We evaluated the inter- and intra-observer reproducibility of two classification systems for central talar fractures (Hawkins, as modified by Canal and Kelly and then by us; AO/AOT).
The analysis and classification of these fractures will be better with CT scans than with X-rays.
Material and Methods
Four observers evaluated 39 X-ray and CT scan files twice in the span of six weeks; each evaluation entailed classifying the fractures and describing their main features. Cohen’s Kappa coefficient for inter-rater agreement was calculated and analysed.
The inter- and intra-observer reproducibility with CT scans was better with X-rays for most of the parameters evaluated. The modified Hawkins classification provided better reproducibility than the AO/AOT one. However, this classification system was not perfect, even after modifications and use of CT scans.
CT scans are an essential tool for the analysis of all talar fractures. We modified the Hawkins classification (as modified by Canal and Kelly) to include a Type 0 (no displacement or less than 2mm), include frontal body fractures that are displaced like neck fractures and take into account comminuted fractures and other trauma in the area.
Level of proof
IV – retrospective clinical study.Le texte complet de cet article est disponible en PDF.
Keywords : Talus, Fracture, Classification, CT scan, X-rays, Inter- and intra-observer reproducibility
MeSH terms : Humans, Talus, Tomography, X-Ray computed/methods, Observer variation, Reproducibility of results, Retrospective studies, Fractures/classification, Fractures/radiography