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Orthopaedics Emergency Medicine A

Garden Classification — Femoral Neck Fractures

Classifies intracapsular femoral neck fractures into 4 types based on displacement. Guides surgical management (fixation vs arthroplasty).

Score interpretation

Undisplaced (Garden I–II) 1–2

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

Displaced (Garden III–IV) 3–4

Garden III–IV: Displaced; AVN risk >30%

→ Hemiarthroplasty (cemented) for older/less active patients; total hip replacement for active patients <70 years; surgical treatment within 36–48h; thromboprophylaxis

Interpretation bands for the Garden Classification. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.