胫骨平台骨折Schatzker改进分型和四柱九区分型的可靠性研究  

Inter-and intra-observer reliability of revised Schatzker classification and Four-column/nine-segment classification of tibial plateau fractures

作　　者：吴明虎 翟启麟 付文芹 何小健 陈农 WU Minghu;ZHAI Qilin;FU Wenqin;HE Xiaojian;CHEN Nong(Department of Orthopaedic Surgery,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201799,China)

机构地区：[1]复旦大学附属中山医院青浦分院骨科,上海201799

出　　处：《中国骨与关节损伤杂志》2024年第12期1271-1274,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的 分析胫骨平台骨折的Schatzker改进分型和四柱九区分型体系的可靠性。方法 回顾性分析自2020-01—2022-06中山医院青浦分院收治的100例胫骨平台骨折患者的影像学资料,由5位创伤骨科不同年资的医师作为观察者,分别按Schatzker改进分型和四柱九区分型体系进行分型,1个月后重复观察和分型,对观察者间和观察者内数据结果分别采用Kendall’s W检验和Kappa分析进行检验。结果 根据初次观察结果,Schatzker改进分型在观察者间的可信度为0.875(χ^(2)=433.103),四柱九区分型体系在观察者间的可信度为0.813(χ^(2)=402.617);根据二次观察结果,两种分型的可信度分别为0.930(χ^(2)=460.290)和0.870(χ^(2)=430.535)。上述结果评级均为优。根据两次观察结果,Schatzker改进分型在观察者内部的可信度为0.784,四柱九区分型体系在观察者内的可信度为0.767,结果评级均为良,高年资医师的观察者内部可信度更高。结论 胫骨平台骨折Schatzker改进分型和四柱九区分型体系在观察者间的可信度评级均为优,在观察者内的可信度评级均为良,两种分型方法均可以有效地指导胫骨平台骨折的形态学分析及治疗。Objective To assess inter-and intra-observer reliagility of revised Schatzker classification system and Four-column/nine-segment system for tibial plateau fractures among orthopaedic surgeons of different level.Methods This retrospective study was conducted with five observers.Radiographic and tomographic imaging of the knee of one hundred patients with tibial plateau fractures between Jan 2020 and Jun 2022 were evaluated.After one month,the test was repeated to evaluate consistency.The level of agreement was calculated by the Kendall's W test and Kappa index.Results In the first test,inter-observer reliability of five surgeons,according to the Kappa index,was 0.875(χ^(2)=433.103)for revised Schatzker classification and 0.813(χ^(2)=402.617)for Four-column/nine-segment.In the second test,values were 0.930(χ^(2)=460.290)and 0.870(χ^(2)=430.535) respectively.The result was considered as excellent.Regarding intra-observer analysis,the mean Kappa indexes of surgeons were 0.784 of revised Schatzker classification and 0.767 of Four-column/nine-segment classification,the result was classified as good.Intra-observer reliability was higher among senior surgeon's.Conclusion Revised Schatzker classification and Fourcolumn/nine-segment classification demonstrate excellent inter-observer reliability and good intra-observer reliability,and both can guide the morphological analysis and treatment effectively.

关 键 词：胫骨平台骨折 Schatzker改进分型 四柱九区分型 

分 类 号：R683.4[医药卫生—骨科学]