title: Partial Flexor Tendon Laceration Assessment: Interobserver and Intraobserver Reliability.
abstract: Accurate assessment of partial-thickness flexor tendon lacerations in the hand is difficult owing to the subjectivity of evaluation. In this study, we created 12 partial-thickness flexor tendon lacerations in a cadaveric hand, evaluated the accuracy of 6 orthopedic residents and 4 fellowship-trained hand surgeons in estimating the percentage thickness of each laceration, and assessed the groups' interobserver and intraobserver agreement. The 10 participants estimated each laceration independently and on 2 separate occasions and indicated whether they would repair it. The actual thickness of each laceration was calculated from measurements made with a pair of digital microcalipers. Overall estimates differed significantly from calibrated measurements. Estimates grouped by residents and fellowship-trained hand surgeons also differed significantly. Third-year residents were the most accurate residents, and fellowship-trained hand surgeons were more accurate than residents. Overall interobserver agreement was poor for both readings. There was moderate overall intraobserver agreement. Fellowship-trained hand surgeons and first-year residents had the highest intraobserver agreement. These results highlight the difficulty in accurately assessing flexor tendon lacerations. Accuracy appears not to improve with surgeon experience.
authors.forename: B Justin
authors.initials: BJ
authors.lastname: Barker
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Kolovich
authors.affiliation: OrthoNeuro, Columbus, OH. rklinefelter@orthoneuro.com.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Klinefelter
mesh_terms: D002102:Cadaver; D005257:Fellowships and Scholarships; D006230:Hand Injuries / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007396:Internship and Residency; D022125:Lacerations / Q000175:diagnosis / Q000601:surgery; D015588:Observer Variation; D009985:Orthopedics / Q000193:education; D015203:Reproducibility of Results; D013708:Tendon Injuries / Q000175:diagnosis* / Q000601:surgery