OBSERVER VARIATION IN THE RADIOGRAPHIC CLASSIFICATION OF FRACTURES OFTHE NECK OF THE FEMUR USING GARDENS SYSTEM

By means of Kappa statistics, we calculated the inter- and intra-obser ver variation in the classification of fractures of the neck of the fe mur according to Garden's system. Radiographs of 96 consecutive patien ts were assessed independently by six observers who agreed on classifi cation for only 14 fractures (15%). The level of agreement was poor fo r the overall classification (Kappa = 0.39). When reducing Garden's sy stem into non-displaced (Stage I and II) and displaced fractures (Stag e III and IV) the level of agreement became acceptable (Kappa = 0.68). However problems remain in distinguishing Stage II and Stage III frac tures, and further improvements in the classification system are neces sary.