This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rayan, F. Articles by Haddad, F. S. Search for Related Content PubMed PubMed Citation Articles by Rayan, F. Articles by Haddad, F. S.

European validation of the Vancouver classification of periprosthetic proximal femoral fractures

¹ University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
² St Georges NHS Trust, 58a Niton Street, London SW6 6NJ, UK.
³ University College London Hospitals, Cecil Fleming House, London WC1E 6DB, UK.

Correspondence should be sent to Mr F. Rayan; e-mail: rayanmarakkar{at}yahoo.co.uk

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.

This article has been cited by other articles:

				K. Corten, F. Vanrykel, J. Bellemans, P. R. Frederix, J.-P. Simon, and P. L. O. Broos An algorithm for the surgical treatment of periprosthetic fractures of the femur around a well-fixed femoral component J Bone Joint Surg Br, November 1, 2009; 91-B(11): 1424 - 1430. [Abstract] [Full Text] [PDF]