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Mnemonics, Simplified Concepts & Thoughts

Garden Classification for Neck of Femur fractures

Epomedicine, May 14, 2026May 14, 2026

History

  • Given by a British Orthopedic surgeon Dr. Robert Symon Garden in 1961
  • Based on original review of 80 patients which he classified into 4 types and followed for 12 months:
    • Type I and II fractures: had 100% union rate
    • Type III: had 93% union rate
    • Type IV: had 57% union rate

Classification

The Garden classification incorporates displacement, fracture completeness, and relationship of bony trabeculae in the femoral head and neck.

Garden IGarden IIGarden IIIGarden IV
DisplacementNoneNonePartialComplete
Fracture completenessIncomplete (medial cortex intact)CompleteCompleteComplete
Relation of bony trabeculaeHead and neck trabeculae malaligned (valgus impaction)All trabeculae aligned and parallelAll trabeculae malaligned (varus impaction)All trabeculae parallel but:
acetabular & head trabeculae aligned and neck trabeculae malaligned
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PGMEE, MRCS, USMLE, MBBS, MD/MS OrthopedicsTrauma

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Epomedicine. Garden Classification for Neck of Femur fractures [Internet]. Epomedicine; 2026 May 14 [cited 2026 Nov 11]. Available from: https://epomedicine.com/medical-students/garden-classification-for-neck-of-femur-fractures/.

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