Do Surgeons Agree on Severity and Origin of Complications in Bone-lengthening Nails? An Inter- and Intra-rater Reliability Study.

IF 1 Q3 ORTHOPEDICS

Strategies in Trauma and Limb Reconstruction Pub Date : 2022-09-01 DOI:10.5005/jp-journals-10080-1571

Markus Winther Frost, Ole Rahbek, Marie Fridberg, Mindaugas Mikužis, Søren Kold

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引用次数: 0

Abstract

Background: Bone-lengthening nails result in various complications with different severity and origin. However, no universal reporting system for complications has been agreed upon, making it difficult to compare different nail designs and patient populations. This study aimed to assess the inter- and intra-rater agreement of a classification system of complications according to severity and origin.

Materials and methods: Four orthopaedic surgeons assessed 48 complications retrieved from patient charts in a single-centre cohort and 49 literature complications cases. Complications were classified according to severity grading (I, II, IIIA and IIIB) from Black et al. and origin with eight main types and 33 subtypes. A blinded independent assessment was performed twice at least six weeks apart. Cohen/Congers kappa estimated for the inter- and intra-rater agreement was interpreted after Svanholm et al.

Results: The surgeons had a good inter-rater agreement for complication severity with a kappa value of 0.68 [95% confidence interval (CI): 0.56-0.79] and complication origin with a kappa value of 0.63 (CI: 0.53-0.73), respectively, on the cohort cases. In literature cases, a good agreement on complication severity and origin grading was shown by kappa values of 0.64 (CI: 0.53-0.75) and 0.74 (CI: 0.65-0.83). The intra-rater assessment of complication severity and origin grading had good to excellent agreement with kappa values ranging from 0.51 to 0.97.

Conclusion and clinical significance: The study presents the first structured complication classification on severity and origin in intramedullary bone-lengthening nails. A good reproducibility agreement in both severity and origin was found between four orthopaedic surgeons for both cohort and literature complication cases. For clinical and research purposes, a shared language for communicating complications is essential. We encourage future studies to use a structured and validated complication classification.

How to cite this article: Frost MW, Rahbek O, Fridberg M, et al. Do Surgeons Agree on Severity and Origin of Complications in Bone-lengthening Nails? An Inter- and Intra-rater Reliability Study. Strategies Trauma Limb Reconstr 2022;17(3):153-158.

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外科医生对骨延长钉并发症的严重程度和来源达成一致吗？评分者间和评分者内的可靠性研究。

背景：骨延长钉会导致不同严重程度和来源的各种并发症。然而，尚未就并发症的通用报告系统达成一致，因此很难比较不同的指甲设计和患者群体。本研究旨在评估根据严重程度和起源的并发症分类系统的评分者之间和评分者内部的一致性。材料和方法：四名整形外科医生评估了从单中心队列的患者图表中检索到的48例并发症和49例文献并发症病例。并发症根据Black等人的严重程度分级（I、II、IIIA和IIIB）和起源进行分类，分为8种主要类型和33种亚型。至少间隔六周进行两次盲法独立评估。在Svanholm等人之后，对Cohen/Congers评估的评分者间和评分者内一致性进行了解释。结果：在队列病例中，外科医生对并发症严重程度的评分者之间一致性良好，分别为0.68[95%置信区间（CI）：0.56-0.79]和0.63（CI：0.53-0.73）的并发症起源。在文献案例中，并发症严重程度和起源分级的kappa值分别为0.64（CI:0.53-0.75）和0.74（CI=0.65-0.83）。评分者内部对并发症严重程度的评估和起源分级有良好到极好的一致性，kappa值范围为0.51到0.97。结论和临床意义：本研究首次对髓内骨延长钉的严重程度和起源。在队列和文献并发症病例中，四名整形外科医生在严重程度和起源方面都发现了良好的再现性一致性。出于临床和研究目的，交流并发症的共享语言至关重要。我们鼓励未来的研究使用结构化和经过验证的并发症分类。如何引用这篇文章：Frost MW，Rahbek O，Fridberg M等人。外科医生对骨延长钉并发症的严重程度和起源达成一致吗？评分者间和评分者内的可靠性研究。创伤肢体康复策略2022；17（3）：153-158。

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.