AbstractTile and Young-Burgess classification systems have been widely used to classify pelvic ring injuries in clinical settings; however, these two systems are rarely mentioned in the literature despite their reproducibility and practical application. The purpose of this study was to assess the interobserver and intraobserver reliability of the Tile and Young-Burgess classification of pelvic ring injuries.

Abstractile和Young-Burgess分类系统已被广泛用于临床环境中骨盆环损伤的分类；然而，这两个系统尽管具有可重复性和实际应用性，但在文献中很少提及。。

Eight hundred seven patients with pelvic fractures who presented to two I-level trauma centres between January 2016 and June 2020 were recruited for this study. The anteroposterior, inlet, and outlet of the pelvis were observed on radiographic images, and CT scans were performed on each patient. The anteroposterior, inlet, and outlet of the pelvis were radiographed at each visit, and CT scans were performed.

本研究招募了2016年1月至2020年6月期间在两个I级创伤中心就诊的87例骨盆骨折患者。在放射学图像上观察骨盆的前后，入口和出口，并对每位患者进行CT扫描。每次就诊时对骨盆的前后，入口和出口进行X线检查，并进行CT扫描。

Four observers were recruited to classify the injury type according to the Young-Burgess and Tile classification systems. Interobserver and intraobserver reliability (kappa coefficient, κ) were applied to assess the reproducibility of the two classification systems. A total of 174 patients (21.56%) could not be classified with the Young-Burgess classification, and all patients could be classified according to the Tile system.

根据Young Burgess和Tile分类系统，招募了四名观察员对伤害类型进行分类。观察者间和观察者内可靠性（kappa系数，κ）用于评估两种分类系统的可重复性。共有174名患者（21.56%）无法按Young-Burgess分类，所有患者均可根据Tile系统进行分类。

The mean κ value of the interobserver reliability was 0.558 (range, 0.444 to 0.653) for the Tile classification, indicating moderate agreement, whereas the mean κ value was 0.637 (range, 0.560 to 0.713), indicating substantial agreement, when the Young-Burgess classification was used. The mean κ value for intraobserver reliability was 0.597 (range, 0.567 to 0.653) for the Tile classification and 0.776 (range, 0.748 to 0.803) for the Young-Burgess classification.

对于瓷砖分类，观察者间可靠性的平均κ值为0.558（范围为0.444至0.653），表明中度一致，而平均κ值为0.637（范围为0.560至0.713），表明使用Young-Burgess分类时基本一致。观察者内可靠性的平均κ值对于瓷砖分类为0.597（范围0.567至0.653），对于Young-Burgess分类为0.776（范围0.748至0.803）。

More pelvic ring injuries could be classified with the Tile classification than.

。

IntroductionThe incidence of pelvic ring injury ranges from 23 to 446 per 100,000 patients1,2,3,4. Pelvic ring injuries are usually caused by high-energy violence. Prompt evaluation and treatment are need because of the risks of morbidity and mortality associated with these injuries5.The preoperative diagnosis of the type of pelvic fracture plays an important role in the treatment and prognosis of patients6,7.

引言骨盆环损伤的发生率为每10万例患者23〜446例[1,2,3,4]。骨盆环损伤通常是由高能暴力引起的。由于与这些损伤相关的发病率和死亡率风险，需要及时评估和治疗5。骨盆骨折类型的术前诊断对患者的治疗和预后起着重要作用6,7。

However, accurate diagnosis is highly challenging for orthopaedic surgeons because of the complex anatomy of the pelvic ring8,9. The Tile and Young-Burgess classification systems are widely used to classify pelvic ring injuries1,5,10. Tile classification was first proposed in 1980 and was applied in modified form as an AO/OTA classification system11,12.

然而，由于骨盆环的复杂解剖结构，准确的诊断对于整形外科医生来说是极具挑战性的8,9。Tile和Young-Burgess分类系统被广泛用于分类骨盆环损伤1,5,10。瓷砖分类于1980年首次提出，并以修改后的形式作为AO/OTA分类系统11,12应用。

The concepts of pelvic stability and the mechanism of injury were emphasized in this classification system12. Pelvic fractures can be divided into three types according to the stability of the posterior arch: stable (Type A), rotationally unstable (Type B), and rotationally and vertically unstable (Type C)12,13.

