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New Classification System for Proximal Fifth Metatarsal Fractures: Intraobserver and Interobserver Reliability Assessment
Indexado
WoS WOS:001388133200001
Scopus SCOPUS_ID:85214032558
DOI 10.1177/10711007241303756
Año 2025
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Background: The most commonly used classification for proximal fifth metatarsal fractures has not shown good reproducibility. The aim of this study was to evaluate the intraobserver and interobserver agreement of a new classification system for such fractures.Methods: The study involved the development of a novel classification system that categorized these fractures into 2 main types and 2 subtypes. This cross-sectional study included a total of 52 cases that were retrospectively collected to assess the reliability of this system. These cases were then evaluated by 3 independent foot and ankle surgeons who classified the fractures based on the newly established classification system. After 10 months, the same evaluators classified the fractures again. The level of agreement among the evaluators, both internally and externally, was assessed using the kappa coefficient, following the criteria established by Landis and Koch. This framework categorizes agreement levels as slight (0.00-0.20), fair (0.21-0.40), moderate (0.41-0.60), substantial (0.61-0.80), or almost perfect (0.81-1.00).Results: Fifty-two fractures were detected, and 312 evaluations were carried out. The interobserver agreement was substantial when assessing the 2 main types, with a kappa value of 0.73, and remained substantial even when considering the subtypes, with a kappa value of 0.67. Similarly, the intraobserver agreement demonstrated substantial outcomes when evaluating the 2 main types, with a kappa value 0.79. It maintained its significance when including the subtypes, with a kappa value 0.77.Conclusion: Lawrence and Botte's classification identifies 3 primary zones and exhibits moderate interobserver agreement. In contrast, the newly proposed system focuses on only 2 main zones and shows better interobserver agreement. The present study introduces a more precise and reproducible framework that reveals consistency among various observers, including the same observer. This framework may be beneficial for biomedical research as it enhances the ability to compare results across different studies.

Revista



Revista ISSN
Foot & Ankle International 1071-1007

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Disciplinas de Investigación



WOS
Orthopedics
Scopus
Surgery
Orthopedics And Sports Medicine
SciELO
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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Fernández-Rojas, Enrique - Las Higueras Hosp - Chile
Universidad Católica de la Santísima Concepción - Chile
Hospital Las Higueras - Chile
2 Araya-Bonilla, Víctor - Las Higueras Hosp - Chile
Universidad Católica de la Santísima Concepción - Chile
Hospital Las Higueras - Chile
3 Barra-Dinamarca, Emilio - Las Higueras Hosp - Chile
Universidad Católica de la Santísima Concepción - Chile
Hospital Las Higueras - Chile
4 Pastor-Villablanca, Juan - San Carlos Hosp - Chile
San Carlos Hospital - Chile
5 Mortada-Mahmoud, Ahmed - Minia Univ Hosp - Egipto
Al-Minya University Hospital - Egipto
6 Alvarado-Livacic, Cristobal - Universidad Católica de la Santísima Concepción - Chile
Hospital Las Higueras - Chile
7 Vilá-Rico, J. - Univ Hosp October 12 - España
UNIV COMPLUTENSE MADRID - España
University Hospital - España
Universidad Complutense de Madrid - España

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Financiamiento



Fuente
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Agradecimientos



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