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Erschienen in:
01.10.2014 | Original Article
Three-column classification and Schatzker classification: a three- and two-dimensional computed tomography characterisation and analysis of tibial plateau fractures
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 7/2014
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Objective
The aim of the study was to evaluate inter-observer reliability and intra-observer reproducibility between the three-column classification and Schatzker classification systems using 2D and 3D CT models.
Materials and methods
Fifty-two consecutive patients with tibial plateau fractures were evaluated by five orthopaedic surgeons. All patients were classified into Schatzker and three-column classification systems using x-rays and 2D and 3D CT images. The inter-observer reliability was evaluated in the first round and the intra-observer reliability was determined during the second round 2 weeks later.
Results
The average intra-observer reproducibility for the three-column classification was from substantial to excellent in all sub classifications, as compared with Schatzker classification. The inter-observer kappa values increased from substantial to excellent in three-column classification and to moderate in Schatzker classification The average values for three-column classification for all the categories are as follows: (I–III) k2D = 0.718, 95 % CI 0.554–0.864, p < 0.0001 and average 3D = 0.874, 95 % CI 0.754–0.890, p < 0.0001. For Schatzker classification system, the average values for all six categories are as follows: (I–VI) k2D = 0.536, 95 % CI 0.365–0.685, p < 0.0001 and average k3D = 0.552 95 % CI 0.405–0.700, p < 0.0001. The values are statistically significant.
Conclusion
Statistically significant inter-observer values in both rounds were noted with the three-column classification, making it statistically an excellent agreement. The intra-observer reproducibility for the three-column classification improved as compared with the Schatzker classification. The three-column classification seems to be an effective way to characterise and classify fractures of tibial plateau.