Traction-Internal Rotation Radiograph Can Improve Agreement in AO/OTA Classification System for Intertrochanteric Fracture,Indian Journal of Orthopaedics

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Traction-Internal Rotation Radiograph Can Improve Agreement in AO/OTA Classification System for Intertrochanteric Fracture
Indian Journal of Orthopaedics ( IF 1.1 ) Pub Date : 2022-08-23 , DOI: 10.1007/s43465-022-00722-4
Chittawee Jiamton _{1,

2} , Prapinporn Sayan ₁ , Pongsakorn Rungchamrussopa _{1,

2} , Piyabuth Kittithamvongs _{1,

2}

Affiliation

Purpose

The objective of our study was to evaluate the inter- and intra-observer reliability of the standard anteroposterior of both hips, traction-internal rotation, and the combination of the two radiographs for intertrochanteric fracture.

Methods

In one hundred cases, three sets of radiographs of intertrochanteric fracture were prepared. Two senior and two junior orthopedic trauma surgeons were asked to classify the radiograph according to AO/OTA classification. The standard both hips radiograph, traction-internal rotation radiograph and combination of both techniques were evaluated. All radiographs were evaluated at two different points in time for all observers. The inter- and intra-observer reliability were analyzed with the Kappa agreement index.

Results

Inter-observer agreement for standard radiographs was “substantial” in one while “moderate” in five among observers. After adding the traction radiograph to the standard radiograph, the agreement was improved to “substantial” in 4 while the rest was “moderate.”

Intra-observer agreement for standard radiographs was “substantial” in two observers and “moderate” in two observers. Adding traction to standard radiographs resulted in “substantial” in three observers and “moderate” in one observer.

Overall pattern stability was changed in 19% after adding the traction film. Thirty-four percent of the fracture which initially diagnosed as A2.1 was changed from stable to unstable fracture patterns after adding the traction film.

Conclusions

Adding traction-internal rotation radiograph to the standard radiograph is a useful method for improving agreement to classify intertrochanteric fracture regarding AO/OTA classification. This may be helpful in determining fracture classification.

中文翻译：

牵引内旋X光片可以提高股骨粗隆间骨折AO/OTA分类系统的一致性

目的

我们研究的目的是评估双髋标准前后位、牵引内旋以及两张 X 线照片组合治疗转子间骨折的观察者间和观察者内的可靠性。

方法

100例，制作3组股骨粗隆间骨折X线片。两名高级骨科创伤外科医生和两名初级骨科创伤外科医生被要求根据 AO/OTA 分类对射线照片进行分类。对标准双髋 X 光片、牵引内旋 X 光片以及两种技术的组合进行了评估。所有观察者在两个不同的时间点对所有射线照片进行评估。用Kappa一致性指数分析观察者间和观察者内的可靠性。