Intra - and interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower - limb closed fractures

Background: The soft tissues injury in periarticular fractures of the lower extremities determines the proper time to perform bone fixation. Objetive: The aim of this study was to determine the intra and interobserver agreement in the Tscherne classification. Methods: This is a descriptive, prospective study for patients admitted to the Pablo Tobón Uribe Hospital (PTUH) with tibial plateau or tibial pilon fractures. We performed a standardize evaluation using video photography at the time of admission and 24, 48, and 72 h after admission. Fifteen five reviewers who had various levels of training produced a total of 1,200 observations. The intraand interobserver agreement was assessed using a weighted kappa for multiple raters and more than two categories. Results: Twenty patients were admitted with tibial plateau and tibial pilon fractures. The intraobserver agreement for all 15 raters was kappa 0.81 (95% CI 0.79-0.83), and the interobserver agreement for all 15 raters was kappa 0.65 (95% CI 0.55-0.73). The interobserver agreement at 24 h was kappa 0.67 (95% CI 0.46-0.86). Conclusions: Classifying the severity of soft tissue injury is critical in planning the surgical management of fractures of the lower extremities. Based on our results, we can reasonably argue that the Tscherne classification produced an adequate level of agreement and could be used to standardize and to guide the treatment, and to conduct research studies. Artículo Original Concordancia intra e interobservador de la clasificación de Oestern y Tscherne para lesiones de tejidos blandos en fracturas cerradas periarticulares del miembro inferior Intraand interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures Carlos Oliver Valderrama-Molina123, Mauricio Estrada-Castrillón1, Jorge Andrés Hincapie2,3, Luz Helena Lugo-Agudelo2,3 1 Hospital Pablo Tobón Uribe, Medellín, Colombia 2 Universidad de Antioquia, Escuela de Medicina de la Rehabilitación en el Grupo Salud, Medellín, Colombia 3 Universidad de Antioquia, Escuela de Medicina, Epidemiología Clínica Grupo Académico, Medellín, Colombia Valderrama-Molina CO, Estrada-Castrillón M, Hincapie JA, Lugo-Agudelo LH. Intraand interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures. Colomb Med. 2014; 45(4): 173-78 © 2014 Universidad del Valle. Este es un artículo de acceso abierto, distribuido bajo los términos de la licencia Creative Commons Attribution License, que permite el uso ilimitado, distribución y reproducción en cualquier medio, siempre que el autor original y la fuente se acrediten Valderrama-Molina CO/et al/Colombia Médica Vol. 45 No4 2014 (Oct-Dic)