Reliability of hip range of motion using goniometry in pediatric femur shaft fractures.
BACKGROUND
The purpose of this study was to determine the interrater reliability of the assessment of range of motion of the hip joint through goniometry.


METHODS
We included children aged 4 to 10 years with a femoral shaft fracture, from 4 study sites, who had had either an early hip spica cast or an external fixator. An assessor blind to treatment received at each site measured range of hip joints motion, using a standardized goniometric technique at 15 and 24 months postfracture.


RESULTS
The intraclass correlation coefficient (ICC) was used to quantify concordance or agreement. Most ICCs for the different aspects of hip range were between 0.2 and 0.5, indicating only slight agreement. The most reliable measure was hip flexion, with an ICC of 0.48 (95% confidence interval 0.29-0.63).


CONCLUSIONS
Goniometric measurement, using standardized protocols for the hip, has low reliability. Only when differences in rotation exceed at least 30 degrees and in flexion-extension exceed 50 degrees should clinicians conclude that true change has occurred.
Owen
Janice
J
Division of Orthopedic Surgery and Population Health Sciences, The Hospital for Sick Children, Toronto, ONT, Canada.
Stephens
Derek
D
Wright
James G
JG
D053587:Arthrometry, Articular; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000503:physiopathology* / Q000628:therapy; D005500:Follow-Up Studies; D005592:Fracture Fixation; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology; D015203:Reproducibility of Results; D016037:Single-Blind Method