European Validation Of The Vancouver Classification Of Periprosthetic Proximal Femoral Fractures



European Validation Of The Vancouver Canada Classification Of Periprosthetic Proximal Femoral Fractures



The Vancouver classification has been shown by its developers to be a valid and reliable method for categorising the configuration of periprosthetic proximal femoral fractures and for planning their management. We have re-validated this classification system independently using the radiographs of 30 patients with periprosthetic fractures. These were reviewed by six experienced consultant orthopaedic surgeons, six trainee surgeons and six medical students in order to assess intra- and interobserver reliability and reproducibility. Each observer read the radiographs on two separate occasions. The results were subjected to weighted kappa statistical analysis. The respective kappa values for interobserver agreement were 0.72 and 0.74 for consultants, 0.68 and 0.70 for trainees on the first and second readings of the radiographs and 0.61 for medical students. The intra-observer agreement for the consultants was 0.64 and 0.67, for the trainees 0.61 and 0.64, and for the medical students 0.59 and 0.60 for the first and second readings, respectively. The validity of the classification was studied by comparing the pre-operative radiological findings within B subgroups with the operative findings. Our data confirm the reliability and reproducibility of this classification system in a European setting and for inexperienced staff. This is a reliable system which can be used by non-experts, between centres and across continents.


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The variance of the supply and demand in the condo market is causing home buyers to be competitive. While buyers looking for detached homes are seeing more selection to choose from as its returning back to a typical market. The difference of the free market activity in the Downtown Vancouver Condos market is making home purchasers be aggressive. While purchasers searching for detached homes are seeing more choice to look over as its returning back to a common market. 698,500 up 12.7% from a year prior. 1,171,500 up 18.3% from a year back. 1,990,000 down 13.5% from a year prior. Add up to stock for condos for sale in downtown Vancouver in June was 694 down 20.7% from a year prior, Townhouses 121 down 2.4%, and withdrew homes 1,482 up 22.7% from a year back. The normal time a Vancouver property was available is 18 up 5.9% from a year back. What Does this All Mean?