Total talar fracture – Inter- and intra-observer reproducibility of two classification systems (Hawkins and AO) for central talar fractures - 02/06/12
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Summary |
Introduction |
We evaluated the inter- and intra-observer reproducibility of two classification systems for central talar fractures (Hawkins, as modified by Canal and Kelly and then by us; AO/AOT).
Hypothesis |
The analysis and classification of these fractures will be better with CT scans than with X-rays.
Material and Methods |
Four observers evaluated 39 X-ray and CT scan files twice in the span of six weeks; each evaluation entailed classifying the fractures and describing their main features. Cohen’s Kappa coefficient for inter-rater agreement was calculated and analysed.
Results |
The inter- and intra-observer reproducibility with CT scans was better with X-rays for most of the parameters evaluated. The modified Hawkins classification provided better reproducibility than the AO/AOT one. However, this classification system was not perfect, even after modifications and use of CT scans.
Discussion |
CT scans are an essential tool for the analysis of all talar fractures. We modified the Hawkins classification (as modified by Canal and Kelly) to include a Type 0 (no displacement or less than 2mm), include frontal body fractures that are displaced like neck fractures and take into account comminuted fractures and other trauma in the area.
Level of proof |
IV – retrospective clinical study.
Le texte complet de cet article est disponible en PDF.Keywords : Talus, Fracture, Classification, CT scan, X-rays, Inter- and intra-observer reproducibility
MeSH terms : Humans, Talus, Tomography, X-Ray computed/methods, Observer variation, Reproducibility of results, Retrospective studies, Fractures/classification, Fractures/radiography
Plan
Vol 98 - N° 4S
P. S56-S65 - juin 2012 Retour au numéro
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