Tibia Plato Kırıklarında Schatzker ve AO / OTA sınıflandırma sistemlerine göre Ortopedi ve Travmatoloji Asistan ve Uzman Hekimler Arasındaki Güvenirlik Analizi

ÖZET Amaç: Bu çalışmadaki amacımız Schatzker ve AO / OTA sınıflamalarının Ortopedi ve Travmatoloji uzmanları ve asistanları arasındaki güvenilirliği incelemektir. Gereç yöntem: Çalışmaya altısı Ortopedi ve Travmatoloji asistanı, altısı ise Ortopedi ve Travmatoloji uzmanı olmak üzere oniki gözlemci katıldı. Gözlemcilerden elektronik posta yoluyla gönderilen 60 tibia plato kırığı olan hastanın anteroposterior ve lateral radyografilerinin bulunduğu standart formları Schatzker ve AO / OTA sınıflandırma sistemlerine göre sınıflamaları istendi. Bulgular: Bu çalışmada Schatzker ve AO / OTA sınıflandırmalarına göre yapılan gözlemciler arası uyumda sadece Schatzker sınıflaması uzman hekimler tarafından değerlendirildiğinde gözlemciler arası uyumun orta düzeyde olduğu olduğu görülmüştür. AO / OTA sınıflamasının uzman hekimler arası, asistan hekimler arası ve tüm hekimler arasında uyumunun düşük düzeyde kaldığı görülmüştür. Sonuç: Schatzker sınıflandırma sistemi AO / OTA sınıflandırma sistemi ile karşılaştırıldığında gözlemciler arası uyumunun daha yüksek olduğu görülmektedir.

Anahtar Kelimeler:

Tibia plato kırıkları, AO / OTA sınıflaması, Schatzker sınıflaması

Tibia Plateau Fractures Inter Observer Reliability Analysis Between Orthopedics and Traumatology Residents and Specialist Physicians According to Schatzker and AO / OTA classification systems

ABSTRACTPurpose: The aim of this study was to investigate the reliability of the Schatzker and AO / OTA classifications between Orthopedics and Traumatology specialists and residents.Material methods: Twelve observers, six of them Orthopedics and Traumatology residents, six of them Orthopedics and Traumatology specialist were participated to the study. 60 tibial plateau fractures radiographs were sent via e-mail to the observers. They were asked to classify anteroposterior and lateral radiographs according to Schatzker and AO / OTA classification systems.Results: In this study according to Schatzker and AO / OTA classifications reliability, only the Schatzker classification was observed to be moderate among the Orthopedics and Traumatology specialist. The AO / OTA classification was found to be fair reliability among the specialist physicians, residents and all physicians. Conclusion: Schatzker classification system compared with the AO / OTA classification system, it is observed that the interobserver consistency is higher.

Keywords:

Tibial plateau fractures, AO / OTA classification system, Schatzker classification system,

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Salduz A, Birisik F, Polat G, Bekler B, Bozdag E, Kilicoglu O. The effect of screw thread length on initial stability of Schatzker type 1 tibial plateau fracture fixation: a biomechanical study. J Orthop Surg Res [Internet]. 2016 Nov 22 [cited 2018 Nov 21];11(1):146. Available from: http://josr-online.biomedcentral.com/articles/10.1186/s13018-016-0484-9
Mthethwa J, Chikate A. A review of the management of tibial plateau fractures. Musculoskelet Surg. 2018;102(2):119–27.
Taskeşen A, Demirkale I, Okkaoğlu MC, Özdemir M, Bilgili MG, Altay M, et al. The pivotal role of the coronal fracture line for a new three-dimensional CT-based fracture classification of bicondylar proximal tibial fractures. Int Orthop [Internet]. 2017;41(6):944–9. Available from: http://dx.doi.org/10.1016/j.injury.2017.06.019
Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, Mavrogenis AF, Korres DS, Soucacos PN. Complications after tibia plateau fracture surgery. Injury [Internet]. 2006 Jun [cited 2018 Nov 21];37(6):475–84. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16118010
Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968-1975. Clin Orthop Relat Res. 1979.
Müller ME, Nazarian S KP. Müller AO Classification of Fractures—Long Bones. AO Found. 1987;
Limb D. Fractures in adults (Rockwood and Green’s). Curr Orthop. 1998;
Luo C-F, Sun H, Zhang B, Zeng B-F. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma [Internet]. 2010 Nov [cited 2018 Nov 27];24(11):683–92. Available from: https://insights.ovid.com/crossref?an=00005131-201011000-00005
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics [Internet]. 1977 Mar [cited 2018 Dec 3];33(1):159–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/843571
Gwet KL. Computing inter-rater reliability and its variance in the presence of high agreement. Br J Math Stat Psychol. 2008;61(1):29–48.
Charalambous CP, Tryfonidis M, Alvi F, Moran M, Fang C, Samarji R, et al. Inter- and intra-observer variation of the Schatzker and AO/OTA classifications of tibial plateau fractures and a proposal of a new classification system. Ann R Coll Surg Engl [Internet]. 2007 May [cited 2018 Nov 21];89(4):400–4. Available from: http://publishing.rcseng.ac.uk/doi/10.1308/003588407X187667
Harish S, Roberts C, Blundell C, Walton NP. AO or Schatzker? How reliable is classification of tibial plateau fractures? Arch Orthop Trauma Surg [Internet]. 2003 Oct 1 [cited 2018 Nov 27];123(8):396–8. Available from: http://link.springer.com/10.1007/s00402-003-0573-1
Mellema JJ, Doornberg JN, Molenaars RJ, Ring D, Kloen P, Babis GC, et al. Interobserver reliability of the Schatzker and Luo classification systems for tibial plateau fractures. Injury. 2016;47(4):944–9.
Zhu Y, Hu C-F, Yang G, Cheng D, Luo C-F. Inter-observer reliability assessment of the Schatzker, AO/OTA and three-column classification of tibial plateau fractures. J Trauma Manag Outcomes [Internet]. 2013 Dec 11 [cited 2018 Nov 21];7(1):7. Available from: http://traumamanagement.biomedcentral.com/articles/10.1186/1752-2897-7-7
Gicquel T, Najihi N, Vendeuvre T, Teyssedou S, Gayet L-E, Huten D. Tibial plateau fractures: Reproducibility of three classifications (Schatzker, AO, Duparc) and a revised Duparc classification. Orthop Traumatol Surg Res [Internet]. 2013 [cited 2018 Nov 27];99:805–16
Taskeşen A, Demirkale I, Okkaoğlu MC, Özdemir M, Bilgili MG, Altay M. Intraobserver and interobserver reliability assessment of tibial plateau fracture classification systems. Eklem Hast ve Cerrahisi. 2017;28(3):177–81.
Millán-Billi A, Gómez-Masdeu M, Ramírez-Bermejo E, Ibañez M, Gelber PE. What is the most reproducible classification system to assess tibial plateau fractures? Int Orthop. 2017;41(6):1251–6.
Martínez-Rondanelli A, Escobar-González SS, Henao-Alzate A, Martínez-Cano JP. Reliability of a four-column classification for tibial plateau fractures. Int Orthop. 2017;41(9):1881–6.