Related Experiment Video
Updated: May 15, 2026
Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
The OTA open fracture classification: a study of reliability and agreement
Julie Agel1, Andrew R Evans, John Lawrence Marsh
1Department of Orthopaedic Surgery and Sports Medicine, Harborview Medical Center, Seattle, WA 98104-2499, USA. bagel@u.washington.edu
Objectives:
To determine the reliability of the Orthopaedic Trauma Association (OTA) Open Fracture Classification.
Design:
Video-based reliability study.
Setting:
Orthopedic meetings and grand rounds.
Patients/Participants:
Orthopedic surgeons.
Intervention:
None.
Main Outcome Measurements:
Interobserver reliability assessment classification.
Results:
The results demonstrate the system to have high reliability and much improvement compared with published Gustilo-Anderson classification reliability studies. Overall interrater reliability (κ) values were highest for arterial injury, with near perfect agreement across all raters and within each value. Skin injury, bone loss, and contamination demonstrated moderate to substantial levels of agreement. Muscle injury had the most disagreement between raters but still demonstrating a fair level of interrater agreement, which is a level of agreement superior to the literature related to the Gustilo-Anderson classification. Levels of agreement were similar between attending surgeons and residents for all categories.
Conclusions:
This study, which included a diverse multicenter multinational cohort of orthopaedic surgeons and residents, of the OTA Open Fracture Classification demonstrated moderate to excellent interobserver reliability.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:18Classification of Bones
Long and Short Bones
The appendicular skeleton, particularly the upper and lower limbs, is primarily made of long and short bones. The long...