- See:
Garden Alignment Index;
- Garden III: 
***
- complete fracture with partial displacement;
- "if it needs a
reduction, then its a type III fracture;"
- frequently there is shortening and external rotation of distal frag;
- retinaculum of Weitbrecht remains attached to, & maintains continuity between, the proximal and distal fragments;
- trabecular pattern of femoral head does not line up w/ those of acetabulum, demonstrating incomplete displacement
between femoral fragments;
-
management:
-
closed reduction and
cannulated screw fixation:
- risk of non union:
- as pointed out by Hammer 1992, 3/17 Garden 3 frx w/ transverse configuration went on to non union,
whereas 6/14 frx w/ vertical configuration went on to non union;
-
hemiarthroplasty
- Garden IV: 
- complete fracture w/ total displacement (some authors feel that the degree of displacement between Garden III and IV fractures is not significant);
- no continuity between proximal and distal fragments;
- femoral head assumes its normal position with in the acetabulum, and therefore the trabecular patterns of the acetabulum and the femoral head are aligned;
-
management:
-
closed reduction and
cannulated screw fixation:
- risk of non union:
- as pointed out by Hammer 1992, 0/3 Garden 4 frx w/ transverse configuration went on to
non union, whereas 2/5 frx w/ vertical configuration went on to non union;
-
hemiarthroplasty
Non Union of Subcapital Femoral Neck Fractures. AJ Hammer.
J. Orthop Trauma. Vol 6, No 1, p 73-77; 1992
Garden grading of intracapsular fractures.
meaningful or misleading?
MJ Parker.
Injury. Vol 24. 1993. p 241.
