Inter-and intra-observer reliability of revised Schatzker classification and Four-column/nine-segment classification of tibial plateau fractures
Objective To assess inter-and intra-observer reliagility of revised Schatzker classification system and Four-column/nine-segment system for tibial plateau fractures among orthopaedic surgeons of different level.Methods This retrospective study was conducted with five observers.Radiographic and tomographic imaging of the knee of one hundred patients with tibial plateau fractures between Jan 2020 and Jun 2022 were evaluated.After one month,the test was repeated to evaluate consis-tency.The level of agreement was calculated by the Kendall's W test and Kappa index.Results In the first test,inter-observer reliability of five surgeons,according to the Kappa index,was 0.875(x2=433.103)for revised Schatzker classification and 0.813(x2=402.617)for Four-column/nine-segment.In the second test,values were 0.930(x2=460.290)and 0.870(x2=430.535)re-spectively.The result was considered as excellent.Regarding intra-observer analysis,the mean Kappa indexes of surgeons were 0.784 of revised Schatzker classification and 0.767 of Four-column/nine-segment classification,the result was classified as good.Intra-observer reliability was higher among senior surgeon's.Conclusion Revised Schatzker classification and Four-column/nine-segment classification demonstrate excellent inter-observer reliability and good intra-observer reliability,and both can guide the morphological analysis and treatment effectively.