Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement
Background: The Mayo-Fundación Jiménez Díaz (FJD) classification for proximal humerus fractures aims to identify specific fracture patterns and apply displacement criteria to each pattern. The classification includes 7 common fracture patterns: isolated fractures of the greater or lesser tuberosity,...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638322000925 |
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| author | Antonio M. Foruria, MD, PhD Natalia Martinez-Catalan, MD Belen Pardos, MD Dirk Larson, MS Jonathan Barlow, MD, MS Joaquín Sanchez-Sotelo, MD, PhD |
| author_facet | Antonio M. Foruria, MD, PhD Natalia Martinez-Catalan, MD Belen Pardos, MD Dirk Larson, MS Jonathan Barlow, MD, MS Joaquín Sanchez-Sotelo, MD, PhD |
| author_sort | Antonio M. Foruria, MD, PhD |
| collection | DOAJ |
| description | Background: The Mayo-Fundación Jiménez Díaz (FJD) classification for proximal humerus fractures aims to identify specific fracture patterns and apply displacement criteria to each pattern. The classification includes 7 common fracture patterns: isolated fractures of the greater or lesser tuberosity, fractures of the surgical neck, impacted fractures involving head rotation in a varus and posteromedial direction or in valgus, and fractures where the humeral head is dislocated (head dislocation), split (head splitting), or depressed (head impaction). The purpose of this study was to evaluate the intraobserver and interobserver agreement of the Mayo-FJD classification system using plain radiographs (xR) and computed tomography (CT). Methods: Three fellowship-trained shoulder surgeons blindly and independently evaluated the xR and CT of 103 consecutive proximal humerus fractures treated at a Level I trauma center. Each surgeon classified all fractures according to the Mayo-FJD classification system on 4 separate sessions at least 6 weeks apart. K values were calculated for intraobserver and interobserver reliability. Results: The average intraobserver agreement was 0.9 (almost perfect) for xR and 0.9 (almost perfect) for CT scans. The average interobserver agreement was 0.69 (substantial) for xR and 0.81 (almost perfect) for CT scans at the first round, and 0.66 (substantial) for xR and 0.75 (substantial) for CT scans at the second round. Conclusion: The pattern-based Mayo-FJD classification scheme for proximal humerus fractures was associated with adequate intraobserver and interobserver agreement using both xR and CT scan. Interobserver agreement was best when fractures were classified using CT scans. |
| first_indexed | 2024-04-12T12:41:54Z |
| format | Article |
| id | doaj.art-a440cc03dc994dfd8d53fac89ca89c3f |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-04-12T12:41:54Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-a440cc03dc994dfd8d53fac89ca89c3f2022-12-22T03:32:45ZengElsevierJSES International2666-63832022-07-0164563568Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreementAntonio M. Foruria, MD, PhD0Natalia Martinez-Catalan, MD1Belen Pardos, MD2Dirk Larson, MS3Jonathan Barlow, MD, MS4Joaquín Sanchez-Sotelo, MD, PhD5Upper Extremity Reconstruction Unit, Orthopedic Surgery Department. Fundación Jiménez Díaz University Hospital, Madrid, SpainUpper Extremity Reconstruction Unit, Orthopedic Surgery Department. Fundación Jiménez Díaz University Hospital, Madrid, SpainUpper Extremity Reconstruction Unit, Orthopedic Surgery Department. Fundación Jiménez Díaz University Hospital, Madrid, SpainDepartment of Statistics, Mayo Clinic, Rochester, Minnesota, USAUpper Extremity Reconstruction division. Orthopedic Surgery Department, Mayo Clinic, Rochester, Minnesota, USAUpper Extremity Reconstruction division. Orthopedic Surgery Department, Mayo Clinic, Rochester, Minnesota, USA; Corresponding author: Joaquín Sanchez-Sotelo, MD, PhD, Gonda 14, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.Background: The Mayo-Fundación Jiménez Díaz (FJD) classification for proximal humerus fractures aims to identify specific fracture patterns and apply displacement criteria to each pattern. The classification includes 7 common fracture patterns: isolated fractures of the greater or lesser tuberosity, fractures of the surgical neck, impacted fractures involving head rotation in a varus and posteromedial direction or in valgus, and fractures where the humeral head is dislocated (head dislocation), split (head splitting), or depressed (head impaction). The purpose of this study was to evaluate the intraobserver and interobserver agreement of the Mayo-FJD classification system using plain radiographs (xR) and computed tomography (CT). Methods: Three fellowship-trained shoulder surgeons blindly and independently evaluated the xR and CT of 103 consecutive proximal humerus fractures treated at a Level I trauma center. Each surgeon classified all fractures according to the Mayo-FJD classification system on 4 separate sessions at least 6 weeks apart. K values were calculated for intraobserver and interobserver reliability. Results: The average intraobserver agreement was 0.9 (almost perfect) for xR and 0.9 (almost perfect) for CT scans. The average interobserver agreement was 0.69 (substantial) for xR and 0.81 (almost perfect) for CT scans at the first round, and 0.66 (substantial) for xR and 0.75 (substantial) for CT scans at the second round. Conclusion: The pattern-based Mayo-FJD classification scheme for proximal humerus fractures was associated with adequate intraobserver and interobserver agreement using both xR and CT scan. Interobserver agreement was best when fractures were classified using CT scans.http://www.sciencedirect.com/science/article/pii/S2666638322000925Mayo-FJD classificationProximal humerus fractureInterobserver agreementComputed tomography (CT)RadiographyFracture pattern |
| spellingShingle | Antonio M. Foruria, MD, PhD Natalia Martinez-Catalan, MD Belen Pardos, MD Dirk Larson, MS Jonathan Barlow, MD, MS Joaquín Sanchez-Sotelo, MD, PhD Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement JSES International Mayo-FJD classification Proximal humerus fracture Interobserver agreement Computed tomography (CT) Radiography Fracture pattern |
| title | Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement |
| title_full | Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement |
| title_fullStr | Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement |
| title_full_unstemmed | Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement |
| title_short | Classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement |
| title_sort | classification of proximal humerus fractures according to pattern recognition is associated with high intraobserver and interobserver agreement |
| topic | Mayo-FJD classification Proximal humerus fracture Interobserver agreement Computed tomography (CT) Radiography Fracture pattern |
| url | http://www.sciencedirect.com/science/article/pii/S2666638322000925 |
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