Garden classification of hip fractures

Dr Matt Adams and A.Prof Frank Gaillard et al.

The Garden classification of subcapital femoral neck fractures is the most widely used. It is simple and predicts the development of AVN 1,2. Garden described particular femoral neck and acetabular trabeculae patterns which can assist in recognizing differences within this classification system 2.

  • Garden stage I: undisplaced incomplete, including valgus impacted fractures
    • medial group of femoral neck trabeculae may demonstrate a greenstick fracture
  • Garden stage II: undisplaced complete
    • no disturbance of the medial trabeculae
  • 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
  • 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 VI are unstable fractures and hence treated with arthroplasty (either hemi- or total arthroplasty) 3.

Fractures
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Article information

rID: 1369
Tag: stub, refs
Synonyms or Alternate Spellings:
  • Garden classification (hip fractures)
  • Garden classification

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Cases and figures

  • Figure 1: diagrams - Garden classification
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  • Case 1 : Garden III
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  • Case 2 : Garden IV
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  • Case 3 : Garden I
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