title: Inter- and intraobserver reliability of the MTM-classification for proximal humeral fractures: a prospective study.
abstract: BACKGROUND
  A precise modular topographic-morphological (MTM) classification for proximal humeral fractures may address current classification problems. The classification was developed to evaluate whether a very detailed classification exceeding the analysis of fractured parts may be a valuable tool.
  
  
  METHODS
  Three observers classified plain radiographs of 22 fractures using both a simple version (fracture displacement, number of parts) and an extensive version (individual topographic fracture type and morphology) of the MTM classification. Kappa-statistics were used to determine reliability.
  
  
  RESULTS
  An acceptable reliability was found for the simple version classifying fracture displacement and fractured main parts. Fair interobserver agreement was found for the extensive version with individual topographic fracture type and morphology.
  
  
  CONCLUSIONS
  Although the MTM-classification covers a wide spectrum of fracture types, our results indicate that the precise topographic and morphological description is not delivering reproducible results. Therefore, simplicity in fracture classification may be more useful than extensive approaches, which are not adequately reliable to address current classification problems.
authors.affiliation: BG Trauma Center, Eberhard-Karls-University, Schnarrenbergstr, 95, D-72076 Tuebingen, Germany. C.Bahrs@gmx.de
authors.forename: Christian
authors.initials: C
authors.lastname: Bahrs
authors.forename: Hagen
authors.initials: H
authors.lastname: Schmal
authors.forename: Erich
authors.initials: E
authors.lastname: Lingenfelter
authors.forename: Bernd
authors.initials: B
authors.lastname: Rolauffs
authors.forename: Kuno
authors.initials: K
authors.lastname: Weise
authors.forename: Klaus
authors.initials: K
authors.lastname: Dietz
authors.forename: Peter
authors.initials: P
authors.lastname: Helwig
mesh_terms: D006801:Humans; D015588:Observer Variation; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012784:Shoulder Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000453:epidemiology*