.
IV.
后踝骨折最常用的两种分类方法是 Haraguchi 和 Bartoníček 分类法。这两种分类方法都是基于骨折的形态。本研究对这两种分类方法进行了观察者内和观察者间的一致性分析。
选择了 39 名符合纳入标准的踝关节骨折患者。所有骨折均由 20 名观察者使用 Bartoníček 和 Haraguchi 分类法进行了两次分析和分类，两次分析之间的间隔至少为 30 天。
采用 Kappa 系数（ƙ）进行分析。在 Bartoníček 分类法中，观察者内的整体值为 ƙ=0.627，在 Haraguchi 分类法中为 ƙ=0.644。第一轮观察者间的整体值为 ƙ=0.589（0.574-0.604），在 Bartoníček 分类法中为 ƙ=0.534（0.517-0.551）。第二轮的系数分别为 ƙ=0.601（0.585-0.616）和 ƙ=0.536（0.519-0.554）。当涉及后踝内侧区域时，一致性最好，Haraguchi II 为 ƙ=0.686 和 ƙ=0.687，Bartoníček III 为 ƙ=0.641 和 ƙ=0.719。基于经验的分析时，Kappa 值没有差异。
后踝骨折的 Bartoníček 和 Haraguchi 分类法均具有较强的观察者内一致性，但在观察者间分析中具有中等至较强的一致性。
IV 级。
