TROCHANTERIC FRACTURES: ARE THE CLASSIFICATIONS RELIABLE?

FRATURAS TROCANTÉRICAS: AS CLASSIFICAÇÕES SÃO CONFIÁVEIS?

ABSTRACT

Objective:  To evaluate classification use based on the assessment of agreement in trochanteric fractures between different observers through a simple proposal of bimodal classification.

Methodology:  A total of 50 radiographic images of femur trochanteric fractures were selected and classified by 22 evaluators, 10 traumatologists and 12 residents, as STABLE or UNSTABLE. The assessment of reproducibility was done using the kappa statistical index. After the evaluation, the groups were isolated and submitted to the ANOVA test with Bonferroni correction to evaluate the statistical differences between them.

Results:  When evaluated by the kappa index, the results of the 50 fractures assessed by the 22 evaluators were k = 0.272. The reproducibility of the classification proposal was considered statistically weak.

Conclusion:  Based on this study, it is recommended that the classifications be extensively tested and reach a minimum level of interobserver reproducibility (kappa > 0.8). It is suggested that classifications that do not achieve this result be improved or abandoned.Level of evidence II, Prospective study.

Keywords:
Trochanteric fracture; Classification; Reliability; Interobserver agreement