Intra- and interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures

Colombia Médica

Carlos Oliver Valderrama-Molina⁴  Jorge Andres Hincapie¹  Mauricio Estrada-Castrillón²  Luz Helena Lugo-Agudelo³ 

[1] Universidad de Antioquia;Hospital Pablo Tobón Uribe;Universidad de Antioquia;Hospital Pablo Tobón UribeUniversidad de Antioquia

关键词: Soft tissue injuries;    classification;    tibial fractures;    Reliability;   

DOI  :  

学科分类：医学（综合）

来源: Universidad del Valle * Facultad de Salud / Universidad del Valle, Faculty of Health

【 摘 要 】

Background:The soft tissues injury in periarticular fractures of the lower extremities determines the proper time to perform bone fixation.Objetive:The aim of this study was to determine the intra and interobserver agreement in the Tscherne classification.Methods:This is a descriptive, prospective study for patients admitted to the Pablo Tobón Uribe Hospital (PTUH) with tibial plateau or tibial pilon fractures. We performed a standardize evaluation using video photography at the time of admission and 24, 48, and 72 h after admission. Fifteen five reviewers who had various levels of training produced a total of 1,200 observations. The intra- and interobserver agreement was assessed using a weighted kappa for multiple raters and more than two categories.Results:Twenty patients were admitted with tibial plateau and tibial pilon fractures. The intraobserver agreement for all 15 raters was kappa 0.81 (95% CI 0.79-0.83), and the interobserver agreement for all 15 raters was kappa 0.65 (95% CI 0.55-0.73). The interobserver agreement at 24 h was kappa 0.67 (95% CI 0.46-0.86).Conclusions: Classifying the severity of soft tissue injury is critical in planning the surgical management of fractures of the lower extremities. Based on our results, we can reasonably argue that the Tscherne classification produced an adequate level of agreement and could be used to standardize and to guide the treatment, and to conduct research studies. Level of Evidence:Level IV, Case Series

【 授权许可】

Unknown