Slovenská chirurgia 1/2023

Reliability of the Sanders classification of calcaneal fractures

Aim of the study: Comparison of interobserver reliability of Sanders classification of calcaneal fracture using full CT scan data or a CT cut in the representative semicoronal plane. Methodology: Fifty entire CT scan data of intraarticular calcaneal fractures were retrieved from hospital Picture Archiving and Communication System (PACS) between 07/2017 and 11/2020. All calcaneal fractures were classified according Sanders independently by 6 assessors from entire set of CT scan data including multiplanar view. Three months later a representative semicoronal CT cut of each case was used to classify calcaneal fracture using Sanders classification. The results were analyzed with a linear weighted kappa test including the categories and subcategories. Results: Mean kappa for Sanders subcategory reached 0,25 (fair reliability) and 0,25 (fair reliability) in four main categories when full set of CT slices was used. Mean kappa for subcategory was 0,28 (fair reliability) and 0,41 (moderate reliability) for main category if representative semicoronal CT cut was used. Conclusion: The results of the study show that using only four main categories and one representative semicoronal CT cut can increase interobserver reliability of Sanders classification of calcaneal fracture.

Keywords: calcaneus fracture, Sanders classification, CT scan