Unified classification of open fractures: Based on Gustilo and OTA classification schemes |
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| Affiliation: | 1. Clinic of Orthopaedics, Academic Hospital of Udine, Italy;2. School of Medicine, University of Bari “Aldo Moro”- AOU Consorziale “Policlinico”, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Unit, Bari, Italy;1. McCaig Institute for Bone and Joint Health and Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;2. Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA;3. Department of Medicine, Harvard Medical School, Boston, MA, USA;4. Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA;5. Beth Israel Deaconess Medical Center, Center for Advanced Orthopedic Studies, Boston, MA, USA;6. Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA;1. Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium;2. Department of Translational Medicine, University of Eastern Piedmont "A. Avogadro", Italy;3. Department of Quality Management, University Hospitals Leuven, Belgium;4. Medical Department, Delta Hospitals Roeselare, Belgium;5. Department of Development and Regeneration, KU Leuven – University of Leuven, Belgium;6. Department of Traumatology, University Hospitals Leuven, Belgium;7. Department of Health Services Policy and Management, Centro de Investigação em Saúde Pública (CISP), Escola Nacional de Saúde Pública (ENSP), Universidade Nova de Lisboa (UNL), Portugal;1. Department of Orthopaedic Surgery, Chosun University, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju, 61453, Republic of Korea;2. Department of Orthopaedic surgery, Gyeongsang National University, College of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongsangnam-do, 51472, Republic of Korea;1. Department of Diagnostic Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;2. Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea |
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| Abstract: | BackgroundThe Orthopaedic Trauma Association (OTA) classification scheme for open fractures has improved precision, validity and reliability over the modified Gustilo classification system. However, it needs to be modified into a simple and practical classification system to gain widespread acceptance and application.Material and methodsWe devised a new “unified” classification of open fractures based on the Gustilo and OTA classification systems. The new classification was tested for interobserver reliability on five different fractures classified by 15 surgeons each using the Krippendorff’s alpha. Preference of surgeons for the Gustilo, OTA and unified classifications was assessed.ResultsThe new classification showed excellent interobserver reliability (α = 0.93). A significantly higher number of surgeons expressed preference for the new over the Gustilo and OTA classifications for routine clinical use.ConclusionThe new “unified” classification of open fractures has good validity, reliability and acceptability, and has the potential to replace all other existing classification systems. |
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| Keywords: | Classification Gustilo Open fractures Orthopaedic Trauma Association Unified |
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