Garden classification

Garden Type 1 Fractured Neck of Femur

The Garden classification is a system of categorizing intracapsular hip fractures of the femoral neck. This fracture often disrupts the blood supply to the femoral head.

British orthopaedic surgeon Robert Symon Garden described a classification system for this type of fracture, referred to as the Garden classification and consisting of four grades:^[1]^[2]

Classification

Type	Description
1	incomplete Stable fracture with impaction in valgus
2	Complete but non displaced with two group of trabeculle in line
3	completely displaced with varus with all three trabeculle disturb.
4	Completely displaced with no contact between the fracture fragments

Clinical relevance

The blood supply of the femoral head is much more likely to be disrupted in Garden types 3 or 4 fractures. Surgeons may treat these types of fracture by replacing the fractured bone with a prosthesis arthroplasty. Alternatively the treatment is to reduce the fracture (manipulate the fragments back into a good position) and fix them in place with metal screws. Common practice is to use repair Garden 1 and 2 fractures with screws, and to replace Garden 3 and 4 fractures with arthroplasty, except in young patients in whom screw repair is attempted first, followed by arthroplasty if necessary.^[3] This is done in an effort to conserve the natural joint since prosthetic joints ultimately wear out and have to be replaced. A serious but common complication of a fractured femoral neck is avascular necrosis. The vasculature to the femoral head is easily disturbed during fractures or from swelling inside the joint capsule. This can lead to strangulation of the blood supply to the femoral head and death of the bone and cartilage.

References

↑ R. S. Garden. Obituary. British Medical Journal, vol 285, 11 December 1982, p.1751.
↑ Hieu T Truong et al. Femoral Neck Fracture Imaging
↑ Akhtar M Khan, Fractures of the Lower Limb

Orthopaedic eponyms

Medical eponyms

Fractures	Bankart's fracture Barton's fracture Bennett's fracture Bosworth fracture Chance fracture Chopart's fracture-dislocation Colles' fracture Dupuytren's fracture Duverney fracture Essex-Lopresti fracture Galeazzi fracture Gosselin fracture Holstein–Lewis fracture Holdsworth fracture Hutchinson's fracture Hoffa fracture Hume fracture Jefferson fracture Jones fracture Lisfranc fracture Maisonneuve fracture Malgaigne's fracture Monteggia fracture Moore's fracture Pipkin fracture-dislocation Plafond fracture Pott's fracture Rolando fracture Segond fracture Shepherd's fracture Smith's fracture Stieda fracture Tillaux-Chaput avulsion fracture Wagstaffe-Le Fort avulsion fracture Volkmann avulsion fracture

Classifications	Bado classification Danis–Weber classification Denis classification Evans-Jensen classification Ficat classification Frykman classification Garden classification Gartland classification Gruen zone Gustilo open fracture classification Haruguchi classification Hawkin's classification Herbert classification Herscovici classification Ideberg classification Jupiter and Mehne classification Lauge-Hansen classification Le Fort fracture of skull Loder classification Mayfield classification Milch classification Neer classification Pipkin classification Pauwel's classification Riseborough and Radin classification Ruedi-Allgower classification Salter–Harris fracture Schatzker classification of tibia plateau fractures Tile classification Schatzker classification of olecranon fractures Sanders classification Seddon classification Seinsheimer classification Schenck classification Teisen classification Tscherne classification Thompson and Epstein classification Vancouver classification Wassel classification Winquist and Hansen classification Young-Burgess classification

Procedures	Akin osteotomy Bankart repair Broström procedure Brunelli procedure Cotrel–Dubousset instrumentation Cunningham Shoulder Reduction Darrach's procedure Darrah procedure Evans technique Girdlestone's Procedure Keller procedure Kocher manoeuvre Krukenberg procedure Latarjet procedure Mumford procedure Ponseti method Swanson's Arthroplasty Tommy John surgery Weil's Osteotomy Weaver–Dunn procedure Zadek's procedure

Anatomy	Gerdy's tubercle Guyon's Canal Harrison's groove Haversian canal Humphrey's ligament Lisfranc joint Lisfranc ligament Lister's tubercle Martin-Gruber Anastomosis Schmorl's nodes Volkmann's canals

