Garden classification of subcapital femoral neck fractures
Last revised by Henry Knipe on 29 May 2024
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Knipe H, Yap J, et al. Garden classification of subcapital femoral neck fractures. Reference article, Radiopaedia.org (Accessed on 05 Jul 2024) https://doi.org/10.53347/rID-1369
rID:
1369
Article created:
Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
29 May 2024,
Henry Knipe ◉
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Revisions:
13 times, by
13 contributors -
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Systems:
Sections:
Synonyms:
- 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 orthopaedic surgeon, in 1961 4.
Quiz questions
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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
Articles:
Cases:
- 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
Multiple choice questions:
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