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Reliability of the Robinson classification for displaced comminuted midshaft clavicular fractures
Sylvia A Stegeman1, Nicole C Fernandes2, Pieta Krijnen1
1Department of Trauma Surgery, Leiden University Medical Center, P.O. box 9600, 2300 RC Leiden, The Netherlands.
Abstract:
This study aimed to assess the reliability of the Robinson classification for displaced comminuted midshaft fractures. A total of 102 surgeons and 52 radiologists classified 15 displaced comminuted midshaft clavicular fractures on anteroposterior (AP) and 30-degree caudocephalad radiographs twice. For both surgeons and radiologists, inter-observer and intra-observer agreement significantly improved after showing the 30-degree caudocephalad view in addition to the AP view. Radiologists had significantly higher inter- and intra-observer agreement than surgeons after judging both radiographs (κmultirater of 0.81 vs. 0.56; κintra-observer of 0.73 vs. 0.44). We advise to use two-plane radiography and to routinely incorporate the Robinson classification in the radiology reports.

