CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(03): 372-378
DOI: 10.1055/s-0040-1718508
Artigos Originais
Trauma

Evaluation of the Reproducibility of Lauge-Hansen, Danis-Weber, and AO Classifications for Ankle Fractures[*]

Article in several languages: português | English
1   Departamento de Ortopedia e Traumatologia, Hospital Regional do Gama, Brasília, DF, Brasil
,
2   Departamento de Medicina, Universidade de Brasília, Brasília, DF, Brasil
,
3   Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada, Brasília, DF, Brasil
,
3   Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada, Brasília, DF, Brasil
,
4   Departamento de Medicina, Centro Universitário de Brasília (CEUB), Brasília, DF, Brasil
,
1   Departamento de Ortopedia e Traumatologia, Hospital Regional do Gama, Brasília, DF, Brasil
› Author Affiliations

Abstract

Objective The present study aims to analyze the intra- and interobserver reproducibility of the Lauge-Hansen, Danis-Weber, and Arbeitsgemeinschaft für Osteosynthesefragen (AO) classifications for ankle fractures, and the influence of evaluators training stage in these assessments.

Methods Anteroposterior (AP), lateral and true AP radiographs from 30 patients with ankle fractures were selected. All images were evaluated by 11 evaluators at different stages of professional training (5 residents and 6 orthopedic surgeons), at 2 different times. Intra- and interobserver agreement was analyzed using the weighted Kappa coefficient. Student t-tests for paired samples were applied to detect significant differences in the degree of interobserver agreement between instruments.

Results Intraobserver analysis alone had a significant agreement in all classifications. Moderate to excellent interobserver agreement was highly significant (p ≤ 0.0001) for the Danis-Weber classification. The Danis-Weber classification showed, on average, a significantly higher degree of agreement than the remaining classification systems (p ≤ 0.0001).

Conclusion The Danis-Weber classification presented the highest reproducibility among instruments and the evaluator's little experience had no negative influence on the reproducibility of ankle fracture classifications. Level of Evidence II, Diagnostic Studies – Investigating a Diagnostic Test.

* Study developed by the Orthopedics and Traumatology Service of the Hospital Regional do Gama, DF, Brazil, and by the Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada (IPE-HOME-DF, in the Portuguese acronym) Brasília, DF, Brazil.




Publication History

Received: 16 March 2020

Accepted: 06 July 2020

Article published online:
18 December 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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