ArticlePatient safety in surgery2020
Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures.
Article in Patient safety in surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Utility of 3-Dimensional Printed Models for Distal Radius Fracture Classification.Hand (New York, N.Y.) · 2026Observational
- A Comprehensive Review of 3D Imaging and Printing in Proximal Humerus Fractures and Sequelae.Journal of clinical medicine · 2025Review
- The role of 3-dimensional printed models in the management of the distal radius fractures.Acta orthopaedica et traumatologica turcica · 2023Article
- FACTORS ASSOCIATED WITH THE OUTCOMES OF OLDER PATIENTS OPERATED DUE TO HIP FRACTURES.Acta ortopedica brasileira · 2023Article
- Three-dimensional printing models increase inter-rater agreement for classification and treatment of proximal humerus fractures.Patient safety in surgery · 2022Article
- THREE-DIMENSIONAL PRINTING IN ORTHOPEDICS: WHERE WE STAND AND WHERE WE ARE HEADING.Acta ortopedica brasileiraArticle
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe agreement for the treatment of proximal humerus fractures is low. Interpretation of exams used for diagnosis can be directly associated with this limitation. This study proposes to compare the agreement between experts and residents in orthopedics for treatment indication of proximal humerus fractures, utilizing 3D-models, holography (augmented reality), x-rays, and tomography as diagnostic methods.
methodsTwenty orthopedists (ten experts in shoulder and elbow surgery and ten experts in traumatology) and thirty resident physicians in orthopedics evaluated nine fractures of the proximal humerus, randomly distributed as x-rays, tomography, 3D-models and holography, using the Neer and AO / OTA Classifications. After, we evaluated the interobserver agreement between treatment options (conservative, osteosynthesis and arthroplasty) and whether the experience of the evaluators interfered with the results.
resultsThe interobserver agreement analysis showed the following kappa-values: κ = 0.362 and κ = 0.306 for experts and residents (3D-models); κ = 0.240 and κ = 0.221 (X-ray); κ = 0.233 and κ = 0.123 (Tomography) and κ = 0.321 and κ = 0.160 (Holography), for experts and residents respectively. Moreover, residents and specialists were discordant in the treatment indication using Tomography as a diagnostic method (
conclusionsThree-dimensional models showed, overall, the highest interobserver agreement (experts versus residents in orthopedics) for the choice of treatment of proximal humerus fractures compared to X-ray, Tomography, and Holography. Agreement in the choice of treatment among experts that used Tomography and Holography as diagnostic methods were two times higher compared to residents.
trial registrationRegistered in Brazil Platform under no. CAAE 12273519.7.0000.5505.
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