Service de chirurgie orthopédique et traumatologique, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, hôpital Jean-Minjoz, 25030 Besançon, France.
Service de chirurgie orthopédique et traumatologique, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, hôpital Jean-Minjoz, 25030 Besançon, France.
Orthop Traumatol Surg Res. 2024 May;110(3):103790. doi: 10.1016/j.otsr.2023.103790. Epub 2023 Dec 8.
A fracture classification system should provide a reliable and reproducible means of communication between different parties. It should be logical and understandable, with few categories to memorize. The aim of this study was to determine the intra- and interobserver reliability of the Schatzker and Mayo classification systems for the assessment of proximal ulna fractures.
Intra- and interobserver reliability studies were conducted on 39 X-rays of injured elbows drawn randomly from 74 cases previously used in a series on predictors of ulnohumeral osteoarthritis in proximal ulna fractures. Ten observers independently reviewed these X-rays on 2 separate occasions 3 months apart. The fracture type was assessed according to the Schatzker and Mayo classification systems during each reading session. Cohen's and Fleiss' kappa were used to measure the intra- and interobserver reliability.
The Schatzker classification had a fair interobserver reliability for the first (Schatzker R, Fleiss' κ: 0.394) and second (Schatzker R, Fleiss' κ: 0.351) readings. The mean intraobserver reliability value between the 10 reviewers for the Schatzker classification was rated as substantial (0.61). The Mayo classification had a fair interobserver reliability for the first (Mayo R, Fleiss' κ: 0.278) and second (Mayo R, Fleiss' κ: 0.292) readings. The mean intraobserver reliability value between the 10 reviewers for the Mayo classification was rated as fair (0.52).
The classification systems for proximal ulna fractures showed poor reproducibility between the different observers since they had low interobserver agreement values. Nevertheless, their use remained reliable since the measured intraobserver agreement value was deemed substantial.
IV; retrospective.
骨折分类系统应提供可靠且可重复的沟通方式，以便不同的群体之间进行交流。它应该具有逻辑性和可理解性，且分类较少，易于记忆。本研究旨在评估 Schatzker 和 Mayo 分类系统在评估尺骨近端骨折中的内部和观察者间可靠性。
对 74 例尺骨近端骨折病例系列研究中随机抽取的 39 例受伤肘部 X 线片进行了内部和观察者间可靠性研究。10 名观察者在 3 个月的间隔时间内分两次独立评估这些 X 线片。每次阅读时，根据 Schatzker 和 Mayo 分类系统评估骨折类型。采用 Cohen 和 Fleiss 的 κ 值评估内部和观察者间可靠性。
Schatzker 分类在第一次（Schatzker R，Fleiss' κ：0.394）和第二次（Schatzker R，Fleiss' κ：0.351）阅读时具有中等观察者间可靠性。10 名观察者之间的 Schatzker 分类的平均观察者内可靠性值被评为中等（0.61）。Mayo 分类在第一次（Mayo R，Fleiss' κ：0.278）和第二次（Mayo R，Fleiss' κ：0.292）阅读时具有中等观察者间可靠性。Mayo 分类的 10 名观察者之间的平均观察者内可靠性值被评为中等（0.52）。
尺骨近端骨折的分类系统在不同观察者之间的重复性较差，因为它们的观察者间一致性值较低。然而，由于测量的观察者内一致性值被认为是实质性的，因此它们的使用仍然是可靠的。
IV；回顾性研究。