该分类系统强调了骨盆稳定性和损伤机制的概念12。根据后弓的稳定性，骨盆骨折可分为三种类型：稳定（A型），旋转不稳定（B型）和旋转和垂直不稳定（C型）12,13。

The Young-Burgess system, which was introduced by Young and Burgess in 1986, classifies pelvic fractures on the basis of the injury mechanism10,14. Pelvic disruptions were divided into four groups: lateral compression pattern, anterior posterior compression pattern, vertical shear pattern, and combined mechanical injuries.Although both classification systems are commonly used, the choice of classification system is controversial for orthopaedic surgeons and may play a negative role in communication and treatment1,5.

Young和Burgess于1986年引入的Young-Burgess系统根据损伤机制对骨盆骨折进行分类10,14。骨盆破裂分为四组：侧向压迫模式，前后压迫模式，垂直剪切模式和联合机械损伤。。

The purpose of this study was to assess the interobserver and intraobserver reliability of the Tile and Young-Burgess classifications for pelvic ring injuries. It was crucial to determine how us.

本研究的目的是评估Tile和Young-Burgess骨盆环损伤分类的观察者间和观察者内可靠性。至关重要的是要确定我们如何。

Data availability

数据可用性

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

在当前研究期间生成和/或分析的数据集可根据合理要求从通讯作者处获得。

ReferencesBerger-Groch, J. et al. The intra- and interobserver reliability of the Tile AO, the Young and Burgess, and FFP classifications in pelvic trauma. Arch. Orthop. Trauma. Surg. 139, 645–650 (2019).Article

参考文献Berger-Groch，J。等人。骨盆创伤中Tile AO，Young和Burgess以及FFP分类的观察者内和观察者间可靠性。拱门。骨科。创伤。外科杂志139645-650（2019）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Buller, L. T., Best, M. J. & Quinnan, S. M. A nationwide analysis of pelvic ring fractures: Incidence and trends in treatment, length of stay, and mortality. Geriatr. Orthop. Surg. Rehabil 7, 9–17 (2016).Article

Buller，L.T.，Best，M.J。＆Quinnan，S.M。骨盆环骨折的全国分析：治疗的发生率和趋势，住院时间和死亡率。老年人。骨科。外科康复7,9-17（2016）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Pereira, G. J. C. et al. Epidemiology of pelvic ring fractures and injuries. Rev. Bras. Ortop. 52, 260–269 (2017).Article

Pereira，G.J.C.等人，《骨盆环骨折和损伤的流行病学》。修订版Bras。奥尔托普。52260-269（2017）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Kannus, P., Parkkari, J., Niemi, S. & Sievanen, H. Low-trauma pelvic fractures in Elderly finns in 1970–2013. Calcif Tissue Int. 97, 577–580 (2015).Article

Kannus，P.，Parkkari，J.，Niemi，S。＆Sievenen，H。1970-2013年老年芬兰人的低创伤骨盆骨折。Calcif Tissue Int.97577–580（2015）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Koo, H. et al. Interobserver reliability of the young-burgess and tile classification systems for fractures of the pelvic ring. J. Orthop. Trauma. 22, 379–384 (2008).Article

Koo，H。等人。骨盆环骨折young-burgess和tile分类系统的观察者间可靠性。骨科杂志。创伤。22379-384（2008）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Rommens, P. M. & Hofmann, A. Comprehensive classification of fragility fractures of the pelvic ring: Recommendations for surgical treatment. Injury 44, 1733–1744 (2013).Article

Rommens，P.M。＆Hofmann，A。骨盆环脆性骨折的综合分类：手术治疗的建议。伤害441733-1744（2013）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Coccolini, F. et al. Pelvic trauma: WSES classification and guidelines. World J. Emerg. Surg. 12, 5 (2017).Article

