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CT-based five-segment classification in Freiberg's infarction: Evaluation of its intraobserver and interobserver
Yi Ren1, Yu Chen1, Ting-Jiang Gan2
1Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China; Department of Orthopaedic Surgery, Shangjin Nanfu Hospital, Chengdu, Sichuan Province 610041, China.
Summary
A new Five-Segment classification system for Freiberg's infarction shows excellent reliability. This computed tomography-based system improves diagnostic accuracy for osteonecrosis of the metatarsal head.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Freiberg's infarction involves osteonecrosis of the metatarsal head.
- Existing classification systems lack detailed mapping of osteonecrosis zones.
- A need exists for a more precise classification system.
Purpose of the Study:
- To develop a novel computed tomography (CT)-based Five-Segment classification system for Freiberg's infarction.
- To assess the intra- and interobserver reliability of this new classification system.
Main Methods:
- A map of osteonecrosis zones was created based on location and frequency.
- The Five-Segment classification system was developed from this map.
- Four evaluators assessed 80 cases twice using the Five-Segment and Smillie classifications.
- Kappa statistics were used to determine reliability.
Main Results:
- The Five-Segment system classified cases into five reproducible types.
- Interobserver reliability (kappa=0.828) and intraobserver reliability (kappa=0.860) were high for the Five-Segment system.
- These values significantly surpassed those of the Smillie classification.
Conclusions:
- The Five-Segment classification system demonstrates excellent interobserver and intraobserver agreement.
- This CT-based system is reliable for managing Freiberg's infarction.
- Further prospective studies are recommended to evaluate its clinical utility and prognostic value.
