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The reliability and validity of the modified Unified Classification System for periprosthetic femoral fractures after hip arthroplasty.

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机构： [a]Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China [b]The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang, China [c]Department of Orthopaedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China [d]Basic Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China [e]Department of Orthopaedics, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi, China [f]Department of Orthopaedics & Traumatology, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, 528401, Guangdong, China

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This study assessed the reliability and validity of the modified Unified Classification System for femur fractures after hip arthroplasty. Four hundred and two cases were evaluated by 6 observers, 3 experts and 3 trainee surgeons. Each observer read the radiographs on 2 separate occasions and classified each case as to its type. Reliability was assessed by looking at the intraobserver and interobserver agreement using the Kappa statistic. Validity was assessed within the B group by looking at the agreement between the radiographic classification and the intraoperative findings. Interobserver and intraobserver agreement and validity were analyzed, using weighted kappa statistics. The mean k value for interobserver agreement was found to be 0.882 (0.833-0.929) for consultants (almost perfect agreement) and 0.776 (0.706-0.836) for the trainees (substantial agreement). Intraobserver k values ranged from 0.701 to 0.972, showing substantial to almost perfect agreement. Validity analysis of 299 type B cases revealed 89.854% agreement with a mean k value of 0.849 (0.770-0.946) (almost perfect agreement). This study has shown that the modified Unified Classification System is reliable and valid. We believe it is useful to improve the judgment of the implant stability, and establish the therapeutic strategy for periprosthetic femoral fracture. Copyright © 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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出版当年[2020]版：

大类 | 4 区医学

小类 | 4 区骨科

最新[2025]版：

大类 | 4 区医学

小类 | 4 区骨科

第一作者：

第一作者机构： [a]Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China [b]The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang, China

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通讯作者：

通讯机构： [a]Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China [b]The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang, China [*1]Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou, 310006, China.

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