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

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.