Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging

Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging

Mostrar otras versiones (1)

<h4>Background</h4> The objective of this study was to investigate inter- and intraobserver reliability of the morphological Mutch classification for greater tuberosity (GT) fragments in consecutive proximal humerus fractures (PHF) regardless of the number of parts according to the Codma...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Sam Razaeian, Said Askittou, Birgitt Wiese, Dafang Zhang, Afif Harb, Christian Krettek, Nael Hawi
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
Materias:
Medicine
R
Science
Q
Acceso en línea:https://doaj.org/article/f284f4ea3f9347c5a91fd1af5422eaed
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:f284f4ea3f9347c5a91fd1af5422eaed
record_format dspace
spelling oai:doaj.org-article:f284f4ea3f9347c5a91fd1af5422eaed2021-11-18T08:14:33ZInter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging1932-6203https://doaj.org/article/f284f4ea3f9347c5a91fd1af5422eaed2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584785/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> The objective of this study was to investigate inter- and intraobserver reliability of the morphological Mutch classification for greater tuberosity (GT) fragments in consecutive proximal humerus fractures (PHF) regardless of the number of parts according to the Codman classification system for three different imaging modalities (plain radiographs, two-dimensional [2-D] computed tomography [CT], and reformatted, three-dimensional [3-D] CT reconstruction). <h4>Materials and methods</h4> One hundred thirty-eight consecutive PHF with GT involvement were identified between January 2018 and December 2018 in a supraregional Level 1 trauma center. GT morphology was classified by three blinded observers according to the morphological Mutch classification using the picture archiving and communication software Visage 7.1 (Visage Imaging Inc., San Diego, CA, USA). Fleiss’ and Cohens’ kappa were assessed for inter- and intraobserver reliability. Strength of agreement for kappa (k) values was interpreted according to the Landis and Koch benchmark scale. <h4>Results</h4> In cases of isolated GT fractures (n = 24), the morphological Mutch classification achieved consistently substantial values for interobserver reliability (radiograph: k = 0.63; 2-D CT: k = 0.75; 3-D CT: k = 0.77). Moreover, use of advanced imaging (2-D and 3-D CT) tends to increase reliability. Consistently substantial mean values were found for intraobserver agreement (radiograph: Ø k = 0.72; 2-D CT: Ø k = 0.8; 3-D CT: Ø k = 0.76). In cases of multi-part PHF with GT involvement (n = 114), interobserver agreement was only slight to fair regardless of imaging modality (radiograph: k = 0.3; 2-D CT: k = 0.17; 3-D CT: k = 0.05). Intraobserver agreement achieved fair to moderate mean values (radiograph: Ø k = 0.56; 2-D CT: Ø k = 0.61; 3-D CT: Ø k = 0.33). <h4>Conclusion</h4> The morphological Mutch classification remains a reliable classification for isolated GT fractures, even with 2-D or 3-D CT imaging. Usage of these advanced imaging modalities tends to increase interobserver reliability. However, its reliability for multi-part fractures with GT involvement is limited. A simple and reliable classification is missing for this fracture entity.Sam RazaeianSaid AskittouBirgitt WieseDafang ZhangAfif HarbChristian KrettekNael HawiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Sam Razaeian
Said Askittou
Birgitt Wiese
Dafang Zhang
Afif Harb
Christian Krettek
Nael Hawi
Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging
description <h4>Background</h4> The objective of this study was to investigate inter- and intraobserver reliability of the morphological Mutch classification for greater tuberosity (GT) fragments in consecutive proximal humerus fractures (PHF) regardless of the number of parts according to the Codman classification system for three different imaging modalities (plain radiographs, two-dimensional [2-D] computed tomography [CT], and reformatted, three-dimensional [3-D] CT reconstruction). <h4>Materials and methods</h4> One hundred thirty-eight consecutive PHF with GT involvement were identified between January 2018 and December 2018 in a supraregional Level 1 trauma center. GT morphology was classified by three blinded observers according to the morphological Mutch classification using the picture archiving and communication software Visage 7.1 (Visage Imaging Inc., San Diego, CA, USA). Fleiss’ and Cohens’ kappa were assessed for inter- and intraobserver reliability. Strength of agreement for kappa (k) values was interpreted according to the Landis and Koch benchmark scale. <h4>Results</h4> In cases of isolated GT fractures (n = 24), the morphological Mutch classification achieved consistently substantial values for interobserver reliability (radiograph: k = 0.63; 2-D CT: k = 0.75; 3-D CT: k = 0.77). Moreover, use of advanced imaging (2-D and 3-D CT) tends to increase reliability. Consistently substantial mean values were found for intraobserver agreement (radiograph: Ø k = 0.72; 2-D CT: Ø k = 0.8; 3-D CT: Ø k = 0.76). In cases of multi-part PHF with GT involvement (n = 114), interobserver agreement was only slight to fair regardless of imaging modality (radiograph: k = 0.3; 2-D CT: k = 0.17; 3-D CT: k = 0.05). Intraobserver agreement achieved fair to moderate mean values (radiograph: Ø k = 0.56; 2-D CT: Ø k = 0.61; 3-D CT: Ø k = 0.33). <h4>Conclusion</h4> The morphological Mutch classification remains a reliable classification for isolated GT fractures, even with 2-D or 3-D CT imaging. Usage of these advanced imaging modalities tends to increase interobserver reliability. However, its reliability for multi-part fractures with GT involvement is limited. A simple and reliable classification is missing for this fracture entity.
format article
author Sam Razaeian
Said Askittou
Birgitt Wiese
Dafang Zhang
Afif Harb
Christian Krettek
Nael Hawi
author_facet Sam Razaeian
Said Askittou
Birgitt Wiese
Dafang Zhang
Afif Harb
Christian Krettek
Nael Hawi
author_sort Sam Razaeian
title Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging
title_short Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging
title_full Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging
title_fullStr Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging
title_full_unstemmed Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging
title_sort inter- and intraobserver reliability of morphological mutch classification for greater tuberosity fractures of the proximal humerus: a comparison of x-ray, two-, and three-dimensional ct imaging
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/f284f4ea3f9347c5a91fd1af5422eaed
work_keys_str_mv AT samrazaeian interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
AT saidaskittou interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
AT birgittwiese interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
AT dafangzhang interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
AT afifharb interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
AT christiankrettek interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
AT naelhawi interandintraobserverreliabilityofmorphologicalmutchclassificationforgreatertuberosityfracturesoftheproximalhumerusacomparisonofxraytwoandthreedimensionalctimaging
_version_ 1718422020717281280

Ejemplares similares