Fractures of the tibial plafond are complex injuries, and previous studies have shown fair to poor interobserver reliability in the classification of these injuries. In an effort to explore methods of improving reliability in the classification of fractures, the authors wish to explore the rank order method of classification of tibial plafond fractures. The purpose of this investigation is to determine the interobserver reliability and the general applicability of the rank order method of classification of tibial plafond fractures.

This study was conducted as a poster presentation at the 1998 Orthopaedic Trauma Association annual meeting (poster #27). To our knowledge, no previous study has attempted to assess the feasibility and reliability of the classification of fracture presented as radiographic images on an internet web site. In addition to the purpose listed above, this study also hopes to determine the interobserver reliability of the classification of tibial plafond fractures when presented as images on an internet web site.

• This internet web site exhibits the mortise and lateral radiographs of ten fractures of the tibial plafond.
• Each observer should view all the images and then rank the ten fractures from the least severe (#1) to the most severe (#10), by recording the number of the ranking in the drop down box next to each of the ten sets of fracture images.
• Each observer should rank the fractures taking into consideration all the radiographic factors he/she believes are important in performing such a ranking.
• After ranking all of the fractures, each observer should click "submit", which will send the observer’s ranking as an email message to Douglas R. Dirschl, MD (dirschld@ohsu.edu).

• This study requires version 4.0 or later of either NetScape Navigator or Internet Explorer.
• Through "Preferences" in Netscape or "Options" in Internet Explorer, both Java and JavaScript must be turned on.
• For optimal image viewing, the display/monitor control panel should be set at a minimum of "16 bit" or "thousands" or "high color".
• The study web page contains smaller 20 images. A high speed connection (T3, T1, cable modem, ADSL, ISDN) is recommended. If the internet connection is a 28.8 kbps modem, allow for a download time of up to 45 seconds.

THANK YOU FOR YOUR PARTICIPATION IN THIS STUDY! Please feel free to send comment related to this study to Douglas R. Dirschl, MD (dirschld@ohsu.edu). If you are encountering technical difficulties performing this study, contact William D. Burman, MD (wdburman@frontiernet.net).