• Valentin Neuhaus, Arjan G J Bot, Thierry G Guitton, David C Ring, Science of Variation Group, Mahmoud I Abdel-Ghany, Jeffrey Abrams, Joshua M Abzug, Lars E Adolfsson, George W Balfour, H Brent Bamberger, Antonio Barquet, Michael Baskies, W Arnold Batson, Taizoon Baxamusa, Grant J Bayne, Thierry Begue, Michael Behrman, Daphne Beingessner, Jan Biert, Julius Bishop, Mateus Borges Oliveira Alves, Martin Boyer, Drago Brilej, Peter R G Brink, Lance M Brunton, Richard Buckley, Juan Carlos Cagnone, Ryan P Calfee, Luiz Augusto B Campinhos, Charles Cassidy, Louis Catalano, Karel Chivers, Pradeep Choudhari, Matej Cimerman, Joseph M Conflitti, Ralph M Costanzo, Brett D Crist, Brian J Cross, Phani Dantuluri, Michael Darowish, Ramon de Bedout, Thomas DeCoster, David G Dennison, Peter H DeNoble, Gregory DeSilva, Thomas Dienstknecht, Scott F Duncan, Xavier A Duralde, Holger Durchholz, Kenneth Egol, Carl Ekholm, Nelson Elias, John M Erickson, J Daniel Espinosa Esparza, C H Fernandes, Thomas J Fischer, Martin Fischmeister, E Forigua Jaime, Charles L Getz, Richard S Gilbert, Vincenzo Giordano, David L Glaser, Taco Gosens, Michael W Grafe, Jose Eduardo Grandi Ribeiro Filho, Robert R L Gray, Lawrence V Gulotta, Nigel William Gummerson, Eric Mark Hammerberg, Edward Harvey, R Haverlag, Patrick D G Henry, Jonathan L Hobby, Eric P Hofmeister, Thomas Hughes, John Itamura, Peter Jebson, Richard Jenkinson, Kyle Jeray, Christopher M Jones, Jedediah Jones, Axel Jubel, Scott G Kaar, K Kabir, F Thomas D Kaplan, Stephen A Kennedy, Michael W Kessler, Hervey L Kimball, Peter Kloen, Cyrus Klostermann, Georges Kohut, G A Kraan, Anze Kristan, Mark I Loebenberg, Kevin J Malone, L Marsh, Paul A Martineau, John McAuliffe, Iain McGraw, Samir Mehta, Milind Merchant, Charles Metzger, S A Meylaerts, Anna N Miller, Jennifer Moriatis Wolf, Joel Murachovsky, Anand Murthi, Michael Nancollas, Betsy M Nolan, Timothy Omara, Reza Omid, Jose A Ortiz, Joachim P Overbeck, Alberto Pérez Castillo, Rodrigo Pesantez, Daniel Polatsch, G Porcellini, Michael Prayson, M Quell, Matthew M Ragsdell, James G Reid, J M Reuver, Marc J Richard, Martin Richardson, Marco Rizzo, Sergio Rowinski, Jorge Rubio, Carlos G Sánchez Guerrero, Wojciech Satora, Peter Schandelmaier, Johan H Scheer, Andrew Schmidt, Todd A Schubkegel, Leah M Schulte, Evan D Schumer, Benjamin W Sears, Adam B Shafritz, Nicholas L Shortt, Todd Siff, Dario Mejia Silva, Raymond Malcolm Smith, Sander Spruijt, Jason A Stein, Emilija Stojkovska Pemovska, Philipp N Streubel, Carrie Swigart, Marc Swiontkowski, George Thomas, Eric T Tolo, Matthias Turina, Minos Tyllianakis, Michel P J van den Bekerom, Huub van der Heide, M A J van de Sande, P V van Eerten, Diederik O F Verbeek, David Victoria Hoffmann, A J H Vochteloo, Robert Wagenmakers, Christopher J Wall, Richard Wallensten, Daniel C Wascher, Lawrence Weiss, J Michael Wiater, Brian P D Wills, Jeffrey Wint, Thomas Wright, Jason P Young, Charalampos Zalavras, Robert D Zura, and Karol Zyto.
• Orthopaedic Hand Service, Massachusetts General Hospital, Boston, MA.
• J Orthop Trauma. 2014 Mar 1; 28 (3): 124-9.

ObjectivesThere is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.DesignWeb-based reliability study.SettingIndependent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey.ParticipantsOne hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns.Main Outcome MeasurementsFleiss kappa (κ) was used to assess the reliability of agreement between the surgeons.ResultsThe overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA.ConclusionsThe New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.

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