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Related Experiment Video

Updated: Jun 19, 2026

Three-Dimensional Reconstruction of Orbital Fractures

Three-Dimensional Reconstruction of Orbital Fractures

Published on: May 16, 2025

Interobserver reliability of coronoid fracture classification: two-dimensional versus three-dimensional computed

Anneluuk Lindenhovius¹, Paul Jack Karanicolas, Mohit Bhandari

¹Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA.

The Journal of Hand Surgery

|October 17, 2009

Summary

Three-dimensional CT scans significantly enhance surgeon agreement on classifying coronoid fractures compared to 2D CT. While 3D CT improves classification accuracy, 2D CT showed better agreement for treatment approach recommendations.

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Published on: September 2, 2025

Area of Science:

Orthopedic Surgery
Radiology
Medical Imaging

Background:

Coronoid fractures are complex elbow injuries.
Accurate classification and treatment planning are crucial for optimal patient outcomes.
Interobserver agreement in evaluating these fractures can be challenging with conventional imaging.

Purpose of the Study:

To evaluate whether three-dimensional computed tomography (3D CT) reconstructions improve interobserver agreement in classifying coronoid fractures compared to two-dimensional CT (2D CT).
To assess the impact of 3D CT on the reliability of identifying specific fracture characteristics and recommending treatment approaches.

Main Methods:

Twenty-nine orthopedic surgeons evaluated 10 coronoid fractures.
Fractures were assessed twice, first with radiographs and 2D CT, then with radiographs and 3D CT.
Surgeons used Regan and Morrey and O'Driscoll et al. classifications, identified characteristics, and recommended treatments. Interobserver agreement was measured using the kappa statistic.

Main Results:

3D CT significantly improved interobserver agreement for both Regan and Morrey (kappa=0.51 vs 0.40) and O'Driscoll et al. (kappa=0.48 vs 0.42) coronoid fracture classifications.
Trends towards improved reliability with 3D CT were observed for fracture comminution and tip fractures.
Interestingly, interobserver agreement on the treatment approach was higher with 2D CT (kappa=0.32 vs 0.27).

Conclusions:

Three-dimensional CT reconstructions enhance interobserver agreement for coronoid fracture classification compared to 2D CT.
While 3D CT aids in fracture characterization, 2D CT may offer better agreement for treatment decisions in some cases.