title: Reliability of Lichtman's classification for Kienböck's disease in 99 subjects.
abstract: OBJECTIVE
  The objective of this research was to investigate the reliability of Lichtman's classification for Kienböck's disease.
  
  
  METHODS
  Interobserver reliability and intraobserver reproducibility were investigated by interpreting both anteroposterior and lateral X-rays of the wrist joint twice in 99 patients with Kienböck's disease using the modified Lichtman's classification system. Observers comprised three orthopaedic surgeons, and no information was exchanged between observers either before or during the study.
  
  
  RESULTS
  Intraobserver reliability was moderate (0.313-0.628), and interobserver reliability was fair (Siegel's kappa = 0.228).
  
  
  CONCLUSIONS
  Low values were obtained regarding interobserver reliability for the modified Lichtman's classification of Kienböck's disease. This classification is thus inadequate for use in clinical settings. A new classification should be established.
authors.affiliation: Department of Hand Surgery, Nagoya University School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Shin
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tatebe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirata
authors.forename: Shukuki
authors.initials: S
authors.lastname: Koh
authors.forename: Takaaki
authors.initials: T
authors.lastname: Shinohara
mesh_terms: D006801:Humans; D010020:Osteonecrosis / Q000145:classification* / Q000000981:diagnostic imaging / Q000601:surgery; D057234:Preoperative Period; D012372:ROC Curve; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000601:surgery