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International Orthopaedics
Published in: International Orthopaedics 9/2015

01-09-2015 | Original Paper

Higher reliability and validity of Baba classification with computerised tomography imaging and implant information for periprosthetic femoral fractures

Authors: Tomonori Baba, Yasuhiro Homma, Hironori Ochi, Hideo Kobayashi, Mikio Matsumoto, Yuko Sakamoto, Hirotomo Kuwahara, Kouichi Maeda, Kazuo Kaneko

Published in: International Orthopaedics | Issue 9/2015

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Abstract

Purpose

Baba classification for periprosthetic femoral fracture focuses on the positional relationship between the implant design and fracture site. The objective of this study was to investigate whether the addition of CT images and implant information to plain radiograms increases the reliability of Baba classification to a level higher than that of Vancouver classification.

Methods

Twenty patients were randomly selected from 61 patients with periprosthetic femoral fracture between 2009 and 2014. After Vancouver and Baba classifications were fully explained to six orthopedic surgeons (three experts and three non-experts), plain radiograms, CT imaging and implant information at the time of injury were presented, and the inter- and intra-observer reliability based on the Vancouver and Baba classifications and accuracy rates of stem stability were investigated.

Results

When interobserver reliability was made based on only radiograms, the mean κ value of Baba classification-based judgments made by the experts was 0.76, and those of Vancouver classification-based judgments made by the experts was 0.41. When interobserver reliability was made based on the radiograms and CT images and implant information, the mean κ value of Baba classification-based judgments made by the experts was 0.94, and those of Vancouver classification-based judgments were 0.48. Intra-observer reliability of Baba classification was 0.81 in the experts. Validity analysis showed 95.0 % agreement within all subgroups.

Conclusions

Reliability and validity of Baba classification was improved when additional information was given. We believe that this new classification is useful to establish a therapeutic strategy for femoral fractures around the stem.
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Metadata
Title
Higher reliability and validity of Baba classification with computerised tomography imaging and implant information for periprosthetic femoral fractures
Authors
Tomonori Baba
Yasuhiro Homma
Hironori Ochi
Hideo Kobayashi
Mikio Matsumoto
Yuko Sakamoto
Hirotomo Kuwahara
Kouichi Maeda
Kazuo Kaneko
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 9/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2674-1

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