Garden classification of subcapital femoral neck fractures
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At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures- Garden classification (hip fractures)
- Garden classification
- Garden classification of hip fractures
The Garden classification of subcapital femoral neck fractures describes femoral neck fracture displacement and aims to assist in clinical decision-making to reduce the rates of non-union and osteonecrosis 1,2,4.
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Usage
The Garden classification is the most commonly used system (c.2018) despite reported poor intraobserver reliability 4. Originally, the classification system was based on AP radiographs, however, many fractures will be re-classified depending on CT appearances 4.
Classification
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Garden stage I: undisplaced incomplete, including valgus-impacted fractures
medial group of femoral neck trabeculae may demonstrate a greenstick fracture
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Garden stage II: undisplaced complete
no disturbance of the medial trabeculae
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Garden stage III: complete fracture, incompletely displaced
femoral head tilts into a varus position, causing its medial trabeculae to be out of line with the pelvic trabeculae
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Garden stage IV: complete fracture, completely displaced
femoral head aligned normally in the acetabulum, and its medial trabeculae are in line with the pelvic trabeculae
In general, stage I and II are stable fractures and can be treated with internal fixation (head-preservation), and stage III and IV are unstable fractures and hence treated with arthroplasty (either hemi- or total arthroplasty) 3.
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History and etymology
This classification was published by Robert Symon Garden, British orthopedic surgeon, in 1961 4.
Quiz questions
References
- 1. Garden RS. Low-angle fixation in fractures of the femoral neck. Bone & Joint Journal. 43-B (4): 647. href="http://bjj.boneandjoint.org.uk/content/jbjsbr/43-B/4/647.full.pdf"
- 2. Garden R. Stability and Union in Subcapital Fractures of the Femur. J Bone Joint Surg Br. 1964;46:630-47. - Pubmed
- 3. Mears S. Classification and Surgical Approaches to Hip Fractures for Nonsurgeons. Clin Geriatr Med. 2014;30(2):229-41. doi:10.1016/j.cger.2014.01.004 - Pubmed
- 4. Kazley J, Banerjee S, Abousayed M, Rosenbaum A. Classifications in Brief: Garden Classification of Femoral Neck Fractures. Clin Orthop Relat Res. 2018;476(2):441-5. doi:10.1007/s11999.0000000000000066 - Pubmed
Incoming Links
- Femoral neck fracture - basicervical
- Garden I femoral neck fracture
- Garden IV femoral neck fracture
- Garden I femoral neck fracture
- Neck of femur fracture
- Pathological right femur basicervical fracture
- Intracapsular fracture neck of femur
- Subcapital neck of femur fracture
- Subcapital fracture due to transient osteoporosis of hip
- Impacted femoral neck fracture
- Intertrochanteric fracture
- Total hip arthroplasty
- Impacted femoral neck fracture
- Intertrochanteric fracture
- Subcaptial fractured neck of femur
- Garden classification of hip fractures (diagram)
- Fractured neck of femur - Garden type III
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