Affordable Access

Access to the full text

Inter-rater variability of three-dimensional fracture reduction planning according to the educational background

  • Zindel, Christoph1, 2
  • Fürnstahl, Philipp1
  • Hoch, Armando1, 2
  • Götschi, Tobias2, 3
  • Schweizer, Andreas2
  • Nagy, Ladislav2
  • Roner, Simon1, 2
  • 1 University of Zurich, Balgrist CAMPUS, Zurich, Switzerland , Zurich (Switzerland)
  • 2 University of Zurich, Zurich, Switzerland , Zurich (Switzerland)
  • 3 ETH Zurich, Zurich, Switzerland , Zurich (Switzerland)
Published Article
Journal of Orthopaedic Surgery and Research
Springer (Biomed Central Ltd.)
Publication Date
Feb 25, 2021
DOI: 10.1186/s13018-021-02312-w
Springer Nature


BackgroundComputer-assisted three-dimensional (3D) planning is increasingly delegated to biomedical engineers. So far, the described fracture reduction approaches rely strongly on the performance of the users. The goal of our study was to analyze the influence of the two different professional backgrounds (technical and medical) and skill levels regarding the reliability of the proposed planning method. Finally, a new fragment displacement measurement method was introduced due to the lack of consistent methods in the literature.Methods3D bone models of 20 distal radius fractures were presented to nine raters with different educational backgrounds (medical and technical) and various levels of experience in 3D operation planning (0 to 10 years) and clinical experience (1.5 to 24 years). Each rater was asked to perform the fracture reduction on 3D planning software.ResultsNo difference was demonstrated in reduction accuracy regarding rotational (p = 1.000) and translational (p = 0.263) misalignment of the fragments between biomedical engineers and senior orthopedic residents. However, a significantly more accurate planning was performed in these two groups compared with junior orthopedic residents with less clinical experience and no 3D planning experience (p < 0.05).ConclusionExperience in 3D operation planning and clinical experience are relevant factors to plan an intra-articular fragment reduction of the distal radius. However, no difference was observed regarding the educational background (medical vs. technical) between biomedical engineers and senior orthopedic residents. Therefore, our results support the further development of computer-assisted surgery planning by biomedical engineers. Additionally, the introduced fragment displacement measure proves to be a feasible and reliable method.Level of EvidenceDiagnostic Level II

Report this publication


Seen <100 times