Distal radius kırıklarında kullanılan sınıflamaların güvenilirlik ve tekrar edilebilirlikleri

Abstract

Amaç: Çalışmamızın amacı distal radius kırıklarınında Universal, AO, Fernandez ve Frykman sınıflamalarının değerlendiriciler arası güvenilirlik ve değerlendirici içi tekrar edilebilirlik özelliklerini değerlendirmekti. Çalışma planı: El bileğinde yer değiştirmiş kırığı olan 50 hastanın standart posteroanterior ve lateral grafileri 2 grup değerlendirici tarafından 2 ay zaman aralığıyla ikişer kez değerlendirildi. Birinci grup en az 5 yıllık tecrübeye sahip 10 ortopedi cerrahından, ikinci grup ise uzmanlık eğitiminin ilk 2 yılı içerisinde olan 10 ortopedi asistanından oluşmaktaydı. Değerlendiricilerin kendi içindeki ve değerlendiriciler arasındaki uyumu Cohen’in kappa testi ile değerlendirildi. Bulgular: Güvenilirlik açısından hiçbir sınıflama sistemi iyi – çok iyi seviyesine ulaşamadı. Fernandez sınıflamasında orta diğer sınıflamalarda ise düşük düzeyde değerlendiriciler arası uyum mevcuttu. Frykman ve Fernandez sınıflamalarında diğerlerine göre daha iyi sonuçlar alınmış olsa da, tüm sınıflamaların tekrar edilebilirliği düşük seviyede kaldı. Çıkarımlar: AO, Frykman, Fernandez ve Universal sınıflama sistemlerinin güvenilirlik ve tekrar edilebilirlik özellikleri açısından birbirlerine belirgin üstünlükleri yoktur. Dört sınıflamanın da güvenilirlik ve tekrar edilebilirlik oranları yetersizdir.

Keywords

• Fernandez; Frykman; radius kırıkları; sınıflama; Universal.

Reliability and reproducibility of classifications for distal radius fractures

Abstract

Objective: The aim of this study was to evaluate the interobserver reliability and intraobserver reproducibility of the Universal, AO, Fernandez and Frykman classifications for distal radius fractures.
Methods: Fifty standard sets of posteroanterior and lateral roentgenograms of displaced distal radius fractures were classified two times by two groups of evaluators at 2-month intervals. The first group consisted of 10 orthopedic surgeons with a minimum of 5 years of experience. The second group consisted of 10 orthopedic residents in their first two years of practice. Interobserver reliability and intraobserver reproducibility were assessed using Cohen’s kappa test.
Results: None of the classifications achieved good – very good reliability levels. The Fernandez classification had a moderate and the others had a fair interobserver agreement kappa coefficient. All classifications had fair kappa intraobserver agreement although the Frykman and Fernandez classifications had better results.
Conclusion: None of the classification systems were superior in terms of reliability and reproducibility. The reliability and reproducibility rates of all four classifications were insufficient.

Keywords

• Agreement
• classification
• Fernandez
• Frykman
• radius fractures
• Universal

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