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Table 1 Detailed rules of Garden classification of the femoral neck fracture

From: An overview on the treatment strategies of non-displaced femoral neck fracture in the elderly

Garden type

Characteristics

Ascription

 I

Incomplete fracture: The fracture line does not pass through the whole femoral neck, there is partial bone connection in the femoral neck, the fracture has no displacement, and a certain blood supply is maintained at the proximal fracture end.

Stable fracture

 II

Complete fracture without displacement: Although the femoral neck was completely broken, it is well aligned. If it is a fracture under the femoral head, it may still heal, but the probability of ONFH is high. If it is a fracture of the middle or basal part of the femoral neck, the fracture is easy to heal and the blood supply of the femoral head is appreciable.

Stable fracture

 III

Complete fracture with partial displacement: Mostly, the distal end of the fracture is displaced upward or the lower corner of the distal end of the fracture is inserted into the proximal section, resulting in the inward rotation and displacement of the femoral head, and the neck shaft angle becomes smaller.

Unstable fracture

 IV

Complete fracture with complete displacement: The proximal end of the fracture can be rotated, and the distal end is mostly shifted back and upward. The joint capsule and synovium are severely damaged, and the blood vessels supplying the femoral head via the joint capsule and synovial membrane are also easily damaged, resulting in ONFH.

Unstable fracture

  1. ONFH, osteonecrosis of femoral head