Interobserver reliability of the Gehweiler classification and treatment strategies of isolated atlas fractures: an internet-based multicenter survey among spine surgeons.
Purpose: Atlas (C1) fractures are commonly rated according to the Gehweiler classification, but literature on its reliability is scarce. In addition, evaluation of fracture stability and choosing the most appropriate treatment regime for C1-injuries are challenging. This study aimed to investigate t...
| Published in: | European Journal of Trauma & Emergency Surgery Vol. 48; no. 1; pp. 601 - 612 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Springer Nature
Feb2022
|
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155125286&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155125286 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Feb2022 vid: 48 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 155125286 145691765 155125286 155125286 10.1007/s00068-020-01494-y 155125286 ppf: 601 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Interobserver reliability of the Gehweiler classification and treatment strategies of isolated atlas fractures: an internet-based multicenter survey among spine surgeons. aug: au: Laubach, Markus Pishnamaz, Miguel Scholz, Matti Spiegl, Ulrich Sellei, Richard Martin Herren, Christian Hildebrand, Frank Kobbe, Philipp affil: Department of Orthopaedic Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany sug: subj: Interrater Reliability Fracture Fixation Methods Fractures Classification Cervical Atlas Injuries Human Descriptive Statistics Data Analysis Software kappa Statistic ab: Purpose: Atlas (C1) fractures are commonly rated according to the Gehweiler classification, but literature on its reliability is scarce. In addition, evaluation of fracture stability and choosing the most appropriate treatment regime for C1-injuries are challenging. This study aimed to investigate the interobserver reliability of the Gehweiler classification and to identify whether evaluation of fracture stability as well as the treatment of C1-fractures are consistent among spine surgeons. Methods: Computed tomography images of 34 C1-fractures and case-specific information were presented to six experienced spine surgeons. C1-fractures were graded according to the Gehweiler classification, and the suggested treatment regime was recorded in a questionnaire. For data analyses, SPSS was used, and interobserver reliability was calculated using Fleiss' kappa (κ) statistics. Results: We observed a moderate reliability for the Gehweiler classification (κ = 0.50), the evaluation of fracture stability (κ = 0.50), and whether a surgical or non-surgical therapy was indicated (κ = 0.53). Type 1, 2, 3a, and 5 fractures were rated stable and treated non-surgically. Type 3b fractures were rated unstable in 86.7% of cases and treated by surgery in 90% of cases. Atlas osteosynthesis was most frequently recommended (65.4%). Overall, 25.8% of type 4 fractures were rated unstable, and surgery was favoured in 25.8%. Conclusion: We found a moderate reliability for the Gehweiler classification and for the evaluation of fracture stability. In particular, diverging treatment strategies for type 3b fractures emphasise the necessity of further clinical and biomechanical investigations to determine the optimal treatment of unstable C1-fractures. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|