Abstract
To determine the Inter & Intra-observer Agreement in Assessment & Classification of Non-unions of fractures based on Radiological appearance.
Medical records and X-rays of patients who attended the Limb Reconstruction Clinic (1987 to 2000) in a University Hospital for fracture non-union were studied. X-rays of one hundred adult patients with established non-union were selected by random sampling.
Common denominators of various classification / assessment systems were selected for study. Observers were selected in 3 categories (2 in each): Senior Limb Reconstruction specialist, Consultant Musculoskeletal Radiologists, Senior trainees (Post-FRCS Orth).
Data was analysed by calculating kappa coefficients (95% confidence intervals). Kappa measures between observer agreements having been corrected for chance.
Radiologists were unable to comment on vascularity. (S= substantial, M= moderate, F= fair & P= poor)
It would appear that the agreement for classification of atrophic/hypertrophic non-union is good all round (both inter & intra). Within this classification, radiologists showed better agreement than trainees whose results were better than Orthopaedic specialists. Agreement of healing potential & infection was fair to poor only. Radiographic analysis of non-union remains poor indicating the need for further study to see whether identifiable features exist.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
