The Reliability and Reproducibility of a New Revised Edelson Classification
Objective Edelson classification is a 3D classification of proximal humeral fractures, but there is a scarcity of application of this classification in large samples, and the accuracy of classification was also not testified. The objective of this research was to verify whether a revised Edelson cla...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.13375 |
| _version_ | 1828237217588314112 |
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| author | Jialiang Guo Weichong Dong Yali Zhou Meishuang Shang Sifan Yang Xiaojuan Zhang Zhiyong Hou Yingze Zhang |
| author_facet | Jialiang Guo Weichong Dong Yali Zhou Meishuang Shang Sifan Yang Xiaojuan Zhang Zhiyong Hou Yingze Zhang |
| author_sort | Jialiang Guo |
| collection | DOAJ |
| description | Objective Edelson classification is a 3D classification of proximal humeral fractures, but there is a scarcity of application of this classification in large samples, and the accuracy of classification was also not testified. The objective of this research was to verify whether a revised Edelson classification produces satisfactory agreement for proximal humeral fracture classification in adult patients. Methods A total of 827 proximal humeral fractures (304 male and 520 female patients, 58.0 ± 16.2 years) were found retrospectively from January 2014 to December 2019, and classified according to the traditional and newly proposed Edelson classification. The three‐dimensional CT images were processed, rotated and visualized within software. Five shoulder surgeons classified each fracture. After data collection, radiographic classifications results were compared by inter‐ and intraobserver analysis with the method of weighted kappa coefficients. Fracture classification based on Edelson and revised Edelson classification was presented and compared. Results The mean k value for the interobserver reliability was 0.748 (range, 0.583 to 0.958) compared with Edelson classification (0.548, range, 0.48 to 0.635), indicating satisfactory agreement. The mean k value for intraobserver reliability was 0.906 (range, 0.823 to 0.943) compared with Edelson classification (0.762, range, 0.666 to 0.808), indicating excellent agreement when using the newly revised Edelson classification. The mechanism was categorized as the shoulder being in a position of forward flexion, abduction, and internal rotation in Edelson I‐IV and bicipital fractures. For the greater tuberosity fracture, the mechanism was classified into two mechanisms based on the presence of a combined dislocation. Bicipital groove fracture is a commonly observed fracture pattern, and included in the revised Edelson classification. Conclusions The revised Edelson classification proposed was more in line with the injury mechanism of the fracture, was beneficial in identifying more fracture types such as bicipital groove fracture, and verified to be a good proximal humeral fracture classification with good reliability compared with the traditional Edelson classification. |
| first_indexed | 2024-04-12T20:45:38Z |
| format | Article |
| id | doaj.art-1b40a70368ad4a268d8fc27cc56781f3 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-12T20:45:38Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-1b40a70368ad4a268d8fc27cc56781f32022-12-22T03:17:17ZengWileyOrthopaedic Surgery1757-78531757-78612022-09-011492307231610.1111/os.13375The Reliability and Reproducibility of a New Revised Edelson ClassificationJialiang Guo0Weichong Dong1Yali Zhou2Meishuang Shang3Sifan Yang4Xiaojuan Zhang5Zhiyong Hou6Yingze Zhang7The School of Medicine Nankai University Tianjin PR ChinaDepartment of Pharmacy The Second Hospital of Hebei Medical University Shijiazhuang PR ChinaDepartment of Orthopaedics The Third Hospital of Hebei Medical University Shijiazhuang PR ChinaDepartment of Orthopaedics The Third Hospital of Hebei Medical University Shijiazhuang PR ChinaDepartment of Orthopaedics The Third Hospital of Hebei Medical University Shijiazhuang PR ChinaDepartment of Orthopaedics The Third Hospital of Hebei Medical University Shijiazhuang PR ChinaDepartment of Orthopaedics The Third Hospital of Hebei Medical University Shijiazhuang PR ChinaDepartment of Pharmacy The Second Hospital of Hebei Medical University Shijiazhuang PR ChinaObjective Edelson classification is a 3D classification of proximal humeral fractures, but there is a scarcity of application of this classification in large samples, and the accuracy of classification was also not testified. The objective of this research was to verify whether a revised Edelson classification produces satisfactory agreement for proximal humeral fracture classification in adult patients. Methods A total of 827 proximal humeral fractures (304 male and 520 female patients, 58.0 ± 16.2 years) were found retrospectively from January 2014 to December 2019, and classified according to the traditional and newly proposed Edelson classification. The three‐dimensional CT images were processed, rotated and visualized within software. Five shoulder surgeons classified each fracture. After data collection, radiographic classifications results were compared by inter‐ and intraobserver analysis with the method of weighted kappa coefficients. Fracture classification based on Edelson and revised Edelson classification was presented and compared. Results The mean k value for the interobserver reliability was 0.748 (range, 0.583 to 0.958) compared with Edelson classification (0.548, range, 0.48 to 0.635), indicating satisfactory agreement. The mean k value for intraobserver reliability was 0.906 (range, 0.823 to 0.943) compared with Edelson classification (0.762, range, 0.666 to 0.808), indicating excellent agreement when using the newly revised Edelson classification. The mechanism was categorized as the shoulder being in a position of forward flexion, abduction, and internal rotation in Edelson I‐IV and bicipital fractures. For the greater tuberosity fracture, the mechanism was classified into two mechanisms based on the presence of a combined dislocation. Bicipital groove fracture is a commonly observed fracture pattern, and included in the revised Edelson classification. Conclusions The revised Edelson classification proposed was more in line with the injury mechanism of the fracture, was beneficial in identifying more fracture types such as bicipital groove fracture, and verified to be a good proximal humeral fracture classification with good reliability compared with the traditional Edelson classification.https://doi.org/10.1111/os.13375Bicipital groove fractureCT reconstructionEdelson classificationRevised Edelson classification |
| spellingShingle | Jialiang Guo Weichong Dong Yali Zhou Meishuang Shang Sifan Yang Xiaojuan Zhang Zhiyong Hou Yingze Zhang The Reliability and Reproducibility of a New Revised Edelson Classification Orthopaedic Surgery Bicipital groove fracture CT reconstruction Edelson classification Revised Edelson classification |
| title | The Reliability and Reproducibility of a New Revised Edelson Classification |
| title_full | The Reliability and Reproducibility of a New Revised Edelson Classification |
| title_fullStr | The Reliability and Reproducibility of a New Revised Edelson Classification |
| title_full_unstemmed | The Reliability and Reproducibility of a New Revised Edelson Classification |
| title_short | The Reliability and Reproducibility of a New Revised Edelson Classification |
| title_sort | reliability and reproducibility of a new revised edelson classification |
| topic | Bicipital groove fracture CT reconstruction Edelson classification Revised Edelson classification |
| url | https://doi.org/10.1111/os.13375 |
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