Gunshot femoral shaft fractures: is the current classification system reliable?

The reliability of the AO/Orthopaedic Trauma Association classification system has not been evaluated for diaphyseal fractures or fractures attributable to gunshot injuries. Therefore, the current authors assessed its reliability for diaphyseal femur fractures and investigated the effect of a gunshot mechanism of injury. Forty-seven diaphyseal femur fractures, 23 caused by gunshots and 24 caused by blunt trauma, were classified by four observers on two occasions.