Is surgeons' experience important on intra- and inter-observer reliability of classifications used for adult femoral neck fracture?

Abstract

Purpose: To evaluate whether surgeons' experience affect inter- and intra-observer reliability among mostly used classification systems for femoral neck fractures.
Material and Methods: A power point presentation was prepared with 107 slides which were antero-posterior radiographs of each femoral neck fracture. 5 residents, 5 orthopaedic surgeons and 5 senior orthopaedic surgeons reviewed this presentation and classified the fractures according to Garden, Pauwels and AO classifications. The order of the slides were changed and reviews were repeated after 3 months. Fleiss kappa and intraclass correlation coefficient values were calculated to evaluate inter and intra-observer reliability.
Results: Garden and AO classifications' inter-observer reliabilities were similar and higher than Pauwels classification. Among three experience groups, the inter-observer reliability for Garden classification was highest in senior surgeon group, the inter-observer reliability for AO classification was highest in surgeon group, and inter-observer reliability of Pauwels classification was highest in low experienced groups (residents and surgeons).  Intra-observer reliability was highest for Garden and lowest for Pauwels classifications. Surgical experience was found to be not effective for intra-observer reliability.
Conclusion: Both Garden and AO classifications were more reliable than Pauwels classification. Surgical experience was not significantly important on these three classification systems' evaluation.

 

DOI: 10.3944/AOTT.2015.15.0234
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

Keywords

• Femoral neck fracture;classifications;reliability;experience.