DOI: 10.36347/sjams.2013.v01i06.0013

Pages: 706-709

Objective and Aim of the study was to assess the interobserver reliability of two frequently used classifications for trochanteric femur fractures, the Boyd-Griffin classification and the AO/ASIF classification. Furthermore, the change in the level of agreement after addition of CT to plain radiograph was also evaluated. Fracture patterns of 31 consecutive patients with trochanteric fracture of the proximal femur were analyzed by four different observers (two radiologists and two orthopaedic surgeons) using plain X-Rays (Standard AP & Lateral views) and with combination of CT Scans. The level of agreement was then analyzed. The mean kappa value for radiologists & orthopaedists using BG system was 0.05 and 0.42. The mean kappa value for radiologists & orthopaedists using AO/ASIF without sub-groups was 0.17 and 0.54. The mean kappa value for radiologists & orthopaedists using AO/ASIF with sub-groups was 0.02 and 0.27. The mean kappa value for radiologists & orthopaedists using Boyd-Griffin system was 0.00 and 0.27. The mean kappa value for radiologists & orthopaedists using AO/ASIF excluding sub-groups system was 0.15 and 0.65. The mean kappa value for radiologists & orthopaedists using AO/ASIF with sub-groups was – 0.12 and 0.29. We found a ‘slight’ reliability for the Boyd-Griffin classification and only a ‘fair’ reliability for the AO/ASIF classification. Furthermore, our study showed that the reliability of the AO/ASIF classification improved when subgroups of the classification were not provided. Addition of computed tomography to the plain radiographs has improved observer reliability from ‘moderate’ to ‘substantial’ levels in comparison to radiographs alone.