A comprehensive classification of mandibular fractures: a preliminary agreement validation study

C. H. Buitrago-Téllez, L. Audigé, E Bradley Strong, P. Gawelin, J. Hirsch, M. Ehrenfeld, R. Ruddermann, P. Louis, C. Lindqvist, C. Kunz, P. Cornelius, K. Shumrick, R. M. Kellman, A. Sugar, B. Alpert, J. Prein, J. Frodel

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

This study evaluates a comprehensive classification system for mandibular fractures based on imaging analysis. The AO/ASIF scheme, defining three fracture types (A, B, C), three groups within each type (e.g. A1, A2, A3) and three subgroups within each group (e.g. A1.1, A1.2, A1.3) with increasing severity from A1.1 (lowest) to C3.3 (highest) was used. The mandible is divided into two vertical units (I and V), two lateral horizontal units (II and IV) and one central unit (III) comprising the symphyseal and parasymphyseal region. Type A fractures are non-displaced, type B are displaced and type C are multifragmentary/defect injuries. Groups and subgroups are further defined in the classification system. Two classification sessions using semi-automatic software with 7 and 9 surgeons were performed to evaluate 100 fracture cases in the first session and 50 in the second. Inter-observer reliability and individual rater's accuracy were evaluated by kappa coefficient and latent class analysis, respectively. The analysis of inter-observer agreement for the detailed coding showed kappa coefficients around 0.50 with higher agreement among raters in the vertical units. This system allows standardization of documentation of mandibular fractures, although improvement in the definition of categories and their application is required.

Original languageEnglish (US)
Pages (from-to)1080-1088
Number of pages9
JournalInternational Journal of Oral and Maxillofacial Surgery
Volume37
Issue number12
DOIs
StatePublished - Dec 2008

Keywords

  • classification
  • conventional panoramic tomography
  • face
  • fractures
  • mandibular fractures
  • reliability
  • validation

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery

Fingerprint Dive into the research topics of 'A comprehensive classification of mandibular fractures: a preliminary agreement validation study'. Together they form a unique fingerprint.

  • Cite this

    Buitrago-Téllez, C. H., Audigé, L., Strong, E. B., Gawelin, P., Hirsch, J., Ehrenfeld, M., Ruddermann, R., Louis, P., Lindqvist, C., Kunz, C., Cornelius, P., Shumrick, K., Kellman, R. M., Sugar, A., Alpert, B., Prein, J., & Frodel, J. (2008). A comprehensive classification of mandibular fractures: a preliminary agreement validation study. International Journal of Oral and Maxillofacial Surgery, 37(12), 1080-1088. https://doi.org/10.1016/j.ijom.2008.06.008