From the Faculty of Health Sciences, Universidad Industrial de Santander, Sociedad Colombiana de Cirugía Ortopédica y Traumatología (SCCOT), Bucaramanga, Colombia (Dr. Osma and Dr. Mantilla), and the Industrial Design College, Universidad Industrial de Santander, Bucaramanga, Colombia (Dr. López).
J Am Acad Orthop Surg Glob Res Rev. 2023 Apr 11;7(4). doi: 10.5435/JAAOSGlobal-D-22-00202. eCollection 2023 Apr 1.
Reliability is the study of internal consistency, reproducibility (intraobserver and interobserver), and agreement. Reproducibility studies that classify tibial plateau fractures have used plain radiography and two-dimensional (2D) CT scans and three-dimensional (3D) printing. The objective of this study was to evaluate the reproducibility of the Luo Classification of tibial plateau factures and the surgical approaches chosen for these fractures based on 2D CT scans and 3D printing.
A reliability study was performed at the Universidad Industrial de Santander, Colombia, that evaluated the reproducibility of the Luo Classification of tibial plateau fractures and the choice of surgical approaches based on 20 CT scans and 3D printing, with five evaluators.
For the trauma surgeon, reproducibility was better when evaluating the classification using 3D printing, with a kappa of 0.81 (95% confidence interval [CI], 0.75-0.93; P < 0.01) than when using CT scans, with a kappa of 0.76 (95% CI, 0.62-0.82; P < 0.01). When comparing the surgical decisions made by the fourth-year resident with those of the trauma surgeon, a fair reproducibility was obtained using CT, with a kappa of 0.34 (95% CI, 0.21-0.46; P < 0.01), which improved to substantial when using 3D printing, with a kappa of 0.63 (95% CI, 0.53-0.73; P < 0.01).
This study found that 3D printing provided more information than CT and decreased measurement errors, thereby improving reproducibility, as shown by the higher kappa values that were obtained.
The use of 3D printing and its usefulness are helpful to decision making when providing emergency trauma services to patients with intraarticular fractures such as those of the tibial plateau.
可靠性研究包括内部一致性、可重复性（观察者内和观察者间）和一致性。对胫骨平台骨折进行分类的可重复性研究已经使用了普通 X 射线和二维（2D）CT 扫描以及三维（3D）打印。本研究的目的是评估基于 2D CT 扫描和 3D 打印的 Luo 胫骨平台骨折分类和选择的手术方法的可重复性。
哥伦比亚工业大学进行了一项可靠性研究，评估了 Luo 胫骨平台骨折分类和基于 20 个 CT 扫描和 3D 打印的手术方法选择的可重复性，有 5 名评估者。
对于创伤外科医生，使用 3D 打印评估分类时的可重复性更好，κ 值为 0.81（95%置信区间[CI]，0.75-0.93；P < 0.01），而使用 CT 扫描时的 κ 值为 0.76（95%CI，0.62-0.82；P < 0.01）。当比较四年级住院医师和创伤外科医生做出的手术决策时，使用 CT 获得了适度的可重复性，κ 值为 0.34（95%CI，0.21-0.46；P < 0.01），而使用 3D 打印时，κ 值提高到了 0.63（95%CI，0.53-0.73；P < 0.01）。
本研究发现，3D 打印提供的信息多于 CT，减少了测量误差，从而提高了可重复性，这一点从更高的κ 值可以看出。
在为关节内骨折（如胫骨平台骨折）患者提供紧急创伤服务时，使用 3D 打印及其有用性有助于决策制定。
