title: Evaluation of the reproducibility of the Tronzo classification for intertrochanteric fractures of the femur.
abstract: OBJECTIVE
  To evaluate the inter-observer reproducibility of the Tronzo classification for transtrochanteric fractures using the kappa concordance coefficient (κ).
  
  
  METHODS
  Twenty radiographic images in anteroposterior view on hips with transtrochanteric fractures of the femur were used. These were classified by 12 observers using the Tronzo method. The images were presented in sequence and a questionnaire containing all the options of the Tronzo classification was filled out, along with a simplified classification using Tronzo divisions into two groups (stable and unstable). The data were analyzed by means of the kappa concordance test.
  
  
  RESULTS
  The following kappa indices were found: for images with stable fractures (Tronzo 1 and 2), 0.11; for images with unstable fractures (Tronzo 3, 3 variant, 4 and 5), 0.52; and for the complete classification, 0.44 (moderate concordance). In turn, the simplified classification did not increase the concordance rates.
  
  
  CONCLUSIONS
  The Tronzo classification is unsuitable for clinical practice. We suggest that another system should be used or created for this type of fracture.
authors.affiliation: Carmino Caricchio Municipal Hospital, São Paulo, SP, Brazil.
authors.forename: Fernando Abdala Silva
authors.initials: FA
authors.lastname: Oliveira
authors.affiliation: Carmino Caricchio Municipal Hospital, São Paulo, SP, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Basile
authors.affiliation: Carmino Caricchio Municipal Hospital, São Paulo, SP, Brazil.
authors.forename: Bruno Cézar Brabo
authors.initials: BC
authors.lastname: Pereira
authors.affiliation: Carmino Caricchio Municipal Hospital, São Paulo, SP, Brazil.
authors.forename: Rafael Levi Louchard Silva
authors.initials: RL
authors.lastname: da Cunha
keywords: Femoral fractures/classification; Femoral fractures/radiographs; Reproducibility of tests