• Ann R Coll Surg Engl · May 2007

    Inter- and intra-observer variation of the Schatzker and AO/OTA classifications of tibial plateau fractures and a proposal of a new classification system.

    • C P Charalambous, M Tryfonidis, F Alvi, M Moran, C Fang, R Samarji, R Samaraji, and P Hirst.
    • Department of Orthopaedics and Trauma, Manchester Royal Infirmary, Manchester, UK. bcharalambos@hotmail.com
    • Ann R Coll Surg Engl. 2007 May 1; 89 (4): 400-4.

    IntroductionThe aim of this study was to evaluate the intra- and inter-observer variation of the Schatzker and AO/OTA classifications in assessing tibial plateau fractures, using plain radiographs.Patients And MethodsFifty tibial plateau fractures were classified independently by six observers as per the Schatzker and AO/OTA classifications, using antero-posterior and lateral plain radiographs. Assessment was done on two occasions, 8 weeks apart.ResultsWe found that both the Schatzker and AO/OTA classifications have a high intra-observer (kappa = 0.57 and 0.53, respectively), and inter-observer (kappa = 0.41 and 0.43, respectively) variation. Classification of tibial plateau fractures into unicondylar versus bicondylar and pure splits versus articular depression +/- split conferred improved inter- and intra-observer variation.ConclusionsThe high inter-observer variation found for the Schatzker and AO/OTA classifications must be taken into consideration when these are used as a guidance of treatment and when used in evaluating patients' outcome. Simply classifying tibial plateau fractures into unicondylar versus bicondylar and pure splits versus articular depression +/- split may be more reliable.

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