INTEROBSERVER RELIABILITY IN THE GUSTILO AND ANDERSON CLASSIFICATION OF OPEN FRACTURES

被引：109

作者：

HORN, BD

RETTIG, ME

机构：

[1] Department of Orthopaedic Surgery, Bellevue Hospital Center, New York, NY

[2] Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA

[3] Department of Orthopaedic Surgery, Hennepin County Medical Center, Minneapolis, MN

来源：

JOURNAL OF ORTHOPAEDIC TRAUMA | 1993年 / 7卷 / 04期

关键词：

OPEN FRACTURES; INTEROBSERVER RELIABILITY; KAPPA STATISTIC;

D O I：

10.1097/00005131-199308000-00012

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

The Gustilo and Anderson classification system is widely used to categorize open fractures. To assess its interobserver reliability, 10 patients with open fractures had photographic slides taken of their wound before and after operative treatment. These slides were then shown to a group of orthopaedic surgeons. After an explanation of the Gustilo and Anderson classification system and each patient's pertinent history and physical examination, the physicians were asked to classify the fracture. Agreement among the various raters was determined by Kappa analysis, which is the preferred measurement of interobserver reliability for nominal data such as classification schemes. Kappa analysis demonstrated only moderate agreement among the observers classifying open fractures using the Gustilo and Anderson system. This seems to indicate that, although useful, the Gustilo and Anderson open fracture classification system does have limitations; studies and treatment recommendations based on it should be interpreted with caution.

引用

页码：357 / 360

页数：4

共 15 条

[1]

Bach A.W., Hansen S.T., Plates versus external fixation in severe open tibial shaft fractures, Clin Orthop, 241, pp. 89-94, (1989)

[2]

Bray T.J., Endicott M., Capra S.E., Treatment of open ankle fractures: Immediate internal fixation versus closed immobilization and delayed fixation, Clin Orthop, 240, pp. 47-52, (1988)

[3]

Brumback R.J., Ellison P.S., Poka A., Lakatos R., Bathon G.H., Burgess A.R., Intramedullary nailing of open fractures of the femoral shaft, J Bone Joint Surg [Am], 71, pp. 1324-1331, (1989)

[4]

Caudle R.J., Stem P.J., Severe open fractures of the tibia, J Bone Joint Surg [Am], 69, pp. 801-807, (1987)

[5]

Cohen J., A coefficient of agreement for nominal scales, Educ Psychol Meas, 20, pp. 37-46, (1960)

[6]

Court-Brown C.M., Wheelwright E.F., Christie J., McQueen M.M., External fixation for type III open tibial fractures, J Bone Joint Surg [Br], 72, pp. 801-804, (1990)

[7]

Cyr L., Kennon F., Measures of clinical agreement for nominal and categorical data: The kappa coefficient, Comput Biol Med, 22, pp. 239-246, (1992)

[8]

Fleiss J., Measuring nominal scale agreement among many raters, Psychol Bull, 76, pp. 378-382, (1971)

[9]

Frandsen P.A., Ersen E., Madsen F., Skjodt T., Garden’s classification of femoral neck fractures: An assessment of interobserver variation, J Bone Joint Surg [Br], 70, pp. 588-590, (1988)

[10]

Gustilo R., Mendoza R., Williams D., Problems in the management of type III (Severe) open fractures. A new classification of type III open fractures, J Trauma, 24, pp. 742-746, (1984)

← 1 2 →