[1]张峻,赵建民,姚晓克,等.增加CT对桡骨远端骨折分型的可靠性及可重复性评价[J].中华老年骨科与康复电子杂志,2024,(05):264-272.[doi:10.3877/cma.j.issn.2096-0263.2024.05.002]
　Zhang Jun,Zhao Jianmin,Yao Xiaoke,et al.Evaluation of the reliability and repeatability of the classification system of distal radius fractures and the effect of increasing CT on the evaluation results[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2024,(05):264-272.[doi:10.3877/cma.j.issn.2096-0263.2024.05.002]
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增加CT对桡骨远端骨折分型的可靠性及可重复性评价()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2024年05期
页码:
264-272
栏目:
上肢骨折
出版日期:
2024-10-05

文章信息/Info

Title:
Evaluation of the reliability and repeatability of the classification system of distal radius fractures and the effect of increasing CT on the evaluation results
作者:
张峻1; 2; 赵建民1; 姚晓克3; 吉浩宇1; 越瑞祥4
010000 呼和浩特，内蒙古医科大学附属医院骨科1；100853 北京，解放军总医院第一医学中心骨科2；610000 成都，成都市第一人民医院骨科3；012000 集宁，乌兰察布市中心医院普通外科4
Author(s):
Zhang Jun1; 2;  Zhao Jianmin1;  Yao Xiaoke3;  Ji Haoyu1;  Yue Ruixiang4
1Department of Orthopaedics,the affiliated hospital of Innermongolia medical university, Hohhot 010000, China; 2Department of Orthopaedics, the First Medical Center of the General Hospital of the People’s Liberation Army, Beijing 100853, China; 3Department of Orthopedics, Chengdu First People’s Hospital, Chengdu 610000, China; 4Department of General Surgery, Wu Lan Cha Bu Central Hospital, Jining 012000, China
关键词:
桡骨远端骨折;  骨折;  分型
Keywords:
Distal radius fractures;  Fracture;  Classification
DOI:
10.3877/cma.j.issn.2096-0263.2024.05.002
文献标志码:
A
摘要:
目的 对桡骨远端骨折的主要分型系统进行一致性检验，为临床医生选择分型系统提供重要指导。方法 2014年1月1日至2018年6月31日，回顾性研究我院220例桡骨远端骨折患者。三名观察者随机选择并评估了50例患者在T1、T2、T3和T4四个不同时间节点的AO/OTA、Frykman、Fernández和Universal分型的放射学数据。时间节点T1和T2用于基于DR确定每个观察者的观察者内重复性。时间节点T3和T4用于基于DR和CT+2D确定每个观察者的观察者间重复性。Cohen’s kappa用于计算一致性。结果 基于DR和DR+CT的观察者间信度Kappa值：AO/OTA分型0.14 vs. 0.32；AO/OTA分组0.18 vs. 0.35；Frykman 0.34 vs. 0.29；Fernández 0.31vs.0.22；Universal 0.27 vs. 0.30。观察者内重复性Kappa值：AO/OTA分型0.47 vs. 0.67；AO/OTA分组0.48 vs. 0.67；Frykman 0.70 vs. 0.66；Fernández 0.59 vs. 0.58；Universal 0.60 vs. 0.59。结论 CT+2D检查的增加可能不会改善Frykman分型、Fernández分型和Universal分型的观察者一致性结果。AO/OTA分型和AO/OTA分组的观察者一致性结果可以得到改善。
Abstract:
Objective Consistency testing is performed on the main classification system of distal radius fractures, which provides an important guidance for clinicians to choose the classification system. Methods A retrospective study was performed. From January 1, 2014 to June 31, 2018, 220 patients with distal radius fractures were included in our hospital. Three observers randomly selected and evaluated the radiography data of 50 cases by AO/OTA, Frykman, Fernández and Universal at four different time nodes of T1, T2, T3 and T4. Time nodes T1 and T2 were used to determine the intra-observer repeatability of each observer based on DR. Time nodes T3 and T4 were used to determine the intra-observer repeatability of each observer based on DR and CT+2D. Cohen’s kappa was used to calculate consistency. Results Inter-observer reliability Kappa values based on DR and DR+CT: AO/OTA classification 0.14 vs. 0.32; AO/OTA grouping 0.18 vs. 0.35; Frykman 0.34 vs. 0.29; Fernández 0.31 vs. 0.22; Universal 0.27 vs. 0.30. The intra-observer repeatability Kappa value: AO/OTA typing 0.47 vs. 0.67; AO/OTA grouping 0.48 vs. 0.67; Frykman 0.70 vs. 0.66; Fernández 0.59 vs. 0.58; Universal 0.60 vs. 0.59. Conclusion The increase of CT+2D examination may not improve the observer consistency results of Frykman classification, Fernández classification, and Universal classification. The observer consistency results of AO/OTA classification and AO/OTA grouping can be improved. Based on previous study and our research, there is currently no gold standard for the classification of distal radius fractures or the recommended classification.

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备注/Memo

备注/Memo:
基金项目：内蒙古自治区高等学校科学研究项目重点项目（NJZZ21034）；内蒙古自治区卫生健康委医疗卫生科技计划项目（20210601）；四川省卫生健康委员会医学科技项目（21PJ138）
更新日期/Last Update: 2024-10-12