The impact of the garden classification on proposed operative treatment

被引:28
作者
Oakes, DA
Jackson, KR
Davies, MR
Ehrhart, KM
Zohman, GL
Koval, KJ
Lieberman, JR
机构
[1] Univ Calif Los Angeles, Med Ctr, Dept Orthopaed Surg, David Geffen Sch Med, Los Angeles, CA 90095 USA
[2] Santa Monica Orthopaed Grp, Santa Monica, CA USA
[3] So Calif Orthopaed Inst, Van Nuys, CA USA
[4] Hosp Joint Dis & Med Ctr, Dept Orthopaed Surg, New York, NY USA
关键词
D O I
10.1097/01.blo.0000059583.08469.e5
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The current study evaluates the interobserver reliability and intraobserver reproducibility of the Garden classification of femoral neck fractures, assesses the influence of a lateral radiograph on a fracture's classification, and determines the classification's impact on the surgeon's choice of operative treatment. Forty radiographs of femoral neck fractures were evaluated independently by five orthopaedic surgeons. Kappa values were calculated for interobserver reliability and intraobserver variability with respect to the readers' ability to assess the fractures using the Garden classification and to determine fracture displacement with and without access to a lateral radiograph. In 69% of the instances in which a reader changed the classification of a fracture, the proposed treatment of the fracture did not change. The Garden classification has poor interobserver reliability but good intraobserver reproducibility. The addition of a lateral radiograph does not seem to improve the reliability of the current Garden classification system but may improve the reader's ability to determine fracture displacement. To improve the reliability and usefulness of the Garden classification, the authors suggest that the classification should be modified to have only two stages (Garden A-nondisplaced or valgus impacted and Garden B-displaced) and to include the use of a lateral radiograph.
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页码:232 / 240
页数:9
相关论文
共 18 条
  • [1] INTRACAPSULAR FRACTURES OF THE FEMORAL-NECK - RESULTS OF CANNULATED SCREW FIXATION
    ASNIS, SE
    WANEKSGAGLIONE, L
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1994, 76A (12) : 1793 - 1803
  • [2] SUBCAPITAL FRACTURES OF FEMUR
    BARNES, R
    BROWN, JT
    GARDEN, RS
    NICOLL, EA
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1976, 58 (01): : 2 - 24
  • [3] Assessment of the AO classification of intracapsular fractures of the proximal femur
    Blundell, CM
    Parker, MJ
    Pryor, GA
    Hopkinson-Woolley, J
    Bhonsle, SS
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1998, 80B (04): : 679 - 683
  • [4] DELEE JC, 1996, FRACTURES ADULTS, P1659
  • [5] DISPLACEMENT IN FEMORAL-NECK FRACTURES - A NUMERICAL-ANALYSIS OF 200 FRACTURES
    ELIASSON, P
    HANSSON, LI
    KARRHOLM, J
    [J]. ACTA ORTHOPAEDICA SCANDINAVICA, 1988, 59 (04): : 361 - 364
  • [6] GARDEN CLASSIFICATION OF FEMORAL-NECK FRACTURES - AN ASSESSMENT OF INTER-OBSERVER VARIATION
    FRANDSEN, PA
    ANDERSEN, E
    MADSEN, F
    SKJODT, T
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1988, 70 (04): : 588 - 590
  • [7] LOW-ANGLE FIXATION IN FRACTURES OF THE FEMORAL NECK
    GARDEN, RS
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1961, 43 (04): : 647 - 663
  • [8] FRACTURES OF THE PROXIMAL PART OF THE FEMUR
    KYLE, RF
    CABANELA, ME
    RUSSELL, TA
    SWIONTKOWSKI, MF
    WINQUIST, RA
    ZUCKERMAN, JD
    SCHMIDT, AH
    KOVAL, KJ
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1994, 76A (06) : 924 - 950
  • [9] MEASUREMENT OF OBSERVER AGREEMENT FOR CATEGORICAL DATA
    LANDIS, JR
    KOCH, GG
    [J]. BIOMETRICS, 1977, 33 (01) : 159 - 174
  • [10] Mc Cabe J, 1994, J BONE JOINT SURG BR, P120