127.
Translation between the Neer classification and the AO/OTA
classification: Do we need to be bilingual to interpret the scientific
literature?
Stig Brorson, Henrik Eckardt, Laurent Audigé, Bernd Rolauffs, Christian
Bahrs
Department of Orthopaedic Surgery Herlev University Hospital, Denmark;
Department of Orthopaedic Surgery, Rigshospitalet, Denmark; AO Clinical
Investigation and Documentation, Dübendorf, Switzerland; Hospital for
Traumatology and Reconstructive Surgery, BG Trauma Center, Tübingen,
Germany; Hospital for Traumatology and Reconstructive Surgery, BG Trauma
Center, Tübingen, Germany
Background:
High quality evidence on outcome after interventions for
fractures of the proximal humerus is sparse. The conduct of randomised
clinical trials and the extrapolation of data are facilitated by a rigorous
approach to classification. However, two partly incommensurable fracture
classification systems are widely used in the scientific literature, the Neer
classification and the AO/OTA classification. It remains difficult to obtain
consensus on treatment recommendations when clear definitions and a
common ‘fracture language’ are lacking.
Purpose / Aim of Study:
To systematically search and analyse classification
data from studies classifying proximal humeral fractures according to both
classification systems.
Materials and Methods:
We ‘mapped’ patterns of translation between the
two classification systems as they appeared in the scientific literature.
Problematic or implausible combinations were identified and discussed.
Findings / Results:
Authors from seven studies provided classification data
within both classification systems (n=2530). Thirty- five percent (151 out of
432)
of the combinations were considered ‘not plausible’. Clinically important
information was lost within both classification systems. Most importantly, the
varus/valgus distinction is not found in the Neer classification, and a clear
definition of displacement is lacking in the AO/OTA classification.
Conclusions:
Ideally, classification data from both systems should be
reported. We propose a cross-table covering all combinations of Neer
categories and AO/OTA subgroups for quality control of studies reporting data
from both classification systems.