Coccolini，F。等人。骨盆创伤：WSES分类和指南。世界J.Emerg。Surg。12，5（2017）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Resnik, C. S., Stackhouse, D. J., Shanmuganathan, K. & Young, J. W. Diagnosis of pelvic fractures in patients with acute pelvic trauma efficacy of plain radiographs. AJR Am. J. Roentgenol. 158, 109–112 (1992).Article

Resnik，C.S.，Stackhouse，D.J.，Shanmuganathan，K。＆Young，J.W。急性骨盆创伤患者骨盆骨折的诊断平片的疗效。AJR Am.J.Roentgenol。158109-112（1992）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Langford, J. R., Burgess, A. R., Liporace, F. A. & Haidukewych, G. J. Pelvic fractures: Part 1. Evaluation, classification, and resuscitation. J. Am. Acad. Orthop. Surg. 21, 448–457 (2013).Article

Langford，J.R.，Burgess，A.R.，Liporace，F.A。和Haidukewych，G.J。骨盆骨折：第1部分。评估，分类和复苏。J、 美国科学院。骨科。Surg.21448-457（2013）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Alton, T. B. & Gee, A. O. Classifications in brief: Young and burgess classification of pelvic ring injuries. Clin. Orthop. Relat. Res. 472, 2338–2342 (2014).Article

Alton，T.B.＆Gee，A.O.分类简介：骨盆环损伤的Young和burgess分类。临床。骨科。相关。第4722338-2342号决议（2014年）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Miranda, M. A., Riemer, B. L., Butterfield, S. L. & Burke, C. J. Pelvic ring injuries. A long term functional outcome study. Clin. Orthop. Relat. Res. 329, 152–159 (1996).Article

Miranda，M.A.，Riemer，B.L.，Butterfield，S.L。和Burke，C.J。骨盆环损伤。长期功能结果研究。临床。骨科。相关。第329152-159号决议（1996年）。文章

Google Scholar

谷歌学者

Pennal, G. F., Tile, M., Waddel, J. P. & Garside, H. Pelvic disruption assessment and classification. Clin. Orthop. Relat. Res. 151, 12–21 (1980).

Pennal，G.F.，Tile，M.，Waddel，J.P。＆Garside，H。骨盆破裂评估和分类。临床。骨科。相关。第151、12-21号决议（1980年）。

Google Scholar

谷歌学者

Zingg, T. et al. Interobserver reliability of the tile classification system for pelvic fractures among radiologists and surgeons. Eur. Radiol. 31, 1517–1525 (2021).Article

Zingg，T.等人。放射科医生和外科医生骨盆骨折tile分类系统的观察者间可靠性。欧洲放射性。。文章

PubMed

PubMed

Google Scholar

谷歌学者

Young, J. W., Burgess, A. R., Brumback, R. J. & Poka, A. Pelvic fractures value of plain radiography in early assessment and management. Radiology. 160, 445–451 (1986).Article

Young，J.W.，Burgess，A.R.，Brumback，R.J。＆Poka，A。骨盆骨折平片在早期评估和管理中的价值。放射学。。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Landis, J. R. & Koch, G. G. The measurement of observer agreement for categorical data. Biometrics. 33, 159–174 (1977).Article

Landis，J.R.＆Koch，G.G。观察者对分类数据的一致性的测量。生物特征。33159-174（1977）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Audigé, L., Bhandari, M., Hanson, B. & Kellam, J. A concept for the validation of fracture classifications. J. Orthop. Trauma. 19, 401–406 (2005).PubMed

。J、 骨科。创伤。19401-406（2005）。PubMed出版社

Google Scholar

谷歌学者

Zhang, R. et al. Three-column classification for Acetabular fractures: Introduction and reproducibility assessment. J. Bone Jt. Surg. Am. 101, 2015–2025 (2019).Article

Zhang，R。等。髋臼骨折的三列分类：简介和可重复性评估。J、 骨Jt。外科杂志1012015-2025（2019）。文章

Google Scholar

谷歌学者

Giorgi, P. D. et al. Reliability and reproducibility analysis of the AOSpine sacral fractures classification system by spinal and pelvic surgeons. Injury 53, 2110–2113 (2022).Article

