Reliability of Lichtman's classification for Kienböck's disease in 99 subjects

Hand Surg. 2011;16(1):15-8. doi: 10.1142/S0218810411005035.

Abstract

Purpose: The objective of this research was to investigate the reliability of Lichtman's classification for Kienböck's disease.

Methods: Interobserver reliability and intraobserver reproducibility were investigated by interpreting both anteroposterior and lateral X-rays of the wrist joint twice in 99 patients with Kienböck's disease using the modified Lichtman's classification system. Observers comprised three orthopaedic surgeons, and no information was exchanged between observers either before or during the study.

Results: Intraobserver reliability was moderate (0.313-0.628), and interobserver reliability was fair (Siegel's kappa = 0.228).

Conclusion: Low values were obtained regarding interobserver reliability for the modified Lichtman's classification of Kienböck's disease. This classification is thus inadequate for use in clinical settings. A new classification should be established.

MeSH terms

  • Humans
  • Osteonecrosis / classification*
  • Osteonecrosis / diagnostic imaging
  • Osteonecrosis / surgery
  • Preoperative Period
  • ROC Curve
  • Radiography
  • Reproducibility of Results
  • Retrospective Studies
  • Wrist Joint / diagnostic imaging*
  • Wrist Joint / surgery