BACKGROUND AND PURPOSE Classification of fractures can be valuable for research purposes but also in clinical work. Especially with are fractures, such as distal ulna fractures, a treatment algorithm based on a classification can be helpful. We compared 3 different classification systems of distal ulna fractures and investigated their reliability and reproducibility. PATIENTS AND METHODS patients with 97 fractures of the distal ulna, excluding the ulnar styloid, were included. All fractures were independently classified by 3 observers according to the classification by Biyani, AO/OTA 2007, and AO/OTA 2018. The classification process was repeated after a minimum of 3 weeks. We used Kappa value analysis to determine inter- and intra-rater agreement. RESULTS The inter-rater agreement of the AO/OTA 2007 classification was judged as fair, ĸ 0.40, whereas the agreement of AO/OTA 2018 and Biyani was moderate at ĸ 0.42 and 0.43 respectively. The intra-rater agreement was judged as moderate for all classifications. INTERPRETATION The differences between the classifications were small and the overall impression was that neither of them was good enough to be of substantial clinical value. The Biyani classification, being developed specifically for distal ulna fractures, was the easiest and most fitting for the fracture patterns seen in our material, but lacking options for fractures of the distal diaphysis. Standard radiographs were considered insufficient for an accurate classification. A better radiographic method combined with a revised classification might improve accuracy, reliability, and reproducibility.

中文翻译：

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3 种不同的尺骨远端骨折影像学分类系统的可靠性和可重复性差。

背景和目的 骨折分类对于研究目的和临床工作都很有价值。特别是对于骨折，例如远端尺骨骨折，基于分类的治疗算法可能会有所帮助。我们比较了 3 种不同的尺骨远端骨折分类系统，并研究了它们的可靠性和可重复性。患者和方法 纳入了 97 例尺骨远端骨折（不包括尺骨茎突）的患者。根据 Biyani、AO/OTA 2007 和 AO/OTA 2018 的分类，所有骨折由 3 名观察员独立分类。至少 3 周后重复分类过程。我们使用 Kappa 值分析来确定评估者间和评估者内的一致性。结果 AO/OTA 2007 分类的评分者间协议被判定为公平，±0.40，而 AO/OTA 2018 和 Biyani 的协议适中，分别为 0.42 和 0.43。对于所有分类，评定者内部一致性被判定为中等。解释 分类之间的差异很小，总体印象是它们都不够好，没有实质性的临床价值。专门针对尺骨远端骨折开发的 Biyani 分类是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。分别为 43 个。对于所有分类，评定者内部一致性被判定为中等。解释 分类之间的差异很小，总体印象是它们都不够好，没有实质性的临床价值。专门针对尺骨远端骨折开发的 Biyani 分类是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。分别为 43 个。对于所有分类，评定者内部一致性被判定为中等。解释 分类之间的差异很小，总体印象是它们都不够好，没有实质性的临床价值。专门针对尺骨远端骨折开发的 Biyani 分类是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。解释 分类之间的差异很小，总体印象是它们都不够好，没有实质性的临床价值。专门针对尺骨远端骨折开发的 Biyani 分类是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。解释 分类之间的差异很小，总体印象是它们都不够好，没有实质性的临床价值。专门针对尺骨远端骨折开发的 Biyani 分类是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。是我们材料中看到的最简单和最适合的骨折模式，但缺乏远端骨干骨折的选择。标准射线照片被认为不足以进行准确分类。更好的射线照相方法与修订后的分类相结合可能会提高准确性、可靠性和可重复性。