Is Pauwels classification still valid?

Abstract

Intracapsular proximal femoral fracture may be classified using the Pauwels classification, which relates to the shearing angle of the fracture surface. It implies that the greater the Pauwels angle, the higher will be the non-union rate. The Pauwels angle was studied in a series of 335 patients and related to the eventual radiological outcome. It was found that neither the Pauwels angle nor the classification had any predictive value for the incidence of non-union. A literature review of previous studies of the Pauwels angle indicated similar results. The continued use of the Pauwels classification in determining if the femoral head should be preserved or replaced is unsound.