Interobserver reliability of the Schatzker and Luo classification systems for tibial plateau fractures

Injury
Jos J MellemaTraumaplatform Study Collaborative & Science of Variation Group

Abstract

Tibial plateau fracture classification systems have limited interobserver reliability and new systems emerge. The purpose of this study was to compare the reliability of the Luo classification and the Schatzker classification for two-dimensional computed tomography (2DCT) and to study the effect of adding three-dimensional computed tomography (3DCT). Eighty-one observers, orthopedic surgeons and residents, were randomized to either 2DCT or 2D- and 3DCT evaluation of a spectrum of 15 complex tibial plateau fractures using web-based platforms in order to classify according to the Schatzker and according to Luo's Three Column classification. Reliability was calculated with the use of Siegel and Castellan's multirater kappa measure. Kappa values were interpreted according to the categorical rating by Landis and Koch. Overall interobserver reliability of the Schatzker classification was significantly better compared to the Luo classification (kSchatzker=0.32 and kLuo=0.28, P=0.021), however, 'fair' for both fracture classification systems. For the Schatzker classification observers agreed significantly better on 2DCT compared to 2D- and 3DCT (k2DCT=0.37 and k2D+3DCT=0.29, P<0.001). The addition of 3DCT did not improve the overall in...Continue Reading

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Citations

Jan 26, 2017·Journal of Digital Imaging·Jos J MellemaUNKNOWN Science of Variation Group & Traumaplatform Study Collaborative
Oct 27, 2017·Chinese Medical Journal·Ya-Ke LiuFan Liu
Aug 23, 2017·International Orthopaedics·Harm Hoekstra
Feb 21, 2018·JBJS Reviews·Adam K LeeCory Collinge
Apr 14, 2017·International Orthopaedics·Angélica Millán-BilliPablo Eduardo Gelber
May 18, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Markus RossmannLars G Grossterlinden
Aug 10, 2020·Clinical Orthopaedics and Related Research·Anne M L MeestersFrank F A IJpma
Apr 20, 2021·Injury·Lucas S MarchandTodd Jaeblon
Sep 4, 2021·BioMed Research International·Maximilian KerschbaumMichael Worlicek
Sep 25, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Mary Kate ErdmanGeoffrey S Marecek

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