August 13, 2015

The AO classification system was determined to be easier to comprehend for the diagnosis of ankle injuries vs. the Lauge-Hansen classification system, with the AO system demonstrating better reliability and reproducibility, according to study results.

Researchers retrospectively analyzed 56 patients (mean age: 63.3 years) who underwent surgery for ankle injuries between October 2008 and October 2013, among which, 25 were left ankle fractures and 31 were right ankle fractures. Examination results and imaging data were collected by a specialist.

Five orthopedic surgeons trained to use the Lauge-Hansen and AO classification systems for classifying ankle injuries were asked to classify all of the patients using the two systems. After 1 month, surgeons repeated the classification process.

One physician not involved with study recorded the two sets of classifications. The researchers analyzed the reliability and reproducibility of the two classification systems and quantified with Cronbach’s alpha coefficient. Additionally, the researchers evaluated results for inter- and intraobserver reliability and reproducibility of both classification systems.

There were a total of 560 classifications. The AO classification systemaverage kappa values for interobserver reliability and intraobserver reproducibility were 0.708 and 0.608, respectively. Average kappa values for the Lauge-Hansen system were 0.402 and 0.398, respectively. The AO system had a Cronbach’s alpha coefficient of 96.7 %, whereas the Lauge-Hansen system’s Cronbach’s alpha coefficient was 76%.

Reliability and reproducibility analysis results demonstrated the AO classification system’s reliability and reproducibility was substantial, whereas the Lauge-Hansen system’s reliability was substantially consistent and reproducibility was fair, according to the researchers. ‒ by Monica Jaramillo

Disclosure: The researchers report no relevant financial disclosures.

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