。伤害532110-2113（2022）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Sagi, H. C., Coniglione, F. M. & Stanford, J. H. Examination under anesthetic for occult pelvic ring instability. J. Orthop. Trauma. 25, 529–536 (2011).Article

Sagi，H.C.，Coniglione，F.M。和Stanford，J.H。在麻醉下检查隐匿性骨盆环不稳定。J、 骨科。创伤。25529-536（2011）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Khurana, B., Sheehan, S. E., Sodickson, A. D. & Weaver, M. J. Pelvic ring fractures what the orthopedic surgeon wants to know. Radiographics. 34, 1317–1333 (2014).Article

Khurana，B.，Sheehan，S.E.，Sodickson，A.D。和Weaver，M.J。骨盆环骨折骨科医生想知道什么。射线照片。341317-1333（2014）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Furey, A. J. et al. Classification of pelvic fractures: Analysis of inter- and intraobserver variability using the Young-Burgess and Tile classification systems. Orthopedics 32, 401 (2009).Article

。骨科32401（2009）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Linnau, K. F. et al. Do initial radiographs agree with crash site mechanism of injury in pelvic ring disruptions? A plot study. J. Orthop. Trauma. 21, 375–380 (2007).Article

Linnau，K.F.等人，最初的X光片是否与骨盆环破裂的碰撞部位损伤机制一致？情节研究。J、 骨科。创伤。21375-380（2007）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Gabbe, B. J. et al. The imaging and classification of severe pelvic ring fractures experiences from two level 1 trauma centres. Bone Joint J. 95-b, 1396–1401 (2013).Article

Gabbe，B.J.等人。严重骨盆环骨折的影像学和分类来自两个1级创伤中心。骨关节J.95-b，1396-1401（2013）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Ghisla, S. et al. Posterior pelvic ring fractures: Intraoperative 3D-CT guided navigation for accurate positioning of sacro-iliac screws. Orthop. Traumatol. Surg. Res. 104, 1063–1067 (2018).Article

Ghisla，S。等。骨盆后环骨折：术中3D-CT引导下骶髂螺钉精确定位导航。骨科。创伤。Surg.Res.1041063–1067（2018）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Brouwers, L., Lansink, K. W. W. & de Jongh, M. A. C. Quality of life after pelvic ring fractures: A cross-sectional study. Injury 49, 812–818 (2018).Article

Brouwers，L.，Lansink，K.W.W.＆de Jongh，M.A.C。骨盆环骨折后的生活质量：横断面研究。伤害49812-818（2018）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Download referencesAcknowledgementsNot applicable.FundingThis study was supported by the National Natural Science Foundation of China (Grant No. 82202682), Natural Science Foundation of Hebei Province (Grant No. H2022206008) and Clinical Innovation Research Team of Hebei Medical University (2022LCTD-B35).Author informationAuthor notesThese authors contributed equally: Ruipeng Zhang and Xi Hou.Authors and AffiliationsDepartment of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaRuipeng Zhang, Xi Hou, Zhongzheng Wang, Siyu Tian, Zhiyong Hou & Yingze ZhangOrthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, ChinaXi HouDepartment of Orthopaedic Surgery, The Second Hospital of Tangshan, Tangshan, Hebei, ChinaJunran Li & Ligeng LiAuthorsRuipeng ZhangView author publicationsYou can also search for this author in.

下载参考确认不适用。。作者信息作者注意到这些作者做出了同样的贡献：张瑞鹏和侯锡。作者和附属机构河北医科大学第三医院骨科，河北石家庄，中国河北省河北省石家庄市河北省骨科研究所，河北省石家庄市河北省唐山市第二医院骨科，河北省唐山市唐山市第二医院，河北省唐山市第二医院，河北省唐山市第二医院，河北省石家庄市，河北省石家庄市，河北省石家庄市，河北省石家庄市，河北省石家庄市，河北省石家庄市，河北省石家庄市，河北省唐山市，河北省唐山市第二医院，河北省唐山市，河北省唐山市，河北省唐山市第二医院，河北省唐山市，河北省唐山市，河北省，河北省，河北省，河北省。

