title: The classification systems for tibial plateau fractures: how reliable are they?
abstract: OBJECTIVE
  The aim of the study was to assess the inter-observer reliability and intraobserver reproducibility of three different classification systems for tibial plateau fractures.
  
  
  METHODS
  Four observers of various levels of experience classified 50 tibial plateau fractures. The same observers repeated the classification of the same fractures after an interval of 8 weeks. Inter- and intra-observer variability was assessed using the mean kappa co-efficient and the mean percentage of agreement.
  
  
  RESULTS
  For inter-observer reliability, the mean kappa co-efficient values for Arbeitsgemeinschaft für Osteosynthesefragen (AO), Schatzker and Hohl and Moore classifications were 0.36, 0.47 and 0.14, respectively. The mean percentage of agreement was 0.52, 0.59 and 0.34, respectively. For intra-observer reliability kappa-values were 0.80, 0.91 and 0.76 and the mean percentage of agreement was 0.88, 0.93 and 0.85 in the same order.
  
  
  CONCLUSIONS
  Our results show that none of the classification systems were ideal. The Schatzker classification system was superior to the AO and the Hohl and Moore systems both in terms of inter-observer reliability and intra-observer reproducibility. However, there is a need for developing a more comprehensive approach to judge the classification systems.
authors.affiliation: Neville Hall Hospital, Abergavenny, NP7 7EG, UK. naidumsuk@yahoo.co.in
authors.forename: Subramanyam Naidu
authors.initials: SN
authors.lastname: Maripuri
authors.forename: Prabhakar
authors.initials: P
authors.lastname: Rao
authors.forename: Abraham
authors.initials: A
authors.lastname: Manoj-Thomas
authors.forename: Khitish
authors.initials: K
authors.lastname: Mohanty
mesh_terms: D006801:Humans; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results; D013978:Tibial Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000473:pathology