一个以冠状腺为中心的近端跨骨折位移的分类系统几乎具有完美的观察者内部和观察者间的协议
Jonathan D Barlow1, Micah J Nieboer1, Alexandra M Cancio-Bello1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Journal of shoulder and elbow surgery
|July 21, 2023
概括
梅奥医院对近腰骨折脱位症的分类显示,外科医生之间存在很高的共识. 该系统可靠地根据冠状腺附着部位对肘部受伤进行分类,有助于管理决策.
科学领域:
- 整形外科手术 整形外科手术
- 创伤学 创伤学 创伤学
- 放射学 放射学是一门学科.
背景情况:
- 肘部骨折 - 涉及近接骨的突移是复杂的伤害.
- 现有的分类系统难以区分蒙特吉亚变体损伤与跨大脑骨折突移,特别是冠状腺干扰.
- 梅奥分类将这些伤害根据冠状腺附着物分为三种类型.
研究的目的:
- 评估梅奥分类系统的观察者内部和观察者间的一致性.
- 评估梅奥分类对近端跨骨骨折移位的可靠性.
- 为了确定协议,使用X射线图和计算机断层扫描 (CT) 扫描.
主要方法:
- 90个近端跨骨骨折位移被5名受过奖学金培训的外科医生独立审查 (3个肩膀/肘部,2个创伤).
- 骨折被使用梅奥系统根据冠状腺附着物 (骨转化,骨或两者都不是) 进行分类.
- 观察者内部可靠性在经过≥6周的洗期后进行评估;观察者间可靠性是使用 κ 值计算的.
主要成果:
- 观察者内部的平均共识为0.87 (几乎完美).
- 观察者间的共识是0.80 (实质性) 在第一个会议和0.89 (几乎完美) 在第二个.
- 总体而言,观察者之间的平均一致性为0.85 (几乎完美).
结论:
- 梅奥分类表现出近乎完美的内部观察者和观察者之间的协议,用于近端跨骨骨折位移.
- 在所有外科医生之间,无论他们的学术专业 (创伤与肩膀/肘部) 是否一致,都是一致的.
- 需要进一步的研究来将这种分类的使用与特定的管理原则和改善患者的治疗结果联系起来.
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