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Interbeoordelaarsbetrouwbaarheid van de Schatzker- en de three-columnclassificatie bij tibiaplateaufracturen

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Nederlands Tijdschrift voor Traumachirurgie

Samenvatting

Ongeveer 1% van alle fracturen zijn tibiaplateaufracturen. Met de recent geïntroduceerde three-columnclassificatie zouden posterieure tibiaplateaufracturen geclassificeerd kunnen worden, waarin de Schatzker-classificatie niet voorziet. De betrouwbaarheid van de nieuwe classificatiemethode is echter nog niet vastgesteld. Het doel van deze literatuurstudie was de interbeoordelaarsbetrouwbaarheid te evalueren van de three-columnclassificatie bij tibiaplateaufracturen, waarbij de Schatzkerclassificatie als referentie wordt gebruikt. De online databases PubMed, Embase en de Cochrane Library zijn doorzocht met vooraf vastgestelde zoektermen, waarop 28 artikelen zijn gevonden. Hiervan bleven 13 artikelen over na het verwijderen van dubbele artikelen. Twee artikelen voldeden aan de inclusiecriteria. De threecolumnclassificatie heeft een hogere interbeoordelaarsbetrouwbaarheid (goed; 95%-BI = 0,718-0,766) dan de Schatzker-classificatie (gem.; 95%-BI = 0,536-0,567). Over de intrabeoordelaarsbetrouwbaarheid kan nog geen uitspraak worden gedaan.

De conclusie is dat de three-columnclassificatie een hogere interbeoordelaarsbetrouwbaarheid heeft dan de Schatzker-classificatie, waardoor deze gemakkelijker te reproduceren is. Tevens is de three-columnclassificatie in staat om posterieure tibiaplateaufracturen te identificeren. Dit maakt deze classificatiemethode geschikt voor implementatie in de praktijk.

Abstract

Approximately 1% of all fractures are tibial plateau fractures. The recently introduced three-column classification seems to have the advantage to classify posterior fractures of the tibial plateau, whereas the Schatzker classification can not. However, the reliability of this new classification method has not yet been determined. The aim of this literature study is to evaluate the interobserverreliabilty of the three-column classification for tibia plateau fractures, using the Schatzker classification as a reference test. A systematic search in the online databases PubMed, Embase and the Cochrane Library resulted in 28 articles. After removal of duplicates, 13 articles remained. Two articles met the inclusion criteria. The three-column classification showed a higher interobserver reliability (subst.; 95%-CI = 0.718-0.766) compared to the Schatzker classification (mod.; 95%- CI = 0.536-0.567). There are no data available on the intra-observer reliability. In conclusion, the three-column classification has a higher interobserver reliability and is therefore more easily to reproduce. The three-column classification is able to identify posterior tibia plateau fractures. This makes this classification method suitable for implementation in clinical practice.

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Authors and Affiliations

  1. Universiteit Utrecht, Utrecht, The Netherlands

    J.K. de Witt

  2. afdeling Traumachirurgie, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands

    T.J. Blokhuis

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  1. J.K. de Witt
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  2. T.J. Blokhuis
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1 geneeskundestudent, Universiteit Utrecht

2 traumachirurg, afdeling Traumachirurgie, Universitair Medisch Centrum Utrecht

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de Witt, J., Blokhuis, T. Interbeoordelaarsbetrouwbaarheid van de Schatzker- en de three-columnclassificatie bij tibiaplateaufracturen. Ned Tijdschr Traumachir 24, 2–7 (2016). https://doi.org/10.1007/s12506-016-0023-7

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  • DOI: https://doi.org/10.1007/s12506-016-0023-7

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