Authors: John ClarkeJenssen Stein Arne Øvre Olav Røise Jan Erik Madsen
Publish Date: 2015/05/01
Volume: 135, Issue: 7, Pages: 913-918
Abstract
Four international orthopedic pelvic trauma centers reviewed the radiological images for 20 acetabular fracture patients Three different image sets were made one set containing plain radiographs including oblique Judet views and 2D axial CT scans The second set contained an AP radiograph of the pelvis without oblique views 2D and 3D CT scans The third set contained all the images The image sets were evaluated in three separate sessions for each session the raters were asked to classify the fracture according to Letournel as well as record a number of other important radiological features concerning the fractureThe interobserver agreement for the Letournel classification was found to be moderate for all image sets The image set without oblique views showed the best agreement with a kappa value of 060 The intra and interobserver agreement for important modifiers were found to be substantial The addition of oblique radiographs did not seem to increase the intra or interobserver agreement for any of the factors evaluated except for the roof arc scoreThe moderate agreement found for the Letournel classification is to be expected given the complexity of the classification The addition of oblique radiographs to the image sets does not seem to improve the reliability and thus its routine use for classification and decision making may be debatedThanks to Wade Smith Department of Orthopedic Surgery Denver Health Medical Center University of Colorado School of Medicine Denver CO USA Eero Hirvensalo Department of Orthopedics and Traumatology Helsinki University Hospital Finland and Matej Cimmermann Deparmet of Traumatology University Medical center Ljubljana Slovenia for invaluable help in collecting the data
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