Garden Classification — Femoral Neck Fractures
Classifies intracapsular femoral neck fractures into 4 types based on displacement. Guides surgical management (fixation vs arthroplasty).
Score interpretation
Garden I–II: Undisplaced; AVN risk ~10%
→ Internal fixation (cannulated screws or dynamic hip screw); surgery within 36h; low-molecular-weight heparin; mobilise day 1 post-op
Garden III–IV: Displaced; AVN risk >30%
→ Replacement arthroplasty with cemented implants (NICE CG124): consider total hip replacement if the person walked independently outdoors with no more than a stick, has no comorbidity making it unsuitable and is expected to stay independent beyond 2 years; otherwise hemiarthroplasty. Surgery on the day of, or the day after, admission; thromboprophylaxis
Interpretation bands for the Garden Classification. Apply clinical judgement and local guidance.
References
- Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br. 1961;43-B:647-663.
Related
Curated clinical cross-links plus same-class fallbacks.
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Lissamine Green 1% Eye Drops · Vital Dye — Ocular Surface Staining (Dry Eye Diagnosis)
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Scaphoid Fracture · BOA; BSSH
- Pelvic Fracture · BOA; ATLS; NICE NG39
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
