{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:03:51Z","timestamp":1789387431820,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T00:00:00Z","timestamp":1535414400000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Femoral intertrochanteric fractures are among the most common fractures in the elderly. There are various classification systems in intertrochanteric fractures. The aim of these classification systems is to help surgeons choose an appropriate treatment. The treatment of femoral intertrochanteric fractures depends on the results of a stability evaluation using imaging studies. However, it is difficult to evaluate the true fracture line using plain X\u2010ray films, especially on the sagittal plane and for intertrochanteric fractures with complex morphologies. The aim of the current study was to determine whether three\u2010dimensional CT (3DCT) improves the reproducibility of stability evaluation for femoral intertrochanteric fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center observational study of intertrochanteric fractures. We retrospectively collected patients in our hospital with intertrochanteric fractures that underwent plain X\u2010ray (anteroposterior, lateral view) CT scans with axial images (2DCT) and 3DCT for an injured hip between 1 December 2011 and 30 November 2015. The exclusion criteria were pathological fractures (due to metastasis or primary bone tumors) and previous intertrochanteric surgery. During this period, 61\u2009patients were enrolled. Two patients were excluded because lateral view X\u2010rays were not available. A total of 59\u2009patients (27 women, 32 men) with an average age of 77\u2009years (range, 55\u201396\u2009years) were included in our final analysis. The stability evaluation (i.e. stable or unstable) and implant choices (i.e. dynamic hip screws or Gamma nail) were recorded independently by four observers (two attending physicians and two residents). All images were reviewed and classified using the AO\/OTA and Evans modified by Jensen (EVJE) classification systems. The session was repeated after a 3\u2010month wash\u2010out period. The inter\u2010observer agreement was evaluated using the Kappa test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The inter\u2010observer agreements, measured by the mean weighted kappa values (expressed as X\u2010ray <jats:italic>vs<\/jats:italic> 3DCT) were as follows: For stability evaluation, the mean kappa values for attending physicians and residents were 0.68 versus 0.76 and 0.55 versus 0.56. For implant choices, the mean kappa values for attending physicians and residents were 0.68 versus 0.76 and 0.57 versus 0.65. For AO\/OTA classification, the values for attending physicians and residents were 0.67 versus 0.65 and 0.70 versus 0.81. For EVJE classification, the values for attending physicians and residents were 0.66 versus 0.63 and 0.56 versus 0.55.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three\u2010dimensional CT improved the reproducibility of stability evaluation for femoral intertrochanteric fractures. Preoperative CT scanning may provide a diagnostic benefit for evaluating the stability of intertrochanteric fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12396","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T02:08:42Z","timestamp":1535594922000},"page":"212-217","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Three\u2010dimensional CT Improves the Reproducibility of Stability Evaluation for Intertrochanteric Fractures"],"prefix":"10.1111","volume":"10","author":[{"given":"Yi\u2010cheng","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010yuan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Show\u2010Chwan Memorial Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010hung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Biotechnology Hung Kuang University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010hui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University  Taichung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010min","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Medicine Chung Shan Medical University  Taichung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2009.08.001"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678008990877"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-61261-9"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199312000-00001"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.13107\/ti.2015.v01i01.003","article-title":"Classifications of intertrochanteric fractures and their clinical importance","volume":"1","author":"Sonawane DV","year":"2015","journal-title":"Trauma Int"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000093.pub5"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2011.566143"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.05.031"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-015-1666-6"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-009-0795-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B6.22109"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bot.0000177107.30837.61"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002640100287"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B1.15295"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200107000-00012"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.10.007"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000100390"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2005.02.005"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(02)00089-X"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/000164701753606662"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.09.019"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000132264.14046.c2"},{"key":"e_1_2_6_25_1","unstructured":"KomagataN.Chance agreement and the significance of the kappa statistic 2002. 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