title: Total talar fracture - inter- and intra-observer reproducibility of two classification systems (Hawkins and AO) for central talar fractures.
abstract: BACKGROUND
  We evaluated the inter- and intra-observer reproducibility of two classification systems for central talar fractures (Hawkins, as modified by Canal and Kelly and then by us; AO/AOT).
  
  
  OBJECTIVE
  The analysis and classification of these fractures will be better with CT scans than with X-rays.
  
  
  METHODS
  Four observers evaluated 39 X-ray and CT scan files twice in the span of six weeks; each evaluation entailed classifying the fractures and describing their main features. Cohen's Kappa coefficient for inter-rater agreement was calculated and analysed.
  
  
  RESULTS
  The inter- and intra-observer reproducibility with CT scans was better with X-rays for most of the parameters evaluated. The modified Hawkins classification provided better reproducibility than the AO/AOT one. However, this classification system was not perfect, even after modifications and use of CT scans.
  
  
  CONCLUSIONS
  CT scans are an essential tool for the analysis of all talar fractures. We modified the Hawkins classification (as modified by Canal and Kelly) to include a Type 0 (no displacement or less than 2mm), include frontal body fractures that are displaced like neck fractures and take into account comminuted fractures and other trauma in the area.
  
  
  METHODS
  IV - retrospective clinical study.
authors.affiliation: Service de chirurgie orthopédique, hôpital de Cavale-Blanche, CHU, boulevard Tanguy-Prigent, 29200 Brest cedex, France.
authors.forename: T
authors.initials: T
authors.lastname: Williams
authors.forename: N
authors.initials: N
authors.lastname: Barba
authors.forename: T
authors.initials: T
authors.lastname: Noailles
authors.forename: V
authors.initials: V
authors.lastname: Steiger
authors.forename: V
authors.initials: V
authors.lastname: Pineau
authors.forename: G
authors.initials: G
authors.lastname: Carvalhana
authors.forename: B
authors.initials: B
authors.lastname: Le Jacques
authors.forename: A
authors.initials: A
authors.lastname: Clave
authors.forename: D
authors.initials: D
authors.lastname: Huten
mesh_terms: D016512:Ankle Injuries / Q000145:classification* / Q000000981:diagnostic imaging*; D005260:Female; D050723:Fractures, Bone / Q000145:classification* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013628:Talus / Q000293:injuries*; D014057:Tomography, X-Ray Computed