Documentation of fracture severity with the AO classification of pediatric long-bone fractures.

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State: Public
Version: Final published version
Serval ID
serval:BIB_33388364BDE5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Documentation of fracture severity with the AO classification of pediatric long-bone fractures.
Journal
Acta Orthopaedica
Author(s)
Slongo T., Audigé L., Lutz N., Frick S., Schmittenbecher P., Hunter J., Clavert J.M.
ISSN
1745-3674 (Print)
ISSN-L
1745-3674
Publication state
Published
Issued date
04/2007
Peer-reviewed
Oui
Volume
78
Number
2
Pages
247-253
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND: The AO comprehensive pediatric longbone fracture classification system describes the localization and morphology of fractures, and considers severity in 3 categories: (1) simple, (2) wedge, and (3) complex. We evaluated the reliability and accuracy of surgeons in using this rating system.
MATERIAL AND METHODS: In a first validation phase, 5 experienced pediatric (orthopedic) surgeons reviewed radiographs of 267 prospectively collected pediatric fractures (agreement study A). In a second study (B), 70 surgeons of various levels of experience in 15 clinics classified 275 fractures via internet. Simple fractures comprised about 90%, 99% and 100% of diaphyseal (D), metaphyseal (M), and epiphyseal (E) fractures, respectively.
RESULTS: Kappa coefficients for severity coding in D fractures were 0.82 and 0.51 in studies A and B, respectively. The median accuracy of surgeons in classifying simple fractures was above 97% in both studies but was lower, 85% (46-100), for wedge or complex D fractures.
INTERPRETATION: While reliability and accuracy estimates were satisfactory as a whole, the ratings of some individual surgeons were inadequate. Our findings suggest that the classification of fracture severity in children should be done in only two categories that distinguish between simple and wedge/complex fractures.
Keywords
Child, Documentation, Fractures, Bone/classification, Fractures, Bone/radiography, Humans, Humeral Fractures/classification, Humeral Fractures/radiography, Injury Severity Score, Predictive Value of Tests, Prospective Studies, Sensitivity and Specificity, Tibial Fractures/classification, Tibial Fractures/radiography
Pubmed
Web of science
Open Access
Yes
Create date
20/01/2013 15:15
Last modification date
20/08/2019 13:19
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