Imaging to improve agreement for proximal humeral fracture classification in adult patient: A systematic review of quantitative studies

Publication date: Available online 26 June 2019Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Hannah Bougher, Archana Nagendiram, Jennifer Banks, Leanne Marie Hall, Clare HealAbstractProximal humeral fracture classification has low reproducibility. Many studies have tried to increase inter- and intra-observer agreement with more sophisticated imaging. The aim of this review was to determine which imaging modality produces the best inter- and intra-observer agreement for proximal humeral fracture classification in adults and to determine if this varies with observer experience or fracture complexity. OvidMEDLINE, The Cochrane Library, EBSCO CINAHL and Elsevier Scopus were searched on July 22nd, 2018. Quantitative studies comparing at least two imaging modalities for inter- or intra-observer agreement of proximal humeral fracture classification in adults were eligible for inclusion in this systematic literature review. Two reviewers independently screened and extracted data. Study quality was appraised using a modified Downs and Black checklist. The search strategy identified 1987 studies, of which 15 met the eligibility criteria. All included studies addressed inter-observer agreement and 8 provided results for intra-observer agreement. A narrative synthesis was performed. Trends were compared between studies as clinical heterogeneity and the statistical measures used by included studies prevented meta-analysis. Inter- and intra-observer agreement was found to i...

Source: Journal of Clinical Orthopaedics and Trauma - June 28, 2019 Category: Orthopaedics Source Type: research