Mayo classification of olecranon fractures revisited – Assessment of intra- and interobserver reliability based on CT scans

• Published in: Journal of orthopaedics 2024-06, Vol.52, p.102-106
• Main Authors: Harbrecht, Andreas, Hackl, Michael, Ott, Nadine, Uschok, Stephan, Wegmann, Kilian, Müller, Lars P., Leschinger, Tim
• Format: Article
• Language: English
• Subjects: CT-scans; Interobserver reliability; Intraobserver reliability; Mayo classification; Olecranon fractures
• ISSN: 0972-978X; 0972-978X
• DOI: 10.1016/j.jor.2024.02.026

Olecranon fractures are classified using the commonly accepted Mayo classification. Its reliability has been analyzed by means of radiographs. A CT scan is often obtained due to joint involvement. Purpose of this study was to evaluate the intra- and interobserver reliability of the Mayo classification based on CT examination. Radiographic and CT images of 20 olecranon fractures were classified by four surgeons at two time points 30 days apart. Intra- and interobserver reliability were assessed using kappa coefficients. Mean intraobserver reliability between X-rays was substantial and between CTs almost perfect (0.76 and 0.82, respectively). Mean interobserver reliability was fair for X-rays and moderate for CTs (0.32 and 0.44, respectively). Despite the more detailed imaging compared with radiography only moderate interobserver reliability was found for the classification of olecranon fractures based on CT imaging. This might lead to inconsistent fracture classification in both scientific and clinical setting.