Reproducibility of the stability-based classification for ankle fractures
- 51 Downloads
Classification of ankle fracture is important when deciding for operative or conservative treatment. This study rates the reproducibility of ankle stability assessment and compares it with the classification by Lauge-Hansen and Arbeitsgemeinschaft für Osteosyntesefragen (AO) in adult patients with primary ankle fractures.
A total of 496 consecutive ankle fractures were included, and the X-ray images were reviewed 2 times by 2 medical students, 2 residents, and 1 consultant in orthopedic traumatology. The raters were blinded to each other and to their own results. Unweighted Kappa statistics were used to assess reproducibility.
Overall mean (95% CI) interrater Kappa results were 0.65 (0.64; 0.68) for Lauge-Hansen, 0.62 (0.60; 0.63) for AO and 0.61 (0.57; 0.62) for the stability assessment. The intrarater results ranged from a mean Kappa of 0.64–0.80 for the medical students, 0.65–0.81 for the residents and 0.82–0.84 for the consultant.
The stability assessment has substantial to almost-perfect agreement which is comparable to the Lauge-Hansen and AO classifications.
KeywordsReproducibility Stability Ankle fracture Classification
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 9.Alexandropoulos C, Tsourvakas S, Papachristos J, Tselios A, Soukouli P (2010) Ankle fracture classification: an evaluation of three classification systems: Lauge-Hansen, A.O. and Broos-Bisschop. Acta Orthop Belg 76(4):521Google Scholar
- 14.EpiData Association. Available at: http://www.epidata.dk/. Accessed 1 Jan 2010
- 15.Sim J, Wright CC (2005) The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 85(3):257Google Scholar