Objective metric of energy absorbed in tibial plateau fractures corresponds well to clinician assessment of fracture severity

Laurence B Kempton; Kevin Dibbern; Donald D Anderson; Saam Morshed; Thomas F Higgins; J. Lawrence Marsh; Todd O McKinley

doi:10.1097/BOT.0000000000000636

$Objective metric of energy absorbed in tibial plateau fractures corresponds well to clinician assessment of fracture severity$

Journal article

Open access

Peer reviewed

Objective metric of energy absorbed in tibial plateau fractures corresponds well to clinician assessment of fracture severity

Laurence B Kempton, Kevin Dibbern, Donald D Anderson, Saam Morshed, Thomas F Higgins, J. Lawrence Marsh and Todd O McKinley

Journal of orthopaedic trauma, Vol.30(10), pp.551-556

10/2016

DOI: 10.1097/BOT.0000000000000636

PMCID: PMC5035182

PMID: 27243347

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https://www.ncbi.nlm.nih.gov/pmc/articles/5035182View

Open Access

Abstract

Objectives: Determine the agreement between subjective assessments of fracture severity and an objective computed tomography (CT)-based metric of fracture energy in tibial plateau fractures. Methods: Six fellowship-trained orthopaedic trauma surgeons independently rank-ordered 20 tibial plateau fractures in terms of severity based on anteroposterior and lateral knee radiographs. A CT-based image analysis methodology was used to quantify the fracture energy, and agreement between the surgeons' severity rankings and the fracture energy metric was tested by computing their concordance, a statistical measure that estimates the probability that any 2 cases would be ranked with the same ordering by 2 different raters or methods. Results: Concordance between the 6 orthopaedic surgeons ranged from 82% to 93%, and concordance between surgeon severity rankings and the computed fracture energy ranged from 73% to 78%. Conclusions: There is a high level of agreement between experienced surgeons in their assessments of tibial plateau fracture severity, and a slightly lower agreement between the surgeon assessments and an objective CT-based metric of fracture energy. Taken together, these results suggest that experienced surgeons share a similar understanding of what makes a tibial plateau fracture more or less severe, and an objective CT-based metric of fracture energy captures much but not all of that information. Further research is ongoing to characterize the relationship between surgeon assessments of severity, fracture energy, and the eventual clinical outcomes for patients with fractures of the tibial plateau.

Details

Title: Subtitle: Objective metric of energy absorbed in tibial plateau fractures corresponds well to clinician assessment of fracture severity
Creators: Laurence B Kempton - Department of Orthopaedic Surgery, Indiana University School of Medicine
Kevin Dibbern - Department of Orthopaedics and Rehabilitation, The University of Iowa
Donald D Anderson - Department of Orthopaedics and Rehabilitation, The University of Iowa
Saam Morshed - Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of California, San Francisco
Thomas F Higgins - Department of Orthopaedics, University of Utah School of Medicine
J. Lawrence Marsh - Department of Orthopaedics and Rehabilitation, The University of Iowa
Todd O McKinley - Department of Orthopaedic Surgery, Indiana University School of Medicine
Resource Type: Journal article
Publication Details: Journal of orthopaedic trauma, Vol.30(10), pp.551-556
DOI: 10.1097/BOT.0000000000000636
PMID: 27243347
PMCID: PMC5035182
NLM abbreviation: J Orthop Trauma
ISSN: 0890-5339
eISSN: 1531-2291
Language: English
Date published: 10/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040275902771

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