Ten-Segment Classification has Lowest Inter/IntraObserver Reliability as Compared to Schatzker, ThreeColumn and AO Systems for Tibial Plateau Fractures: A Comparison Based on Surgeons' Experience

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Gahlot Nitesh; Kunal Kishor; Elhence Abhay; Meena Umesh; Gupta Akshat; Netaji Jeshwanth; Swami Dharampal; Goyal Meghal; JAMAL ASHRAF

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Journal: Archives of Bone and Joint Surgery Year:2023 | Volume:11 | Issue:4 Page(s): 256-261

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Title

Ten-Segment Classification has Lowest Inter/IntraObserver Reliability as Compared to Schatzker, ThreeColumn and AO Systems for Tibial Plateau Fractures: A Comparison Based on Surgeons' Experience

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Keywords

Clinical competence

Computer-assisted

Image processing

Observer variation

Tomography

X-Ray computed

Abstract

Objectives: The primary aim of this study was to assess the reliability of the ten-segment classification system proposed (TSC) by Krause et al. and see how it compares with the traditionally used Schatzker classification, AO classification system, and Luo ’, s “, Three columns”,classification (ThCC) system. The second aim of this study was to assess the inter-observer reliability of the above classifications based on professional experience by comparing the entry level of residents (1 year into postgraduation), senior residents (1 year after postgraduation completion), and faculty (>10 years after postgraduation completion). Methods: 50 TPFs were classified by a 10-segment classification system, and its intra-observer (at 1-month interval) and inter-observer reproducibility was checked using k values by three different groups with varying levels of experience (Group I, II, and III comprised of 2 juniors residents, senior residents and consultants each), and the same was compared for three other common classification systems (Schatzker, AO and 3 –, column). Results: 10-segment classification showed least k for both inter-observer (0. 08) and intra-observer (0. 03) reliability. Highest individual inter-observer (k= 0. 52) and intra-observer reliability (k= 0. 31) was for Schatzker classification in Group I. Lowest individual inter-observer and intra-observer reliability was seen for 10-segment classification (k= 0. 07) and AO classification system (k=-0. 03) respectively. Conclusion: 10-segment classification showed the lowest k for both inter-observer and intra-observer reliability. The inter-observer reliability for the Schatzker, AO, and 3-column classifications reduced with increasing experience of the observer (JR>SR>Consultant). A possible reason could be a more critical evaluation of the fractures with increasing seniority.

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APA: Copy

Gahlot, Nitesh, Kunal, Kishor, Elhence, Abhay, Meena, Umesh, Gupta, Akshat, Netaji, Jeshwanth, Swami, Dharampal, Goyal, Meghal, & JAMAL, ASHRAF. (2023). Ten-Segment Classification has Lowest Inter/IntraObserver Reliability as Compared to Schatzker, ThreeColumn and AO Systems for Tibial Plateau Fractures: A Comparison Based on Surgeons' Experience. THE ARCHIVES OF BONE AND JOINT SURGERY, 11(4), 256-261. SID. https://sid.ir/paper/1085390/en

Vancouver: Copy

Gahlot Nitesh, Kunal Kishor, Elhence Abhay, Meena Umesh, Gupta Akshat, Netaji Jeshwanth, Swami Dharampal, Goyal Meghal, JAMAL ASHRAF. Ten-Segment Classification has Lowest Inter/IntraObserver Reliability as Compared to Schatzker, ThreeColumn and AO Systems for Tibial Plateau Fractures: A Comparison Based on Surgeons' Experience. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2023;11(4):256-261. Available from: https://sid.ir/paper/1085390/en

IEEE: Copy

Nitesh Gahlot, Kishor Kunal, Abhay Elhence, Umesh Meena, Akshat Gupta, Jeshwanth Netaji, Dharampal Swami, Meghal Goyal, and ASHRAF JAMAL, “Ten-Segment Classification has Lowest Inter/IntraObserver Reliability as Compared to Schatzker, ThreeColumn and AO Systems for Tibial Plateau Fractures: A Comparison Based on Surgeons' Experience,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 11, no. 4, pp. 256–261, 2023, [Online]. Available: https://sid.ir/paper/1085390/en

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