The Reliability of Proximal Femoral Shaft Fracture Classification

PURPOSE: The Garden classification by which femur neck fracture is classified and the Boyd-Griffin classification by which trochanteric fracture is classified are studied on the reproducibility, repeatability, interobserver's and intraobserver's reliability and then reliability. MATERIALS AND METHODS: 56 cases in femoral neck fracture and 60 cases in trochanteric fracture who were operated from May 1999 to December 2003 were classified by three observers who are hip surgeon, orthopaedic surgeon and senior residentship doctors three times. Femur neck fracture was classified by Garden's method which used commonly and trochanteric fracture was classified by Boyd-Griffin method which is classified by the pattern of fracture and degree of comminution. We got the interobserver's and intraobserver's Kappa score using the Stata 7.0 statistically. The statistical analysis was made by Stata 7.0. RESULTS: Garden classification in femur neck fracture showed moderate agreement in intraobserver reliability and fair agreement in interobserver reliability. Boyd-Griffin classification in trochanteric fracture showed substantial agreement in intraobserver reliability and moderate agreement in interobserver reliability. CONCLUSION: Boyd-Griffin classification showed over moderate agreement but Garden classification showed fair agreement, so using Garden classification in femur neck fracture has some problem in reliability and application.