Reliability and accuracy of roentgenographic measures in determining the degree of comminution of femoral shaft fractures

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Published: Apr 30, 2011
Keywords:
Reliability accuracy comminution femoral fracture

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Chaimongkol W, MD
Department of Orthopaedic Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Tangtrakulwanich B, MD, Ph.D
Department of Orthopaedic Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

Abstract

Objective: The aim of this study was to evaluate both the reliability and accuracy of plain and high resolution radiographs in determining the degree of comminution of femoral fractures.


Methods: Eighteen patients were selected for evaluation of femoral fracture using plain and high resolution radiography, followed by computerized tomography (CT) with reconstruction.  Three groups of assessors included four orthopedic members of staff, four senior residents, and four junior residents (first and second year).  Consensus agreement of the staff reading the CT scans was considered as “the gold standard”.


Results: The accuracy in determining the degree of comminution of plain radiography was 45.8%, 70.8% and 70.8% for junior resident, senior resident and staff, respectively. Those for high resolution radiography were 50.0%, 68.0% and 73.6%.  Interobserver reliability in both plain and high resolution radiography was moderate in both the senior resident and staff groups, but only fair among the junior residents.  The intraobserver reliability in the staff group was substantial in both types of x-rays.


Conclusion: The difference in accuracy and reliability between plain and high resolution radiographs is marginal when used to define the degree of comminution of femoral shaft fracture, except when interpreted by assessors with less experience.

Article Details

Issue
Vol. 35 No. 1-2 (2011): January-April
Section
Original Articles

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