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Multicenter Study
. 2011 May 6:12:89.
doi: 10.1186/1471-2474-12-89.

Development and validation of a paediatric long-bone fracture classification. A prospective multicentre study in 13 European paediatric trauma centres

Dorien Schneidmüller  1 , Christoph Röder, Ralf Kraus, Ingo Marzi, Martin Kaiser, Daniel Dietrich, Lutz von Laer
Affiliations
Multicenter Study

Development and validation of a paediatric long-bone fracture classification. A prospective multicentre study in 13 European paediatric trauma centres

Dorien Schneidmüller et al. BMC Musculoskelet Disord. .

Abstract

Background: The aim of this study was to develop a child-specific classification system for long bone fractures and to examine its reliability and validity on the basis of a prospective multicentre study.

Methods: Using the sequentially developed classification system, three samples of between 30 and 185 paediatric limb fractures from a pool of 2308 fractures documented in two multicenter studies were analysed in a blinded fashion by eight orthopaedic surgeons, on a total of 5 occasions. Intra- and interobserver reliability and accuracy were calculated.

Results: The reliability improved with successive simplification of the classification. The final version resulted in an overall interobserver agreement of κ = 0.71 with no significant difference between experienced and less experienced raters.

Conclusions: In conclusion, the evaluation of the newly proposed classification system resulted in a reliable and routinely applicable system, for which training in its proper use may further improve the reliability. It can be recommended as a useful tool for clinical practice and offers the option for developing treatment recommendations and outcome predictions in the future.

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Figures

Figure 1
Figure 1
Flow chart of study history.
Figure 2
Figure 2
Overall structure of the Li-La Classification of paediatric fractures of long bones.
Figure 3
Figure 3
Overview of Li-La classification of paediatric long bone fractures: articular fractures.
Figure 4
Figure 4
Overview of Li-La classification of paediatric long bone fractures: shaft fractures.
Figure 5
Figure 5
A buckle fracture of the distal radius. The classification is determined as follows: localization in the skeleton - radius = 2; localization in the bone - metaphysis (square rule) = 3; morphology - shaft = s; fracture type - buckle fracture = 2; displacement - non-displaced = 0. Code: 2.3.s.2.0.
See this image and copyright information in PMC

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