Assessment of interobserver reliability and intraobserver repeatability of letournel and judet classification for acetabular fractures
Background: Acetabular fractures account for 1–2% of all fractures and pose significant challenges for orthopedic surgeons due to complex anatomy and risks of long-term functional impairment. The Letournel and Judet (L-J) classification system, while popular for its simplicity and association with s...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Journal of Orthopaedic Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773157X24002145 |
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| Summary: | Background: Acetabular fractures account for 1–2% of all fractures and pose significant challenges for orthopedic surgeons due to complex anatomy and risks of long-term functional impairment. The Letournel and Judet (L-J) classification system, while popular for its simplicity and association with surgical outcomes, raises concerns about interobserver reliability and intraobserver repeatability across different populations. Objective: To assess the interobserver reliability and intraobserver repeatability of the L-J classification for acetabular fractures and evaluate the impact of CT scans on classification reliability. Methods: This prospective observational study was conducted at B & B Hospital, Gwarko, Lalitpur, Nepal, over one year. A total of 45 skeletally mature patients with confirmed acetabular fractures were recruited. Six experienced pelvic surgeons were divided into three groups and independently classified each fracture using the L-J system based on plain radiographs, Judet views, and CT scans. Results: The mean age of participants was 36.75 years, with 86 % male representation. Fracture side distribution showed 46 % on the left and 54 % on the right. Interobserver reliability, assessed using Cohen's kappa coefficient, showed substantial agreement (k = 0.77) for most fracture types. Intraobserver repeatability also demonstrated substantial consistency among individual assessors over time. The evaluation of CT scans revealed insights into the reliability of the L-J classification system. Conclusion: This study enhances the understanding of the L-J classification's reliability for acetabular fractures, providing crucial information for its effective implementation in clinical practice. |
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| ISSN: | 2773-157X |