title: Is it time to revisit the AO classification of fractures of the distal radius? Inter- and intra-observer reliability of the AO classification.
abstract: We conducted an observational radiographic study to determine the inter- and intra-observer reliability of the AO classification of fractures of the distal radius. Plain posteroanterior and lateral radiographs of 456 patients with an acute fracture of the distal radius were classified by a consultant orthopaedic hand specialist and two specialist trainees, and the k coefficient for the inter- and intra-observer reliability of the type, group and subgroup classification was calculated. Only the type of fracture (A, B or C) was found to provide substantial intra-observer reliability (k type 0.65). The inclusion of 'group' and 'subgroup' into the classification reduced the inter-observer reliability to fair (kgroup 0.29, ksubgroup = 0.28) and the intra-observer reliability to moderate (kgroup 0.53, ksubgroup 0.49). Disagreement was found to arise between specific subgroups, which may be amenable to clarification.
authors.affiliation: University of Warwick, Clinical Trials Unit, Clinical Sciences Research laboratories, Clifford Bridge Road, Coventry, CV2 2DX, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Plant
authors.affiliation: University of Warwick, Clinical Trials Unit, Clinical Sciences Research laboratories, Clifford Bridge Road, Coventry, CV2 2DX, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hickson
authors.affiliation: University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, UK.
authors.forename: H
authors.initials: H
authors.lastname: Hedley
authors.affiliation: University of Warwick, Statistics & Epidemiology, Warwick Medical School, Coventry, CV4 7AL, UK.
authors.forename: N R
authors.initials: NR
authors.lastname: Parsons
authors.affiliation: University of Warwick, Clinical Trials Unit, Division of Health Science, Coventry, CV4 7AL, UK.
authors.forename: M L
authors.initials: ML
authors.lastname: Costa
mesh_terms: D006801:Humans; D057072:Intra-Articular Fractures / Q000145:classification / Q000000981:diagnostic imaging; D011859:Radiography; D011885:Radius Fractures / Q000145:classification* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D014458:Ulna Fractures / Q000145:classification; D014954:Wrist Injuries / Q000145:classification / Q000000981:diagnostic imaging
keywords: AO classification; Cohen’s k Test; Distal radius fracture