Download PDF
J Hand Microsurg 2012; 04(01): 12-15
DOI: 10.1007/s12593-012-0062-2
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Scaphoid Nonunion Advanced Collapse Classifications: A Reliability Study

Fernando Travaglini Penteado
,
João Baptista Gomes dos Santos
,
Fábio Augusto Caporrino
,
Vinícius Ynoe de Moraes
,
João Carlos Belloti
,
Flávio Faloppa
Subject Editor:
Further Information

Publication History

29 November 2011

09 January 2012

Publication Date:
05 September 2016 (online)

  PDF Download  Permissions and Reprints

Abstract

Watson & Ballet and Vender staging systems are widely known for classifying SNAC wrist osteoarthritis. Despite of its day-to-day use, no assessment for its agreement was performed. To Evaluate the intra and interobserver agreement for these classification systems. Forty-eight posteroanterior wrist radiographs from patients with osteoarthritis due to scaphoid nonunion were evaluated at two occasions—in a 1 week interval—by five observers with different expertise—hand surgeons, hand surgery residents, orthopedic surgeons and orthopedic surgery residents. They rated osteoarthritis stages according to the above-cited systems. Kappa statistics were performed for measuring agreement. Unsatisfactory (Cohen’s Kappa <0.5) agreement was found for all intra and inter observer measures for both systems. There was no clear correlation between expertise and kappa values. Unsatisfactory agreement was found for both classifications, despite the evaluator expertise. A rationale of a more reliable classification is needed.

Keywords

Scaphoid non-union - Wrist osteoarthritis - Agreement - Kappa statistics - Hand surgery - Classification systems
 

  • References

  • 1 Moritomo H, Tada K, Yoshida T, Masatomi T. The relationship between the site of nonunion of the scaphoid and scaphoid nonunion advanced collapse (SNAC). J Bone Joint Surg Br 1999; 81 ((5)) 871-876
    CrossrefPubMedSearch in Google Scholar
  • 2 Dt A, Watson HK, Damon C, Herber S, Paly W. Scapholunate advanced collapse wrist salvage. J Hand Surg Am 1994; 19 ((5)) 741-750
    CrossrefPubMedSearch in Google Scholar
  • 3 Kawamura K, Chung KC. Treatment of scaphoid fractures and nonunions. J Hand Surg Am 2008; 33 ((6)) 988-997
    CrossrefPubMedSearch in Google Scholar
  • 4 Krimmer H, Krapohl B, Sauerbier M, Hahn P. Posttraumatic carpal collapse (SLAC- and SNAC-wrist)—stage classification and therapeutic possibilities. Handchir Mikrochir Plast Chir 1997; 29 ((5)) 228-233
    PubMedSearch in Google Scholar
  • 5 Proctor MT. Non-union of the scaphoid: early and late management. Injury 1994; 25 ((1)) 15-20
    CrossrefPubMedSearch in Google Scholar
  • 6 Krakauer JD, Bishop AT, Cooney WP. Surgical treatment of scapholunate advanced collapse. J Hand Surg Am 1994; 19 ((5)) 751-759
    CrossrefPubMedSearch in Google Scholar
  • 7 Gohritz A, Gohla T, Stutz N, Moser V, Koch H, Krimmer H, Lanz U. Special aspects of wrist arthritis management for SLAC and SNAC wrists using midcarpal arthrodesis: results of bilateral operations and conversion to total arthrodesis. Bull Hosp Jt Dis 2005; 63 ((1–2)) 41-48
    PubMedSearch in Google Scholar
  • 8 Drac P, Pilny J, Manak P, Ira D, Cizmar I. Proximal row carpectomy in the treatment of degenerative arthritis of the wrist. Acta Chir Orthop Traumatol Cech 2009; 76 ((1)) 25-29
    PubMedSearch in Google Scholar
  • 9 Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg Am 1984; 9 ((3)) 358-365
    CrossrefPubMedSearch in Google Scholar
  • 10 Watson HK, Ryu J. Evolution of arthritis of the wrist. Clin Orthop Relat Res 1986; 202: 57-67
    PubMedSearch in Google Scholar
  • 11 Vender MI, Watson HK, Wiener BD, Black DM. Degenerative change in symptomatic scaphoid nonunion. J Hand Surg Am 1987; 12 ((4)) 514-519
    CrossrefPubMedSearch in Google Scholar
  • 12 Inoue G, Sakuma M. The natural history of scaphoid nonunion. Arch Orthop Trauma Surg 1996; 115 ((1)) 1-4
    CrossrefPubMedSearch in Google Scholar
  • 13 Karanicolas PJ, Bhandari M, Kreder H, Moroni A, Richardson M, Walter SD, Norman GR, Guyatt GH. on Behalf of the Collaboration for Outcome Assessment in Surgical Trials Musculoskeletal Group Evaluating agreement: conducting a reliability study.. J Bone Joint Surg Am 2009; 91 ((Supplement_3)) 99-106
    CrossrefPubMedSearch in Google Scholar
  • 14 Belloti JC, Tamaoki MJ, Franciozi CE, Santos JB, Balbachevsky D, Chap Chap E, Albertoni WM, Faloppa F. Are distal radius fracture classifications reproducible? Intra and interobserver agreement. Sao Paulo Med J 2008; 126 ((3)) 180-185
    CrossrefPubMedSearch in Google Scholar
  • 15 Matsunaga FT, Tamaoki MJ, Cordeiro EF, Uehara A, Ikawa MH, Matsumoto MH, dos Santos JB, Belloti JC. Are classifications of proximal radius fractures reproducible?. BMC Musculos-kelet Disord 2009; 10: 120
    CrossrefPubMedSearch in Google Scholar
  • 16 Moraes VY, Belloti JC, Moraes FY, Galbiatti JA, Palacio EP, Santos JB, Faloppa F. Hierarchy of evidence relating to hand surgery in Brazilian orthopedic journals. Sao Paulo Med J 2011; 129 ((2)) 94-98
    CrossrefPubMedSearch in Google Scholar
  • 17 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33 ((1)) 159-174
    CrossrefPubMedSearch in Google Scholar
  • 18 Strauch RJ. Scapholunate advanced collapse and scaphoid nonunion advanced collapse arthritis—update on evaluation and treatment. J Hand Surg Am 2011; 36 ((4)) 729-735
    CrossrefPubMedSearch in Google Scholar
  • 19 Petrie A. Statistics in orthopaedic papers. J Bone Joint Surg Br 2006; 88 ((9)) 1121-1136
    PubMedSearch in Google Scholar