How are femoral neck hip fractures classified?

Updated: Jan 08, 2019
  • Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

The most commonly used classification system for femoral neck fractures is the Garden classification. The fractures are divided into 4 groups according to the degree of displacement and fracture fragments. [4, 5, 6] This classification system gives guidance for treatment options and surgical implants. The following 4 groups comprise this classification system:

  • Garden type I: Incomplete fracture with valgus impaction, as shown below

    Garden I femoral neck fracture. Note the valgus im Garden I femoral neck fracture. Note the valgus impaction with compression of the superior femoral head-neck junction.
    Lateral view of a Garden I femoral neck fracture. Lateral view of a Garden I femoral neck fracture. Compression of the head-neck junction inferiorly.
  • Garden type II: Complete fracture without displacement

  • Garden type III: Complete fracture with partial displacement of the fracture fragments

  • Garden type IV: Complete fracture with total displacement allowing the femoral head to rotate back to an anatomic position

This classification can be further simplified into nondisplaced, Garden I and II, or displaced Garden III and IV fractures.


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