title: Importance of radiological studies by means of computed tomography for managing fractures of the tibial plateau.
abstract: OBJECTIVE
  To evaluate the concordance among knee surgery specialists regarding the classification and surgical technique indicated in cases of tibial plateau fracture, using conventional radiographs and computed tomography.
  
  
  METHODS
  Forty-four patients with fractures of the tibial plateau shown on radiographic and tomographic images were selected. These were evaluated by specialists at two different times, with an interval of seven days. On the first occasion, the specialists only had access to the radiographs, while on the second occasion they had access to both radiographs and computed tomography images. Their concordance was evaluated by means of the kappa coefficient.
  
  
  RESULTS
  The interobserver reliability of the Schatzker classification on the first occasion was 0.36 and on the second occasion, 0.35. This was considered to present low reproducibility. In evaluating the intra-observer reproducibility of this classification, the mean kappa index was 0.42, which was classified as moderate. From evaluating the choice of surgical access, the inter-observer reliability was 0.55 on the first occasion and 0.50 on the second, which was considered to present moderate reproducibility. Evaluation on the implant chosen showed that the interobserver reliability was 0.01 on the first occasion and -0.06 on the second, which was considered to be poor and discordant. In evaluating the classification of the three columns, the inter-observer reproducibility was 0.47 (p < 0.0001), which was classified as moderate concordance.
  
  
  CONCLUSIONS
  Use of computed tomography did not present any improvement in the inter-observer concordance, using the Schatzker classification, and did not produce any change in the preoperative planning.
authors.affiliation: Instituto Romeu Krause of Traumatology and Orthopedics, Recife, PE, Brazil.
authors.forename: Clécio
authors.initials: C
authors.lastname: de Lima Lopes
authors.affiliation: Knee Treatment Center, Recife, PE, Brazil.
authors.forename: Carlos Antônio
authors.initials: CA
authors.lastname: da Rocha Cândido Filho
authors.affiliation: Hospital Otávio de Freitas, Recife, PE, Brazil.
authors.forename: Thiago Almeida
authors.initials: TA
authors.lastname: de Lima E Silva
authors.affiliation: Instituto Romeu Krause of Traumatology and Orthopedics, Recife, PE, Brazil.
authors.forename: Marcelo Carvalho Krause
authors.initials: MC
authors.lastname: Gonçalves
authors.affiliation: Hospital Otávio de Freitas, Recife, PE, Brazil.
authors.forename: Ricardo Lyra
authors.initials: RL
authors.lastname: de Oliveira
authors.affiliation: Hospital Otávio de Freitas, Recife, PE, Brazil.
authors.forename: Paulo Rogério Gomes
authors.initials: PR
authors.lastname: de Lima
keywords: Computed tomography; Operative surgical procedures; Tibial fractures/classification; Tibial fractures/radiography