Scapula fractures

Interobserver reliability of classification and treatment

The Science of Variation Group

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.

Original languageEnglish (US)
Pages (from-to)124-129
Number of pages6
JournalJournal of Orthopaedic Trauma
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2014

Fingerprint

Scapula
Intra-Articular Fractures
Therapeutics
Motion Pictures
Tomography
Orthopedic Surgeons

Keywords

  • New International Classification for Scapular Fractures
  • OTA/AO fracture classification
  • reliability
  • scapula

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Scapula fractures : Interobserver reliability of classification and treatment. / The Science of Variation Group.

In: Journal of Orthopaedic Trauma, Vol. 28, No. 3, 01.03.2014, p. 124-129.

Research output: Contribution to journalArticle

The Science of Variation Group. / Scapula fractures : Interobserver reliability of classification and treatment. In: Journal of Orthopaedic Trauma. 2014 ; Vol. 28, No. 3. pp. 124-129.
@article{fc009b4e268a4831a84454fdbc01b9ec,
title = "Scapula fractures: Interobserver reliability of classification and treatment",
abstract = "Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71{\%} proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57{\%} PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81{\%}. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73{\%} PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.",
keywords = "New International Classification for Scapular Fractures, OTA/AO fracture classification, reliability, scapula",
author = "{The Science of Variation Group} and Valentin Neuhaus and Bot, {Arjan G.J.} and Guitton, {Thierry G.} and Ring, {David C.} and Abdel-Ghany, {Mahmoud I.} and Jeffrey Abrams and Abzug, {Joshua M.} and Adolfsson, {Lars E.} and Balfour, {George W.} and Bamberger, {H. Brent} and Antonio Barquet and Michael Baskies and Batson, {W. Arnold} and Taizoon Baxamusa and Bayne, {Grant J.} and Thierry Begue and Michael Behrman and Daphne Beingessner and Jan Biert and Julius Bishop and Alves, {Mateus Borges Oliveira} and Martin Boyer and Drago Brilej and Brink, {Peter R.G.} and Brunton, {Lance M.} and Richard Buckley and Cagnone, {Juan Carlos} and Calfee, {Ryan P.} and Campinhos, {Luiz Augusto B.} and Charles Cassidy and Louis Catalano and Karel Chivers and Pradeep Choudhari and Matej Cimerman and Conflitti, {Joseph M.} and Costanzo, {Ralph M.} and Crist, {Brett D.} and Cross, {Brian J.} and Phani Dantuluri and Michael Darowish and {De Bedout}, Ramon and Thomas DeCoster and Dennison, {David G.} and DeNoble, {Peter H.} and Gregory DeSilva and Thomas Dienstknecht and Duncan, {Scott F.} and Duralde, {Xavier A.} and Holger Durchholz and Streubel, {Philipp N}",
year = "2014",
month = "3",
day = "1",
doi = "10.1097/BOT.0b013e31829673e2",
language = "English (US)",
volume = "28",
pages = "124--129",
journal = "Journal of Orthopaedic Trauma",
issn = "0890-5339",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Scapula fractures

T2 - Interobserver reliability of classification and treatment

AU - The Science of Variation Group

AU - Neuhaus, Valentin

AU - Bot, Arjan G.J.

AU - Guitton, Thierry G.

AU - Ring, David C.

AU - Abdel-Ghany, Mahmoud I.

AU - Abrams, Jeffrey

AU - Abzug, Joshua M.

AU - Adolfsson, Lars E.

AU - Balfour, George W.

AU - Bamberger, H. Brent

AU - Barquet, Antonio

AU - Baskies, Michael

AU - Batson, W. Arnold

AU - Baxamusa, Taizoon

AU - Bayne, Grant J.

AU - Begue, Thierry

AU - Behrman, Michael

AU - Beingessner, Daphne

AU - Biert, Jan

AU - Bishop, Julius

AU - Alves, Mateus Borges Oliveira

AU - Boyer, Martin

AU - Brilej, Drago

AU - Brink, Peter R.G.

AU - Brunton, Lance M.

AU - Buckley, Richard

AU - Cagnone, Juan Carlos

AU - Calfee, Ryan P.

AU - Campinhos, Luiz Augusto B.

AU - Cassidy, Charles

AU - Catalano, Louis

AU - Chivers, Karel

AU - Choudhari, Pradeep

AU - Cimerman, Matej

AU - Conflitti, Joseph M.

AU - Costanzo, Ralph M.

AU - Crist, Brett D.

AU - Cross, Brian J.

AU - Dantuluri, Phani

AU - Darowish, Michael

AU - De Bedout, Ramon

AU - DeCoster, Thomas

AU - Dennison, David G.

AU - DeNoble, Peter H.

AU - DeSilva, Gregory

AU - Dienstknecht, Thomas

AU - Duncan, Scott F.

AU - Duralde, Xavier A.

AU - Durchholz, Holger

AU - Streubel, Philipp N

PY - 2014/3/1

Y1 - 2014/3/1

N2 - Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.

AB - Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.

KW - New International Classification for Scapular Fractures

KW - OTA/AO fracture classification

KW - reliability

KW - scapula

UR - http://www.scopus.com/inward/record.url?scp=84894548416&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894548416&partnerID=8YFLogxK

U2 - 10.1097/BOT.0b013e31829673e2

DO - 10.1097/BOT.0b013e31829673e2

M3 - Article

VL - 28

SP - 124

EP - 129

JO - Journal of Orthopaedic Trauma

JF - Journal of Orthopaedic Trauma

SN - 0890-5339

IS - 3

ER -