Are plain radiographs reliable in Lichtman classification?
Ahmet Nadir Aydemir1, Mehmet Yücens1, Cengiz Eren Cansu2, Ahmet Fahir Demirkan1
1Department of Orthopedics and Traumatology, Pamukkale University Faculty of Medicine, Denizli, Turkey
2Department of Orthopedics and Traumatology, Marmara University Faculty of Medicine, Istanbul, Turkey
Keywords: Agreement, classification, Kienböck, Lichtman, reliability
Objectives: This study aims to investigate the reliability of the Lichtman classification among residents, orthopedic surgeons, and hand surgeons.
Materials and methods: This study was carried out with 30 male observers (mean age 37.8 years; range, 26 to 62 years) who agreed to participate in the study. All observers were orthopedic surgeons. The observers were separated into three groups that consist of 10 residents, 10 orthopedic surgeons, and 10 hand surgeons. The anteroposterior and lateral wrist radiographs of 20 patients (12 males, 8 females; mean age 49 years; range, 38 to 74 years) diagnosed as Kienböck’s disease were sent to observers via e-mail as a survey. All 40 radiographs were asked to be kept classified.
Results: The classification of Kienböck’s disease was analyzed by 30 observers on 40 digital radiographs. The overall agreement with the Lichtman classification was fair within all of the observers (kappa=0.203). When groups were evaluated within themselves, the agreement level was found poor in group 1 (kappa=0.162) and fair in group 2 (kappa=0.210) and group 3 (kappa=0.252).
Conclusion: A useful classification system in orthopedics and traumatology should classify the type of musculoskeletal disorder reliably, facilitate communication in clinical practice, guide preoperative planning, and enable comparison of results between studies. The Lichtman classification alone is insufficient and should be supported by other imaging and measurement techniques.
Citation: Aydemir AN, Yücens M, Cansu CE, Demirkan AF. Are plain radiographs reliable in Lichtman classification?. Jt Dis Relat Surg 2020;31(1):34-38.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.