Reliability and Reproducibility of the OTA/AO Classification for Humeral Shaft Fractures

Kiran C. Mahabier, Esther M.M. Van Lieshout, Boyd C. Van Der Schaaf, Gert R. Roukema, Bas J. Punt, Michael H.J. Verhofstad, Dennis Den Hartog*, Hugo W. Bolhuis, P. Koen Bos, Maarten W.G.A. Bronkhorst, Milko M.M. Bruijninckx, P. Ted Den Hoed, Boudewijn J. Dwars, J. Carel Goslings, Robert Haverlag, Martin J. Heetveld, Albert J.H. Kerver, Karel A. Kolkman, Peter A. Leenhouts, Ron OnstenkMartijn Poeze, Rudolf W. Poolman, W. Herbert Roerdink, Jan Bernard Sintenie, Nicolaj M.R. Soesman, Frank H.W.M. Van Der Heijden, Peer Van Der Zwaal, Jan P. Van Dijk, Hans Peter W. Van Jonbergen, Egbert J.M.M. Verleisdonk, Jos P.A.M. Vroemen, Marco Waleboer, Wietse P. Zuidema, the HUMMER trial investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: This study aimed to determine interobserver reliability and intraobserver reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. Methods: Thirty observers (25 orthopaedic trauma surgeons and 5 general orthopaedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included. Periprosthetic, recurrent, and pathological fractures were excluded. Radiographs were provided in random order, and observers were blinded to clinical information. To determine intraobserver agreement, radiographs were reviewed again after 2 months in a different random order. Agreement was assessed using kappa statistics. Results: Interobserver agreement for the 3 fracture types was moderate (κ = 0.60; 0.59-0.61). It was substantial for type A (κ = 0.77; 0.70-0.84) and moderate for type B (κ = 0.52; 0.46-0.58) and type C fractures (κ = 0.46; 0.42-0.50). Interobserver agreement for the 9 fracture groups was moderate (κ = 0.48; 95% CI, 0.48-0.48). Orthopaedic trauma surgeons had better overall agreement for fracture types, and general orthopaedic surgeons had better overall agreement for fracture groups. Observers classified 64% of fractures identically in both rounds. Intraobserver agreement was substantial for the 3 types (κ = 0.80; 0.77-0.81) and 9 groups (κ = 0.80; 0.77-0.82). Intraobserver agreement showed no differences between surgical disciplines. Conclusions: The OTA/AO classification for humeral shaft fractures has a moderate interobserver and substantial intraobserver agreement for fracture types and groups.

Original languageEnglish
Pages (from-to)e75-e80
JournalJournal of Orthopaedic Trauma
Volume31
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Cite this

Mahabier, K. C., Van Lieshout, E. M. M., Van Der Schaaf, B. C., Roukema, G. R., Punt, B. J., Verhofstad, M. H. J., ... the HUMMER trial investigators (2017). Reliability and Reproducibility of the OTA/AO Classification for Humeral Shaft Fractures. Journal of Orthopaedic Trauma, 31(3), e75-e80. https://doi.org/10.1097/BOT.0000000000000738