股骨颈骨折：放射学分类的可靠性,BMC Musculoskeletal Disorders

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股骨颈骨折：放射学分类的可靠性
BMC Musculoskeletal Disorders ( IF 2.2 ) Pub Date : 2022-01-25 , DOI: 10.1186/s12891-022-05007-3
Gianpiero Cazzato _{1,

2} , Maria Serena Oliva ₂ , Giulia Masci _{2,

3} , Raffaele Vitiello ₂ , Alessandro Smimmo ₂ , Maria Rosaria Matrangolo ₂ , Osvaldo Palmacci ₂ , Stefano D'Adamio _{1,

2} , Antonio Ziranu ₂

Affiliation

股骨颈骨折（FNF）是老年人最常见的损伤之一。为了执行正确的治疗并允许外科医生促进沟通，必须采用有效的放射线照相分类系统。本研究旨在评估2018年AO/OTA分类、AO/OTA简化版和Garden分类的可靠性。六名骨科医生根据创伤经历分为三组，使用 Garden 分类、2018 AO/OTA 和简化 AO/OTA 分类评估了 150 例 FNF 的盲法前后位和侧位 X 线摄影。一个月后，射线照片被重新编号，然后每个观察者对射线照片进行第二次评估。Kappa 统计分析用于确定分类的可靠性。计算 Cohen 的 Kappa 以确定观察者内和观察者间的可靠性。Fleiss 的 Kappa 用于确定多评估者一致性。Garden 分类的观察者间可靠性 k 值为 0.28 至 0.73，平均值为 0.49。AO 分类的可靠性为 0.2 至 0.42，平均为 0.30。简化的 AO/OTA 分类显示可靠性从 0.38 到 0.58，平均为 0.48。Garden 分类的观察者内部可靠性值为 0.48 至 0.79，平均值为 0.63。AO 分类的可靠性从 0.2 到 0.64，平均为 0.5。简化的 AO/OTA 分类显示可靠性为 0.4 至 0.75，平均为 0.61。修订后的 2018 年 AO/OTA 分类简化了之前的囊内骨折分类，但仍然不可靠，只有相当的观察者间可靠性。简化的 AO/OTA 分类显示出与 Garden 分类相似的可靠性，具有中等的观察者间可靠性。外科医生的经验似乎并没有提高可靠性。就可靠性而言，没有任何分类被证明是优越的。

"点击查看英文标题和摘要"

Femoral neck fracture: the reliability of radiologic classifications

Femoral neck fractures (FNF) are one of the most common injury in the elderly. A valid radiographic classification system is mandatory to perform the correct treatment and to allow surgeons to facilitate communication. This study aims to evaluate reliability of 2018 AO/OTA Classification, AO/OTA simplified and Garden classification. Six Orthopaedic surgeons, divided in three groups based on trauma experience, evaluated 150 blinded antero-posterior and latero-lateral radiography of FNF using Garden classification, 2018 AO/OTA and simplified AO/OTA classification. One month later, the radiographs were renumbered and then each observer performed a second evaluation of the radiographs. The Kappa statistical analysis was used to determine the reliability of the classifications. Cohen’s Kappa was calculated to determine intra and inter observer reliability. Fleiss’ Kappa was used to determine multi-rater agreement. The k values of interobserver reliability for Garden classification was from 0,28 to 0,73 with an average of 0,49. AO classification showed reliability from 0,2 to 0,42, with average of 0,30. Simplified AO/OTA classification showed a reliability from 0,38 to 0,58 with an average of 0,48. The values of intra observer reliability for Garden classification was from 0,48 to 0,79 with an average of 0,63. AO classification showed reliability from 0,2 to 0,64 with an average of 0,5. Simplified AO/OTA classification showed a reliability from 0,4 to 0,75 with an average of 0,61. The revised 2018 AO/OTA classification simplified the previous classification of intracapsular fracture but remain unreliable with only fair interobserver reliability. The simplified AO/OTA classification show a reliability similar to Garden classification, with a moderate interobserver reliability. The experience of the surgeons seems not to improve reliability. No classification has been shown to be superior in terms of reliability.

更新日期：2022-01-25

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