title: Inter-observer variation in the diagnosis of coronal articular fracture lines in the lunate facet of the distal radius.
abstract: BACKGROUND
  Several studies support the use of CT for diagnosing coronal fractures of the distal radius but the inter-observer reliability of these observations is less well studied. We tested the null hypothesis that radiographs alone and the combination of radiographs and two-dimensional computed tomography scans (2DCT) have the same inter-observer variation for the diagnosis of coronal articular fracture lines in the distal radius.
  
  
  METHODS
  Using a web-based survey, 63 surgeons were randomized to evaluate 16 fractures of the distal radius on radiographs alone or radiographs and 2DCT for the presence or absence of a coronal fracture line of the lunate facet and, if present, the stability of the fracture. The kappa multirater measure was calculated to estimate agreement between observers.
  
  
  RESULTS
  The inter-observer variation in diagnosis of a coronal fracture line was fair with both radiographs and 2DCT, as was the diagnosis of instability of the volar lunate facet fracture when present.
  
  
  CONCLUSIONS
  Two-dimensional computed tomography does not improve observer agreement on the diagnosis of coronal plane articular fracture lines in the lunate facet of the distal radius.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Mathieu M E
authors.initials: MM
authors.lastname: Wijffels
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Computed tomography; Coronal plane fracture line; Distal radius fracture; Radiographs