ArticleSao Paulo medical journal = Revista paulista de medicina2008
Are distal radius fracture classifications reproducible? Intra and interobserver agreement.
Article in Sao Paulo medical journal = Revista paulista de medicina, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed.
- Treatment of reducible unstable fractures of the distal radius in adults: a randomised controlled trial of De Palma percutaneous pinning versus bridging external fixation.BMC musculoskeletal disorders · 2010Trial
- Distal Radius Fracture Pattern Correlates with Pronator Quadratus Injury Severity.Journal of wrist surgery · 2026Article
- Article
- Multimodality Imaging in Wrist Fractures and Dislocations.The Indian journal of radiology & imaging · 2025Review
- Assessment of Reproducibility and Agreement of the IDEAL Classification for Distal Radius Fractures.Revista brasileira de ortopedia · 2024Article
- Mayo classification of olecranon fractures revisited - Assessment of intra- and interobserver reliability based on CT scans.Journal of orthopaedics · 2024Article
- Evaluation of a 3D-printed hands-on radius fracture model during teaching courses.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Evaluation of Intra- and Interobserver Reproducibility of the New AO/OTA Classification for Distal Radius Fractures Compared with the Fernandez Classification.Revista brasileira de ortopedia · 2022Article
- Article
- Association of secondary displacement of distal radius fractures with cortical bone quality at the distal radius.Archives of orthopaedic and trauma surgery · 2021Article
- Evaluation of the Reproducibility of Lauge-Hansen, Danis-Weber, and AO Classifications for Ankle Fractures.Revista brasileira de ortopedia · 2021Article
- Observational
- Intra and Interobserver Agreement Regarding the Walch Classification System for Shoulder Joint Arthritis.Revista brasileira de ortopedia · 2019Article
- Bone Microarchitecture and Distal Radius Fracture Pattern Complexity.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2019Article
- A novel and simple classification for ligamentum teres pathology based on joint hypermobility.Journal of hip preservation surgery · 2018Review
- Classification systems for distal radius fractures.Acta orthopaedica · 2017Article
- Classification and treatment of distal radius fractures: a survey among orthopaedic trauma surgeons and residents.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2017Article
- AO Distal Radius Fracture Classification: Global Perspective on Observer Agreement.Journal of wrist surgery · 2017Article
- Is surgeons' experience important on intra- and inter-observer reliability of classifications used for adult femoral neck fracture?Acta orthopaedica et traumatologica turcica · 2016Article
- Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing?Annals of the Royal College of Surgeons of England · 2016Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
CONTEXT AND
objectiveVarious classification systems have been proposed for fractures of the distal radius, but the reliability of these classifications is seldom addressed. For a fracture classification to be useful, it must provide prognostic significance, interobserver reliability and intraobserver reproducibility. The aim here was to evaluate the intraobserver and interobserver agreement of distal radius fracture classifications. DESIGN AND
settingThis was a validation study on interobserver and intraobserver reliability. It was developed in the Department of Orthopedics and Traumatology, Universidade Federal de São Paulo - Escola Paulista de Medicina.
methodX-rays from 98 cases of displaced distal radius fracture were evaluated by five observers: one third-year orthopedic resident (R3), one sixth-year undergraduate medical student (UG6), one radiologist physician (XRP), one orthopedic trauma specialist (OT) and one orthopedic hand surgery specialist (OHS). The radiographs were classified on three different occasions (times T1, T2 and T3) using the Universal (Cooney), Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF), Frykman and Fernández classifications. The kappa coefficient (kappa) was applied to assess the degree of agreement.
resultsAmong the three occasions, the highest mean intraobserver k was observed in the Universal classification (0.61), followed by Fernández (0.59), Frykman (0.55) and AO/ASIF (0.49). The interobserver agreement was unsatisfactory in all classifications. The Fernández classification showed the best agreement (0.44) and the worst was the Frykman classification (0.26).
conclusionThe low agreement levels observed in this study suggest that there is still no classification method with high reproducibility.
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