CPRs	Harris Hip Score Kocher criteria Mirel's Score Rowe Score

Clinical signs	Andersson lesion Baastrup's sign Bouchard's nodes Boutonniere deformity Coopernail's sign Codman triangle Destot's sign Frankel's sign Heberden's node Kanavel's sign Larrey's sign Trendelenburg gait

Clinical examination	Allis test Apley grind test Apley scratch test Barlow's maneuver Clarke's test Cozen's test Cotton test Durkan's test Finkelstein's test Froment's sign Jobe's test Kapandji score Gaenslen's test Galeazzi test Gerber's test Hawkins–Kennedy test Hubscher's maneuver Lachman test Lasègue's sign McMurray test Mulder's sign Neer impingement sign O'Brien's test Ober's test Ortolani test Patrick's test Phalen maneuver Simmonds' test Schober's test Speed's test Thomas test Thompson test Tinel sign Trendelenburg's sign Yergason's test Waddell's signs Watson's test Wilson test

Congenital conditions	Albers-Schonberg disease Albright's hereditary osteodystrophy Antley–Bixler syndrome Apert syndrome Beals syndrome Bechterew's Bruck syndrome Camurati–Engelmann disease Catel–Manzke syndrome Cole carpenter syndrome Conradi–Hünermann syndrome Currarino syndrome Ehlers–Danlos syndrome Eiken syndrome Ellis–van Creveld syndrome Erlenmeyer flask deformity Fairbanks disease Hajdu–Cheney syndrome Jansen's metaphyseal chondrodysplasia Kashin–Beck disease Klippel–Feil syndrome Klippel–Trénaunay–Weber syndrome Kniest dysplasia Lobstein syndrome Madelung's deformity Maffucci syndrome Marfan syndrome Marie-Strümpell disease Marshall syndrome Marshall–Smith syndrome McCune–Albright syndrome Melnick–Needles syndrome Morton's toe Ollier disease Rett syndrome Rubinstein–Taybi syndrome Scheuermann's disease Schwartz–Jampel syndrome Silver–Russell syndrome Teunissen–Cremers syndrome Trevor disease Wiedemann syndrome

Acquired conditions	Baker's cyst Bankart lesion Barré–Liéou syndrome Blount's disease Brodie abscess Chandler's disease De Quervain syndrome Dupuytren's contracture Ewing's sarcoma Freiberg disease Garre's sclerosing osteomyelitis Gorham's disease Haglund's deformity Hill–Sachs lesion Iselin's disease Kashin–Beck disease Kienbock's disease Köhler disease Legg–Calvé–Perthes syndrome Morton's neuroma O'Donoghue's triad Osgood–Schlatter disease Paget's disease of bone Panner disease Perthes Lesion Preiser disease Sever's disease Stener lesion Sudeck's atrophy Tietze syndrome Volkmann's contracture

Orthopedic implants	Austin Moore prosthesis Baksi's prosthesis Charnley prosthesis Denis Browne bar Ender's nail Grosse-Kempf nail Harrington rod Herbert screw Kirschner wire Kuntscher nail Moore's pin Neer's prosthesis Rush nail Schanz screw Seidel nail Smith Peterson nail Steinmann pin Swanson prosthesis Talwalkar nail Thompson prosthesis

Orthopaedic instruments	Bryant's traction Charnley Retractor Darrach elevator Faraboeuf forceps Gigli saw Hohmann retractor Ilizarov apparatus Inge retractor Jungbluth forceps Matta forceps Taylor Spatial Frame Thomas splint Verbrugge forceps Volkmann retractor Weber forceps

Surgical approaches	Hardinge lateral approach to the hip Moore or Southern posterior approach to the hip Smith-Petersen anterior approach to the hip Watson-Jones anterolateral approach to the hip

Radiographic signs	Baumann's angle Blumensaat's line Bohler's angle Cobb angle Fairbank's changes Gilula's Lines Harris lines Hilgenreiner's line Kellgren-Lawrence grading scale Klein's line Loosers zone Pauwel's angle Perkin's line Shenton's Line Southwick angle Thurstan Holland sign Trethowan's sign Terry-Thomas sign

Radiographic projections	Judet view Broden's view

Principles	Wolff's law Hueter-Volkmann law Charley's principles of three-point fixation

This article is issued from Wikipedia - version of the Friday, January 22, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.