Abstract：
BACKGROUND: The most universal method for classifying pertrochanteric fractures is the AO/OTA classification. These fractures are classified into different categories according to the features found in the anteroposterior radiograph of the hip. Anteroposterior radiograph of the hip with internal rotation traction can improve the characterization of the fracture. Inter- and intra-observer reliability in any classification is essential to achieve a homogeneous agreement for decision making. Our objective is assessing the overall reliability and by level of experience of the new AO/OTA classification of pertrochanteric fractures.
METHODS: A hospital registry was used to collect patients with pertrochanteric hip fracture who had anteroposterior radiograph of the hip with and without internal rotation traction. We selected six evaluators stratified by levels of expertise in orthopedic trauma, leaving three groups: advanced, intermediate and beginner. Radiographs were sent through electronic forms and inter- and intra-observer reliability was calculated using the kappa (K) statistic.
RESULTS: 115 (one hundred fifteen) patients were included, each with their corresponding anteroposterior radiograph of the hip with and without internal rotation traction. Overall inter- and intra-observer reliability was moderate on both anteroposterior radiographs of the hip with and without internal rotation traction. Regarding the different levels of experience, the advanced level group reached a substantial inter- and intra-observer reliability in both anteroposterior radiographs with and without traction, while the rest of the groups with lower level of experience obtained a lesser reliability.
CONCLUSIONS: Our study found that the internal rotation traction x-ray did not improve the reliability of the new AO/OTA classification for pertrochanteric fractures, as assessed by inter- and intra-observer agreement, in either the overall group or in groups divided by experience level.
METHODS: A hospital registry was used to collect patients with pertrochanteric hip fracture who had anteroposterior radiograph of the hip with and without internal rotation traction. We selected six evaluators stratified by levels of expertise in orthopedic trauma, leaving three groups: advanced, intermediate and beginner. Radiographs were sent through electronic forms and inter- and intra-observer reliability was calculated using the kappa (K) statistic.
RESULTS: 115 (one hundred fifteen) patients were included, each with their corresponding anteroposterior radiograph of the hip with and without internal rotation traction. Overall inter- and intra-observer reliability was moderate on both anteroposterior radiographs of the hip with and without internal rotation traction. Regarding the different levels of experience, the advanced level group reached a substantial inter- and intra-observer reliability in both anteroposterior radiographs with and without traction, while the rest of the groups with lower level of experience obtained a lesser reliability.
CONCLUSIONS: Our study found that the internal rotation traction x-ray did not improve the reliability of the new AO/OTA classification for pertrochanteric fractures, as assessed by inter- and intra-observer agreement, in either the overall group or in groups divided by experience level.
摘要：
背景：对股骨转子骨折进行分类的最通用方法是AO/OTA分类。根据在髋部前后X线片中发现的特征，将这些骨折分为不同的类别。内旋牵引的髋关节前后位X线片可以改善骨折的特征。在任何分类中，观察者之间和观察者内部的可靠性对于达成决策的同质协议至关重要。我们的目标是评估股骨转子骨折的新AO/OTA分类的总体可靠性和经验水平。
方法：使用医院登记处收集股骨粗隆间骨折患者，这些患者有或没有内旋牵引的髋部正位X线片。我们选择了六名评估人员，根据骨科创伤的专业知识水平进行分层，留下三个群体:高级，中级和初学者。通过电子形式发送射线照片，并使用kappa（K）统计量计算观察者之间和观察者之间的可靠性。
结果：115（一百一十十五）名患者被纳入，每个都有相应的髋关节前后位X光片，有或没有内旋牵引。在有和没有内旋牵引的情况下，髋部前后X光片的观察者间和观察者内的总体可靠性均中等。关于不同的经验水平，在有牵引和没有牵引的前后射线照相中，高级组达到了观察者间和观察者内的实质性可靠性，而其他经验水平较低的组获得了较低的可靠性。
结论：我们的研究发现内旋牵引X线并没有提高股骨转子骨折的新AO/OTA分类的可靠性，根据观察员之间和内部协议的评估，在整体小组或按经验水平划分的小组中。
方法：使用医院登记处收集股骨粗隆间骨折患者，这些患者有或没有内旋牵引的髋部正位X线片。我们选择了六名评估人员，根据骨科创伤的专业知识水平进行分层，留下三个群体:高级，中级和初学者。通过电子形式发送射线照片，并使用kappa（K）统计量计算观察者之间和观察者之间的可靠性。
结果：115（一百一十十五）名患者被纳入，每个都有相应的髋关节前后位X光片，有或没有内旋牵引。在有和没有内旋牵引的情况下，髋部前后X光片的观察者间和观察者内的总体可靠性均中等。关于不同的经验水平，在有牵引和没有牵引的前后射线照相中，高级组达到了观察者间和观察者内的实质性可靠性，而其他经验水平较低的组获得了较低的可靠性。
结论：我们的研究发现内旋牵引X线并没有提高股骨转子骨折的新AO/OTA分类的可靠性，根据观察员之间和内部协议的评估，在整体小组或按经验水平划分的小组中。
