Reliability and reproducibility of classifications for distal radius fractures

Abstract

The aim of this study was to evaluate the interobserver reliability and intraobserver reproducibility of the Universal, AO, Fernandez and Frykman classifications for distal radius fractures. Fifty standard sets of posteroanterior and lateral roentgenograms of displaced distal radius fractures were classified two times by two groups of evaluators at 2-month intervals. The first group consisted of 10 orthopedic surgeons with a minimum of 5 years of experience. The second group consisted of 10 orthopedic residents in their first two years of practice. Interobserver reliability and intraobserver reproducibility were assessed using Cohen's kappa test. None of the classifications achieved good- very good reliability levels. The Fernandez classification had a moderate and the others had a fair interobserver agreement kappa coefficient. All classifications had fair kappa intraobserver agreement although the Frykman and Fernandez classifications had better results. None of the classification systems were superior in terms of reliability and reproducibility. The reliability and reproducibility rates of all four classifications were insufficient.