Aybar´s classification: a simple classification for open fractures with good interobserver and intraobserver reliability.

Abstract

Abstract Purpose Currently, the Gustilo-Anderson classification is the most widely used means of assessing open injuries, but it has many limitations. A limitation of Gustilo-Anderson classification and current classification is that does not address the severity of injuries of the bone. The aim of this paper is to show the Aybar classification, as a simple classification of open fractures that have a good interobserver and intraobserver reliability. Methods Retrospective study of 141 open tibial fractures. Aybar classification was developed in 1982 and modified to its present form after the experienced in their use and the development of new management of open fractures. Thirty-eight independent, blinded observers reviewed the radiographs and skin lesions images in two separate occasions, with a minimum two-week interval between sittings. The observers represented a different level of orthopaedic training. Interobserver and intraobserver reliability, was analyzed. Results Inter-observer and intra-observer assessment demonstrated a high reliability compared with the Gustilo–Anderson classification. Also, there was a high agreement between residents and surgeons, with kappa value > 0.80. Conclusions The classification had a good inter-observer and intra-observer agreement and it is presents in a simple and understandable shape for the prognostics of open fracture, through a cross-table diagram.

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