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Garden Hip Fracture Classifications

The Garden hip classification system is widely used to classify femoral neck fractures. The femoral neck is the portion of the femur, or thigh bone, which is close to the hip socket. It connects the head of the femur to the femoral shaft. The Garden classification system consists of four stages and is useful for predicting the development of avascular necrosis, or AVN, of the hip postfracture, according to Radiopaedia website. AVN is bone death when there is poor blood supply to a bone.

  1. Stage 1

    • A Garden 1 fracture is an incomplete or impacted undisplaced fracture of the femoral neck. An incomplete fracture does not extend fully through the bone. An undisplaced fracture is when the broken pieces maintain alignment.

    Stage 2

    • A Garden 2 fracture is a complete undisplaced fracture of the femoral neck. A complete fracture extends fully through the bone. Surgical treatment with screws is typical for fixation of Stage 1 and 2 fractures, according to Wheeless' "Textbook of Orthopaedics."

    Stage 3

    • A Garden 3 fracture is a complete partially displaced fracture of the femoral neck. A partially displaced fracture is when the bone pieces become partially separated.

    Stage 4

    • A Garden 4 fracture is a complete fully displaced fracture of the femoral neck. A fully displaced fracture is when the bone pieces become separated with no alignment between the proximal and distal fragments. Surgical treatment with screws or replacement of the entire proximal femoral bone is required for fixation of Stage 3 and 4 fractures, according to Wheeless' "Textbook of Orthopaedics."

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