Fiabilit茅 d鈥檜ne classification de Garden simplifi茅e pour les fractures intracapsulaires du col f茅moral

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• 作者：D. Van Embden^a ; ^{daphnevanembden@hotmail.com} ; S.J. Rhemrev^a ; F. Genelin^b ; S.A.G. Meylaerts^a ; G.R. Roukema^c
• 关键词：Hip fracture ; Femoral neck fracture ; Fracture classification
• 刊名：Revue de Chirurgie Orthop篓娄dique et Traumatologique
• 出版年：2012
• 期刊代码：pca328_18770517
• 类别：med
• 出版时间：June, 2012
• 卷：98
• 期：4
• 页码：360-361
• 文件大小：190 K

摘要

Summary

Background

The Garden classification is used to classify intracapsular proximal femur fractures. The reliability of this classification is poor and several authors advise a simplified classification of intracapsular hip fractures into non-displaced and displaced fractures. However, this proposed simplified classification has never been tested for its reliability.

Hypothesis

We estimate simplifying the classification of femoral neck fractures will lead to a higher inter-observer agreement.

Materials and Methods

Ten observers, trauma surgeons and residents, from two different institutes classified 100聽intracapsular femoral neck fractures. The inter-observer agreements were calculated using the multi-rater Fleiss鈥?kappa.

Results

The inter-observer kappa for the Garden classification was 0.31. An agreement of 魏0.52 was observed if the Garden classification was simplified and the fractures were classified by our observers as 鈥榥on-displaced鈥?or 鈥榙isplaced鈥? No difference in reliability was seen for the use of the four-grade Garden classification as well as the simplified classification between trauma surgeons and residents.

Discussion

Classification of intracapsular hip fractures according to the four-grade Garden classification is unreliable. The reliability of classification improves when the Garden classification is simplified in a classification using the terms: 鈥榥on-displaced鈥?or 鈥榙isplaced鈥?

Level of evidence

Level IV. Diagnostic retrospective study.