title: The OTA open fracture classification: a study of reliability and agreement.
abstract: OBJECTIVE
  To determine the reliability of the Orthopaedic Trauma Association (OTA) Open Fracture Classification.
  
  
  METHODS
  Video-based reliability study.
  
  
  METHODS
  Orthopedic meetings and grand rounds.
  
  
  METHODS
  Orthopedic surgeons.
  
  
  METHODS
  None.
  
  
  METHODS
  Interobserver reliability assessment classification.
  
  
  RESULTS
  The results demonstrate the system to have high reliability and much improvement compared with published Gustilo-Anderson classification reliability studies. Overall interrater reliability (κ) values were highest for arterial injury, with near perfect agreement across all raters and within each value. Skin injury, bone loss, and contamination demonstrated moderate to substantial levels of agreement. Muscle injury had the most disagreement between raters but still demonstrating a fair level of interrater agreement, which is a level of agreement superior to the literature related to the Gustilo-Anderson classification. Levels of agreement were similar between attending surgeons and residents for all categories.
  
  
  CONCLUSIONS
  This study, which included a diverse multicenter multinational cohort of orthopaedic surgeons and residents, of the OTA Open Fracture Classification demonstrated moderate to excellent interobserver reliability.
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, Harborview Medical Center, Seattle, WA 98104-2499, USA. bagel@u.washington.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Agel
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Evans
authors.forename: John Lawrence
authors.initials: JL
authors.lastname: Marsh
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Decoster
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Lundy
authors.forename: James F
authors.initials: JF
authors.lastname: Kellam
authors.forename: Clifford B
authors.initials: CB
authors.lastname: Jones
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Desilva
mesh_terms: D000328:Adult; D000465:Algorithms; D005260:Female; D005597:Fractures, Open / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D015601:Injury Severity Score; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009985:Orthopedics; D011361:Professional Competence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States