PubMed Google ScholarXi HouView author publicationsYou can also search for this author in

PubMed Google ScholarXi HouView作者出版物您也可以在

PubMed Google ScholarZhongzheng WangView author publicationsYou can also search for this author in

PubMed谷歌学者Zhongzheng WangView作者出版物您也可以在

PubMed Google ScholarSiyu TianView author publicationsYou can also search for this author in

PubMed Google ScholarSiyu TianView作者出版物您也可以在

PubMed Google ScholarJunran LiView author publicationsYou can also search for this author in

PubMed Google ScholarJunran LiView作者出版物您也可以在

PubMed Google ScholarLigeng LiView author publicationsYou can also search for this author in

PubMed Google ScholarLigeng LiView作者出版物您也可以在

PubMed Google ScholarZhiyong HouView author publicationsYou can also search for this author in

PubMed Google ScholarZhiyong HouView作者出版物您也可以在

PubMed Google ScholarYingze ZhangView author publicationsYou can also search for this author in

PubMed Google ScholarYingze ZhangView作者出版物您也可以在

PubMed Google ScholarContributionsR. P. Z., and Y. Z. Z. designed the study. R. P. Z., Z. Z. W., S. Y. T., and J. R. L. collected relevant data. R. P. Z., X. H., and L. G. L. wrote the main manuscript text. Z. Y. H., and Y. Z. Z. revised the manuscript. All authors read and approved the final manuscript.Corresponding authorCorrespondence to.

PubMed谷歌学术贡献。P、 Z.和Y.Z.Z.设计了这项研究。R、 P.Z.，Z.Z.W.，S.Y.T。和J.R.L.收集了相关数据。R、 P.Z.，X.H。和L.G.L.撰写了主要的手稿文本。Z、 Y.H.和Y.Z.Z.修改了手稿。所有作者都阅读并批准了最终稿件。对应作者对应。

Yingze Zhang.Ethics declarations

张迎泽。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Additional informationPublisher’s noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Rights and permissions

Additional informationPublisher的noteSpringer Nature在已发布地图和机构隶属关系中的管辖权主张方面保持中立。权限和权限

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.

开放获取本文是根据知识共享署名非商业性NoDerivatives 4.0国际许可证授权的，该许可证允许以任何媒介或格式进行任何非商业性使用，共享，分发和复制，只要您对原始作者和来源给予适当的信任，提供知识共享许可证的链接，并指出您是否修改了许可材料。

You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

根据本许可证，您无权共享源自本文或其部分的改编材料。本文中的图像或其他第三方材料包含在文章的知识共享许可证中，除非该材料的信用额度中另有说明。如果材料未包含在文章的知识共享许可证中，并且您的预期用途未被法律法规允许或超出允许的用途，则您需要直接获得版权所有者的许可。

To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/..

要查看此许可证的副本，请访问http://creativecommons.org/licenses/by-nc-nd/4.0/..

Reprints and permissionsAbout this articleCite this articleZhang, R., Hou, X., Wang, Z. et al. Reliability of interobserver and intraobserver assessments of the Tile versus Young-Burgess classifications for pelvic ring injuries.

转载和许可本文引用本文Zhang，R.，Hou，X.，Wang，Z。等人。Tile与Young-Burgess骨盆环损伤分类的观察者间和观察者内评估的可靠性。

Sci Rep 14, 27099 (2024). https://doi.org/10.1038/s41598-024-78604-yDownload citationReceived: 22 April 2024Accepted: 01 November 2024Published: 07 November 2024DOI: https://doi.org/10.1038/s41598-024-78604-yShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1427099（2024）。https://doi.org/10.1038/s41598-024-78604-yDownload引文接收日期：2024年4月22日接受日期：2024年11月1日发布日期：2024年11月7日OI：https://doi.org/10.1038/s41598-024-78604-yShare本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

Provided by the Springer Nature SharedIt content-sharing initiative

由Springer Nature SharedIt内容共享计划提供

KeywordsPelvic injuryClassificationTileYoung-BurgessReliabilitySurgical strategy

关键词骨盆损伤分类直到Young-BurgessReliability手术策略