Abstract
Five observers using the Jensen modification of the Evans classification and the AO
classification (with and without subgroups) classified the radiographs of 88 trochanteric
hip fractures. Each observer classified the radiographs independently on two occasions
3 months apart. Kappa statistical analysis was used for determination of intra- and
inter-observer variation.
For the Jensen classification, the mean kappa value was 0.52 (range: 0.44–0.60) for
intra-observer variation and 0.34 (range: 0.17–0.38) for inter-observer variation.
For the AO system with subgroups, the mean kappa value was 0.42 (range: 0.20–0.65)
for intra-observer variation and 0.33 (range: 0.14–0.48) for inter-observer variation.
For the AO classification system without subgroups, the mean kappa value was 0.71
(range: 0.60–0.81) for intra-observer variation and 0.62 (range: 0.50–0.71) for inter-observer
variation.
We recommend classifying trochanteric fractures into three groups as that of the AO
system without the subgroups. For ease of use, these three groups may be termed stable
trochanteric, unstable trochanteric and trans-trochanteric. Neither the Jensen classification
nor the AO classification with subgroups is an acceptable classification system for
trochanteric hip fractures.
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Article info
Publication history
Accepted:
April 8,
2002
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
