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勒图尔内尔和朱代分类法的观察者间可靠性评估

ASSESSMENT OF INTEROBSERVER RELIABILITY FOR THE LETOURNEL AND JUDET CLASSIFICATION.

作者信息

Yucens Mehmet, Aydemir Ahmet Nadir, Demirkan Ahmet Fahir

机构信息

Pamukkale University, Faculty of Medicine, Departament of Orthopaedics, Denizli, Turkey.

出版信息

Acta Ortop Bras. 2024 Mar 22;32(1):e267640. doi: 10.1590/1413-785220243201e267640. eCollection 2024.

Abstract

INTRODUCTION

The Judet and Letournel classification is the most widely used classification system for acetabular fractures. Some complex fractures couldn't be classified according to this classification. The main purpose of this study was to evaluate the reliability of the Letournel and Judet classification system for acetabular fractures.

MATERIAL AND METHODS

10 acetabular fractures were analyzed among 17 orthopedic surgeons. The surgeons were asked to classify the fractures according to the Judet and Letournel classification. Their experience, the number of surgeries, and the incision type that the surgeon uses for the anterior part of the acetabulum were recorded.

RESULTS

The overall interobserver agreement for the Letournel classification was found to be poor, with a Kappa value of 0.287. The Kappa value for interobserver agreement was 0.224 for plain radiographs, 0.293 for 2D-CT, and 0.321 for 3D-CT scans. There was no significant difference between the incision types used by the surgeons. The highest reliability was determined among the surgeons who operate on 10-20 acetabular fractures per year, with a Kappa value of 0.309.

CONCLUSION

This results revealed that the Judet and Letournel Judet classification is not sufficient to classify acetabular fractures because of unclassified fractures and the complex algorithm of the system. .

摘要

引言

Judet和Letournel分类法是髋臼骨折最广泛使用的分类系统。一些复杂骨折无法根据此分类法进行分类。本研究的主要目的是评估Letournel和Judet髋臼骨折分类系统的可靠性。

材料与方法

17名骨科医生对10例髋臼骨折进行分析。要求医生根据Judet和Letournel分类法对骨折进行分类。记录他们的经验、手术数量以及医生用于髋臼前部的切口类型。

结果

发现Letournel分类法的观察者间总体一致性较差,Kappa值为0.287。X线平片的观察者间一致性Kappa值为0.224,二维CT为0.293,三维CT扫描为0.321。医生使用的切口类型之间无显著差异。每年进行10 - 20例髋臼骨折手术的医生中可靠性最高,Kappa值为0.309。

结论

该结果表明,由于存在无法分类的骨折以及该系统复杂的算法,Judet和Letournel分类法不足以对髋臼骨折进行分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8b9/10962095/d490671e3a9c/1809-4406-aob-32-01-e267640-gf01.jpg

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