The increasing incidence of fragility fractures, particularly those affecting the proximal femur, has led to a rise in patients with fixation implants and peri-implant fractures. These secondary fractures, occurring around implanted devices such as intramedullary nails, present significant challenges in diagnosis and treatment. A novel classification system, the Vergilius Classification, was developed to provide a structured approach to peri-nail fractures, incorporating fracture location, morphology, fragment count, and healing status of previous fractures. This study aimed to evaluate the agreement among medical professionals in applying this new classification system. A total of 35 medical professionals, including physiatrists, trauma surgeons, and radiologists, participated in the study. They were asked to classify 15 anonymized clinical cases according to the Vergilius system, and their responses were analyzed for accuracy, agreement, and face validity. The results showed a high level of agreement (80%) across most categories, with the location of the fracture, fracture morphology, and number of fracture fragments (2, 3, >3) demonstrating the strongest consensus. However, agreement regarding the healing status of previous fractures was lower. Participants rated the classification as clear, easy to use, and potentially beneficial in clinical practice. This study confirms that the Vergilius Classification System is reliable and applicable for peri-nail fractures. Future real-world cohort studies are needed to further assess its clinical impact.<\/p>\n
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