vancouver classification vancouver classification the vancouver classification is a grading system used in orthopaedics to determine management of post-operative periprosthetic femoral fractures following a hip arthroplasty. it is named for the city vancouver, home to the university of british columbia where the authors of the 1995 paper worked. classification type description treatment a fracture in the trochanteric region orif if displaced b1 fracture around stem or just below, with well fixed stem orif with cables and plate b2 fracture around stem or just below, with loose stem but good proximal bone revision of femoral component b3 fracture around stem or just below, with poor quality or severely comminuted proximal bone revision of femoral component with proximal femoral replacement c fracture below the prosthesis orif with plate