Agreement between Sanders classification of intraarticular calcaneal fractures and assessment during the surgery |
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| Institution: | 1. Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;2. Trauma Research Center, Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;3. Bone and Joint Diseases Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;1. Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, Italy;2. IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi, 4, 20161, Milan, Italy;3. Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy;4. Humanitas Clinical and Research Center - IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy;1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Seongnam, Gyeonggi 13620, South Korea;2. Department of Mathematics, College of Natural Sciences, Ajou University, 206 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi 16499, South Korea;1. Department of Trauma Surgery, Otto-von-Guericke University, Leipziger Str. 44 Magdeburg, Germany;2. Gesellschaft für klinische und Versorgungsforschung mbH, Halberstädter Str. 40a, Magdeburg, Germany;1. Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China;2. Department of Traumatic Orthopaedics, Ningbo No.6 Hospital, Zhengjiang, China;3. Department of TCM, Jing’an District Center Hospital, Shanghai, China;1. Department of Orthopaedics and Traumatology, Santa Maria Hospital, Borgo Val di Taro, PR, Italy;2. Orthopaedics and Traumatology, PBS Group, Italy |
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| Abstract: | BackgroundSanders classification, based on the number of displaced fractured fragments of posterior facet, can predict the prognosis of calcaneal intraarticular fractures. The aim of the study was assessing not only intraobserver reproducibility and interobserver reliability of Sanders classification but also the agreement between preoperative reported types based on computed tomography (CT) scan and direct observation during the surgery.MethodsIn this cross-sectional study, preoperative CT scans of 100 patients with intra-articular calcaneal fracture operated by a single surgeon were studied by two orthopedic and trauma surgeons (A & B), twice with an interval of three weeks. Their result were compared with each other and with the number of displaced fractured fragments recorded in the operation notes. Quadratic weighted kappa test was used to check the agreement between two observers and between the observers and the surgeon.ResultsIntraobserver reproducibility for Sanders classification of intraarticular calcaneal fractures was found to be good to excellent (A1–A2: 0.91 and B1–B2: 0.75). There was a moderate agreement between the two observers (A1–B1: 0.56, A1–B2:0.58, A2–B1:0.48, and A2–B2:0.51). The agreement between reported types of Sanders classification and the number of displaced fractured fragments seen during the surgery was fair (A1-surgeon: 0.27, A2-surgeon: 0.29, B1-surgeon: 0.38, and B2-surgeon: 0.50).ConclusionsAgreement between Sanders classification and what is real during surgery is fair. Hence, Sanders classification as determined in the widest cut of coronal CT scan extended posteriorly should be cautiously interpreted for surgery. |
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| Keywords: | Fractures Calcaneus Sanders classification Reproducibility Reliability Validity |
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