Computed tomography improves the diagnostic accuracy but not the interobserver reliability of the Boileau classification of proximal humerus fracture sequelae.
Boileau classification
Sensitivity and specificity
computed tomography scan
diagnostic accuracy
proximal humerus fracture sequelae
Journal
Shoulder & elbow
ISSN: 1758-5732
Titre abrégé: Shoulder Elbow
Pays: United States
ID NLM: 101506589
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
27
09
2022
revised:
13
12
2022
accepted:
13
12
2022
pmc-release:
01
12
2024
medline:
20
11
2023
pubmed:
20
11
2023
entrez:
20
11
2023
Statut:
ppublish
Résumé
The aim of this study was to investigate the impact of computed tomography on the reliability of Boileau classification for proximal humerus fracture sequelae. A prospective study was designed using STARD guidelines. We included all patients diagnosed with proximal humerus fracture sequelae who underwent surgery at our institution between 2017 and 2021. Preoperative radiographs and computed tomography scans were reviewed by three independent observers. Intra- and inter-observer reliability and the diagnostic accuracy of radiographs and computed tomography scans in detecting chronic dislocation, nonunion, and severe greater tuberosity dislocation were assessed. Fifty-two patients were included in the study. The overall interobserver agreement was low on both radiographs and computed tomography scans. On radiographic images, we found a sensitivity of 97%, 88.9%, and 84.1%, and a specificity of 58.3%, 40%, and 53.3% to detect chronic dislocation, nonunion, and greater tuberosity dislocation, respectively. On computed tomography scans we reported a sensitivity of 100%, 96.8%, and 93.7%, and a specificity of 91.7%, 86.7%, and 93.3% to detect chronic dislocation, nonunion, and greater tuberosity dislocation, respectively. Computed tomography scan was more specific than radiographs in the assessment of proximal humerus fracture sequelae. However, even using a three-dimensional evaluation of the deformity, the Boileau classification had a poor interobserver reliability. I. Testing previously developed diagnostic criteria in a consecutive series of patients and a universally applied "gold standard."
Sections du résumé
Background
UNASSIGNED
The aim of this study was to investigate the impact of computed tomography on the reliability of Boileau classification for proximal humerus fracture sequelae.
Methods
UNASSIGNED
A prospective study was designed using STARD guidelines. We included all patients diagnosed with proximal humerus fracture sequelae who underwent surgery at our institution between 2017 and 2021. Preoperative radiographs and computed tomography scans were reviewed by three independent observers. Intra- and inter-observer reliability and the diagnostic accuracy of radiographs and computed tomography scans in detecting chronic dislocation, nonunion, and severe greater tuberosity dislocation were assessed.
Results
UNASSIGNED
Fifty-two patients were included in the study. The overall interobserver agreement was low on both radiographs and computed tomography scans. On radiographic images, we found a sensitivity of 97%, 88.9%, and 84.1%, and a specificity of 58.3%, 40%, and 53.3% to detect chronic dislocation, nonunion, and greater tuberosity dislocation, respectively. On computed tomography scans we reported a sensitivity of 100%, 96.8%, and 93.7%, and a specificity of 91.7%, 86.7%, and 93.3% to detect chronic dislocation, nonunion, and greater tuberosity dislocation, respectively.
Discussion
UNASSIGNED
Computed tomography scan was more specific than radiographs in the assessment of proximal humerus fracture sequelae. However, even using a three-dimensional evaluation of the deformity, the Boileau classification had a poor interobserver reliability.
Level of Evidence
UNASSIGNED
I. Testing previously developed diagnostic criteria in a consecutive series of patients and a universally applied "gold standard."
Identifiants
pubmed: 37981965
doi: 10.1177/17585732221150785
pii: 10.1177_17585732221150785
pmc: PMC10656970
doi:
Types de publication
Journal Article
Langues
eng
Pagination
634-640Informations de copyright
© The Author(s) 2023.
Déclaration de conflit d'intérêts
The authors, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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