Abstract
Introduction
We compare the intra- and interobserver reproducibility of classifications of tibial plateau fractures most commonly used in our clinical practice. These were the AO and Schatzker classifications.
Patients and methods
Agreement was measured using kappa coefficients on the data obtained from three observers reviewing 30 fractures and these values were interpreted according to Landis and Koch.
Results
It was found that both classifications were substantially reliable with regards to intraobserver reliability but that the Schatzker system was only fairly reliable and the AO classification moderately reliable with regards to interobserver reliability. Breaking down the AO classification, with regards to intraobserver reliability, the AO group was substantially reliable and the type excellently reliable. For interobserver reliability, the AO group was moderately reliable while the AO type was substantially reliable.
Conclusion
For tibial plateau fractures seen on plain x-ray, the AO classification is more reliable between observers than the Schatzker classification.
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References
Tscherne H, Lobenhoffer P (1993) Tibial plateau fractures. Management and expected results (review). Clin Orthop Relat Res 74:1745–1750
Waddell JP, Johnston DW, Neidre A (1981) Fractures of the tibial plateau: a review of 95 patients and comparison of treatment methods. J Trauma 21:376–381
Muller ME, Allgower M, Schneider R, Willenegger H (1991) Manual of Internal Fixation, 3rd edn. Springer, Berlin Heidelberg New York, pp 142–143
Schatzker J, McBroom R, Bruce D (1979) The tibial plateau fracture: the Toronto experience 1968–1975. Clin Orthop Rel Res 138:94–104
Landis JR, Koch GC (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Burstein AH (1993) Fracture classification systems: do they work and are they useful? (editorial). JBJS 75-A:1743–1744
Frandsen PA, Andersen E, Madsen F, Skjodt T (1988) Garden's classification of femoral neck fractures: an assessment of inter-observer variation. JBJS 70(B):588–90
Lindsjo U (1985) Classification of ankle fractures: the Lauge-Hansen or AO system? Clin Orthop 10:12–16
Thomsen NOB, Overgaard S, Olsen LH, Hansen H, Nielsen ST (1991) Observer variation in radiographic classification of ankle fractures. JBJS 73(B):676–678
Smith RM (2000) The classification of fractures (editorial). JBJS 82(B):625–626
Swiontkowski MF, Sands AK, Agel J, Diab M, Schwappach JR, Kreder HJ (1997) Inter-observer variation in the AO/OTA fracture classification system for pilon fractures: is there a problem? J Orthop Trauma 11(7):467–470
Sidor ML, Zuckerman JD, Lyon T, Koval K, Cuomo F, Schoenberg N (1993) The Neer classification system for proximal humeral fractures: an assessment of interobserver reliability and intraobserver reproducibility. JBJS 75(A):1745–1750
Siebenrock KA, Gerber C (1993) The reproducibility of classification of fractures of the proximal end of the humerus. JBJS 75(A):1751–1755
Sanders RW (1997) The problem with apples and oranges (editorial). J Orthop Trauma 11(7):465–466
Chan PSH, Klimliewicz JJ, Luchetti WT, Esterhai JL, Kneeland JB, Dalinka MK, Heppenstall RB (1997) Impact of CT on treatment plan and fracture classification of tibial plateau fractures. J Orth Trauma 11(7):484–489
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Walton, N.P., Harish, S., Roberts, C. et al. AO or Schatzker? How reliable is classification of tibial plateau fractures?. Arch Orthop Trauma Surg 123, 396–398 (2003). https://doi.org/10.1007/s00402-003-0573-1
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DOI: https://doi.org/10.1007/s00402-003-0573-1