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European validation of the Vancouver classification of periprosthetic proximal femoral fractures.

Rayan, F; Dodd, M; Haddad, FS; (2008) European validation of the Vancouver classification of periprosthetic proximal femoral fractures. J Bone Joint Surg Br , 90 (12) 1576 - 1579. 10.1302/0301-620X.90B12.20681.

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Abstract

The Vancouver classification has been shown by its developers to be a valid and reliable method for categorising the configuration of periprosthetic proximal femoral fractures and for planning their management. We have re-validated this classification system independently using the radiographs of 30 patients with periprosthetic fractures. These were reviewed by six experienced consultant orthopaedic surgeons, six trainee surgeons and six medical students in order to assess intra- and interobserver reliability and reproducibility. Each observer read the radiographs on two separate occasions. The results were subjected to weighted kappa statistical analysis. The respective kappa values for interobserver agreement were 0.72 and 0.74 for consultants, 0.68 and 0.70 for trainees on the first and second readings of the radiographs and 0.61 for medical students. The intra-observer agreement for the consultants was 0.64 and 0.67, for the trainees 0.61 and 0.64, and for the medical students 0.59 and 0.60 for the first and second readings, respectively. The validity of the classification was studied by comparing the pre-operative radiological findings within B subgroups with the operative findings. This revealed agreement for 77% of these type-B fractures, with a kappa value of 0.67. Our data confirm the reliability and reproducibility of this classification system in a European setting and for inexperienced staff. This is a reliable system which can be used by non-experts, between centres and across continents.

Type:Article
Title:European validation of the Vancouver classification of periprosthetic proximal femoral fractures.
Location:England
DOI:10.1302/0301-620X.90B12.20681
Language:English
Keywords:Acetabulum, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Europe, Female, Femoral Fractures, Hip Prosthesis, Humans, Male, Middle Aged, Observer Variation, Reproducibility of Results, Retrospective Studies
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)

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