OBSERVER VARIATION IN THE LAUGE-HANSEN CLASSIFICATION OF ANKLE FRACTURES - PRECISION IMPROVED BY INSTRUCTION

We investigated whether instruction can decrease the variation in the classification of ankle fractures. The radiographs of 100 consecutive ankle fractures were twice assessed by 8 observers, using the Lauge-Ha nsen classification system. 1 group of 4 observers was given special i nstruction between 2 assessments. Without instruction the interobserve r variation was identical at the first and second assessments. After i nstruction, the agreement increased from 0.66 to 0.75. These results s how that the variation in the Lauge-Hansen classification system can b e reduced by instruction.