The reliability of a simplified Garden classification for intracapsular hip fractures

Orthopaedics & Traumatology, Surgery & Research : OTSR
D Van EmbdenG R Roukema

Abstract

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. We estimate simplifying the classification of femoral neck fractures will lead to a higher inter-observer agreement. Ten observers, trauma surgeons and residents, from two different institutes classified 100 intracapsular femoral neck fractures. The inter-observer agreements were calculated using the multi-rater Fleiss' kappa. The inter-observer kappa for the Garden classification was 0.31. An agreement of κ0.52 was observed if the Garden classification was simplified and the fractures were classified by our observers as 'non-displaced' or 'displaced'. 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. Classification of intracapsular hip fractures according to the four-grade Garden classification is unreliable. The reliability of classification improves when the ...Continue Reading

References

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Citations

Mar 28, 2013·International Orthopaedics·Henrik PalmKenneth Brian Holtz
Mar 13, 2014·Der Orthopäde·M Knobe, C H Siebert
Apr 12, 2014·Clinics in Geriatric Medicine·Simon C Mears
Mar 25, 2014·Geriatric Orthopaedic Surgery & Rehabilitation·Daniel Godoy MonzónMartin Buttaro
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Jan 26, 2018·Revista Brasileira De Ortopedia·Vinícius Alexandre de Souza AlmeidaWalter Manna Albertoni
Jun 10, 2019·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·Tommaso MalutaBruno Magnan
Sep 29, 2017·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Wayne HoskinsXavier L Griffin
Jul 1, 2018·Skeletal Radiology·Kimia Khalatbari KaniFelix S Chew
Aug 9, 2019·BMC Musculoskeletal Disorders·Mehdy FarhangArkan S Sayed-Noor
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Aug 11, 2020·International Orthopaedics·Pablo A SlullitelUNKNOWN HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group
Nov 18, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Kanu Okike, Ian G Hasegawa
Jan 11, 2021·Seminars in Roentgenology·Roger J BartolottaAlice S Ha
Dec 22, 2019·Orthopaedics & Traumatology, Surgery & Research : OTSR·Roger ErivanStéphane Boisgard
Dec 2, 2019·Orthopaedics & Traumatology, Surgery & Research : OTSR·Gyu Min KongGu-Hee Jung
Apr 7, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Patrick HaubruckMichael C Tanner

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