Subcapital fracture is the commonest type of intracapsular fracture of the proximal femur. The fracture line extends through the junction of the head and neck of femur.
Although many classifications are proposed Garden classification and Pauwel classification are generally followed from a practical point of view as these two systems take into consideration stability of the fractures.
Garden classification is based on the pre-reduction displacement of the femoral head. Further the displacement is graded as per position of the principal (medial) compressive trabeculae.
- type one is incomplete, stable and impacted
- type two is complete, stable and undisplaced
- type three is complete, unstable and partially displaced
- type four is complete, unstable and fully displaced
Pauwel classification is based on post-reduction angulation of fracture line to the horizontal evaluated on a AP radiograph.
Lesser the angulation more stable the fracture with a better a prognosis.
- <30 degrees
- 30-70 degrees
- >70 degrees
- avascular necrosis
- 1. Greenspan A. Orthopedic Imaging. LWW. ISBN:1608312879. Read it at Google Books - Find it at Amazon
- 2. Sheehan SE, Shyu JY, Weaver MJ, Sodickson AD, Khurana B. Proximal Femoral Fractures: What the Orthopedic Surgeon Wants to Know. Radiographics : a review publication of the Radiological Society of North America, Inc. 35 (5): 1563-84. doi:10.1148/rg.2015140301 - Pubmed