Background: The ways to classify the femoral periprosthetic fractures after total hip replacement are various. Vancouver type is the most widely used among clinical application. However, there is no clear objective criterion for the stability of the prosthesis and the degree of bone loss in the classification system. According to the clinical experience, Baba et al found that when the femur and prosthesis were stable, the fracture of the prosthesis did not occur in the biological or bone cement fixation area, but in the non-fixed area, and they proposed a new type and tried to be used in clinical treatment. Anyway, how is the clinical application value of this type? Does this type have its advantages compared with the traditional Vancouver type? Few studies are rare.
Purpose: Vancouver typing and Baba typing were used to analyze the case of periprosthetic fractures in our hospital in order to find out the clinical application value of Baba typing.
Methods: From January 2005 to January 2014, 43 cases of femoral periprosthetic fractures were studied, including 7 males and 14.6 females, aged from 71.2 to 36 years old. Information of patients and X-ray of immediately after operation and X-ray of 1 year after operation were collected. 4 doctors (2 associate chief physicians, 2 residents) were introduced to the Baba typing and Vancouver typing, which made them able to evaluate the classification before operation and after 2 weeks, the same method was used to evaluate. The results of the evaluation would be discussed to reconfirm to propose a recommendation of surgical method, which would be compared with the actual situation. The reliability and validity of Baba typing and Vancouver typing were calculated by statistical analysis.
Results: In the final coincidence of operation, the Baba typing and Vancouver typing were 83.7% and 86% respectively, and the Baba score was slightly higher than Vancouver score. The reliability of Baba classification and Vancouver classification were 0.76 and 0.51, respectively, and the reliability of the observation was 0.74 and 0.65 respectively. The validity of the two types was 0.81 and 0.78 respectively.
Conclusion: Baba typing can be easily applied to clinical, and its surgical compliance, reliability and validity are higher than Vancouver typing, can be a better guide among clinical treatment.
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