Three-column classification may provide better acetabular fracture diagnosis
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Published results showed greater interobserver and intraobserver reliability when a three-column classification system was used to diagnose acetabular fractures compared with use of the Judet-Letournel classification.
Zhiyong Hou, MD, and colleagues took preoperative radiographs and CT scans of 1,028 patients with acetabular fractures who had undergone surgical treatment from June 2011 to January 2017. Four observers compared the interobserver and intraobserver reliability of the three-column classification system for acetabular fractures with the Judet-Letournel classification system.
Results showed the Judet-Letournel classification could not classify 20.33% of patients, while the 3-column classification could not classify 0.29% of patients. Researchers found moderate agreement in the interobserver reliability for the Judet-Letournel classification compared with substantial agreement when using the three-column classification. Intraobserver reliability had substantial agreement with the Judet-Letournel classification vs. excellent agreement with the three-column classification, according to results.
“The novel classification system had a strong regularity in the classification principle of acetabular fractures and solved many problems in Judet-Letournel classification. Thus, the comparative study of 1,028 acetabular patients from seven primary trauma centers using two classification systems demonstrated that three-column classification had higher interobserver and intraobserver reliability than the Judet-Letournel classification,” Hou told Healio.com/Orthopedics. “What’s more, certain fracture patterns in the three-column classification scheme generally correlated with surgical strategies, which could provide a reference to the approach choice for orthopedic surgeons.” – by Casey Tingle
Disclosure: Hou reports no relevant financial disclosures.
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