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The intra- and interobserver reliability of the Tile AO, the Young and Burgess, and FFP classifications in pelvic trauma

  • Josephine Berger-GrochEmail author
  • Darius M. Thiesen
  • Lars G. Grossterlinden
  • Jan Schaewel
  • Florian Fensky
  • Maximilian J. Hartel
Trauma Surgery
  • 19 Downloads

Abstract

Introduction

Several different systems of classification have been developed to understand the complexity of pelvic ring fractures, to facilitate communication between physicians and to support the selection of appropriate therapeutic measures. The purpose of this study was to measure the inter- and intraobserver reliability of Tile AO, Young and Burgess, and FFP classification in pelvic ring fractures. The Rommens classification system (FFP) is analyzed for the first time.

Materials and methods

Four reviewers (2 × senior pelvic trauma surgeon, 1 × resident, 1 × medical student) separately analyzed and classified 154 CT scans of patients with pelvic fracture. The Tile AO, the Young and Burgess, and the FFP classifications (subgroup with patients ≥ 60 years) were compared. Another blinded re-evaluation was carried out after 2 months to determine intraobserver reliability.

Results

The overall interobserver agreement was fair for all classification systems (ICC: OTA 0.55, Young and Burgess 0.42, FFP 0.54). For specific categories, (e.g. type B or C fractures), there was a substantial agreement between the experienced surgeons (kappa: OTA 0.64, Young and Burgess 0.62, FFP 0.68). For inexperienced observers, there was a fair agreement in all systems (kappa: OTA 0.23, Young and Burgess 0.23, FFP 0.36).

Conclusions

All three classifications reach their maximum reliability with advanced expertise in the surgery of pelvic fractures. The novel FFP classification has proved to be at least equivalent when directly compared to the established systems. The FFP classification system showed substantial reliability in patients older than 60 years.

Keywords

Pelvic trauma Classification Interobserver reliability FFP OTA Young and Burgees 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures involving human participants were in accordance with the ethical standards of the institutional and national research committee (reference number: WF-009/18) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

402_2019_3123_MOESM1_ESM.pdf (612 kb)
Supplementary material 1 (PDF 611 KB)
402_2019_3123_MOESM2_ESM.xlsx (19 kb)
Supplementary material 2 (XLSX 18 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Trauma-, Hand-, and Reconstructive SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Orthopedics, Trauma-and Spine SurgeryAsklepios Hospital Hamburg-AltonaHamburgGermany

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