Ullrich, Bernhard W., Schnake, Klaus J., Spiegl, Ulrich J. A., Schenk, Philipp, Mendel, Thomas, Behr, Lars, Bula, Philipp, Fluecht, Laura B., Franck, Alexander, Gercek, Erol, Grueninger, Sebastian, Hartung, Philipp, Jacobs, Cornelius, Katscher, Sebastian, Klauke, Friederike, Liepold, Katja, Mueller, Christian W., Mueller, Michael, Osterhoff, Georg, Partenheimer, Axel, Piltz, Stefan, Riehle, Marion, Sauer, Daniel, Scheyerer, Max Joseph, Schleicher, Philipp, Schmeiser, Gregor, Schmidt, Rene, Scholz, Matti, Siekmann, Holger, Sprengel, Kai, Stoevesandt, Dietrich, Verheyden, Akhil and Zimmermann, Volker (2021). OF-Pelvis classification of osteoporotic sacral and pelvic ring fractures. BMC Musculoskelet. Disord., 22 (1). LONDON: BMC. ISSN 1471-2474

Full text not available from this repository.

Abstract

Objectives Osteoporotic fractures of the pelvis (OFP) are an increasing issue in orthopedics. Current classification systems (CS) are mostly CT-based and complex and offer only moderate to substantial inter-rater reliability (interRR) and intra-rater reliability (intraRR). MRI is thus gaining importance as a complement. This study aimed to develop a simple and reliable CT- and MRI-based CS for OFP. Methods A structured iterative procedure was conducted to reach a consensus among German-speaking spinal and pelvic trauma experts over 5 years. As a result, the proposed OF-Pelvis CS was developed. To assess its reliability, 28 experienced trauma and orthopedic surgeons categorized 25 anonymized cases using X-ray, CT, and MRI scans twice via online surveys. A period of 4 weeks separated the completion of the first from the second survey, and the cases were presented in an altered order. While 13 of the raters were also involved in developing the CS (developing raters (DR)), 15 user raters (UR) were not deeply involved in the development process. To assess the interRR of the OF-Pelvis categories, Fleiss' kappa (kappa(F)) was calculated for each survey. The intraRR for both surveys was calculated for each rater using Kendall's tau (tau(K)). The presence of a modifier was calculated with kappa(F) for interRR and Cohen's kappa (kappa(C)) for intraRR. Results The OF-Pelvis consists of five subgroups and three modifiers. Instability increases from subgroups 1 (OF1) to 5 (OF5) and by a given modifier. The three modifiers can be assigned alone or in combination. In both surveys, the interRR for subgroups was substantial: kappa(F) = 0.764 (Survey 1) and kappa(F) = 0.790 (Survey 2). The interRR of the DR and UR was nearly on par (kappa(F) Survey 1/Survey 2: DR 0.776/0.813; UR 0.748/0.766). The agreement for each of the five subgroups was also strong (kappa(F) min.-max. Survey 1/Survey 2: 0.708-0.827/0.747-0.852). The existence of at least one modifier was rated with substantial agreement (kappa(F) Survey 1/Survey 2: 0.646/0.629). The intraRR for subgroups showed almost perfect agreement (tau(K) = 0.894, DR: tau(K) = 0.901, UR: tau(K) = 0.889). The modifier had an intraRR of kappa(C) = 0.684 (DR: kappa(C) = 0.723, UR: kappa(C) = 0.651), which is also considered substantial. Conclusion The OF-Pelvis is a reliable tool to categorize OFP with substantial interRR and almost perfect intraRR. The similar reliabilities between experienced DRs and URs demonstrate that the training status of the user is not important. However, it may be a reliable basis for an indication of the treatment score.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Ullrich, Bernhard W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnake, Klaus J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spiegl, Ulrich J. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schenk, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mendel, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Behr, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bula, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fluecht, Laura B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Franck, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gercek, ErolUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grueninger, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartung, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jacobs, CorneliusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katscher, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klauke, FriederikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liepold, KatjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, Christian W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Osterhoff, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Partenheimer, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Piltz, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riehle, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sauer, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheyerer, Max JosephUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schleicher, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmeiser, GregorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, ReneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scholz, MattiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siekmann, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sprengel, KaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stoevesandt, DietrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verheyden, AkhilUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zimmermann, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-604523
DOI: 10.1186/s12891-021-04882-6
Journal or Publication Title: BMC Musculoskelet. Disord.
Volume: 22
Number: 1
Date: 2021
Publisher: BMC
Place of Publication: LONDON
ISSN: 1471-2474
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
FRAGILITY FRACTURES; INSUFFICIENCY FRACTURES; SPINE; SYSTEM; RECOMMENDATIONS; RELIABILITY; MRI; CTMultiple languages
Orthopedics; RheumatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60452

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item