Is surgeons' experience important on intra- and inter-observer reliability of classiŞcations used for adult femoral neck fracture?

Abstract

Purpose: To evaluate whether surgeons' experience affect inter- and intra-observer reliability amongmostly used classiŞcation systems for femoral neck fractures.Material and methods: A power point presentation was prepared with 107 slides which were anteroposterior radiographs of each femoral neck fracture. Five residents, 5 orthopaedic surgeons and 5 senior orthopaedic surgeons reviewed this presentation and classiŞed the fractures according to Garden,Pauwels and AO classiŞcations. The order of the slides was changed and reviews were repeated after 3months. Fleiss kappa and intraclass correlation coefŞcient values were calculated to evaluate inter andintra-observer reliability.Results: Garden and AO classiŞcations' inter-observer reliabilities were similar and higher than PauwelsclassiŞcation. Among three experience groups, the inter-observer reliability for Garden classiŞcation washighest in senior surgeon group, the interobserver reliability for AO classiŞcation was highest in surgeongroup, and interobserver reliability of Pauwels classiŞcation was highest in low experienced groups(residents and surgeons). Intra-observer reliability was highest for Garden and lowest for PauwelsclassiŞcations. Surgical experience was found to be not effective for intraobserver reliability.Conclusion: Both Garden and AO classiŞcations were more reliable than Pauwels classiŞcation. Surgicalexperience was not signiŞcantly important on these three classiŞcation systems' evaluation.Level of Evidence: Level IV, Diagnostic study© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)