An 80-year-old woman with osteoporosis slips on the floor. X-ray shows a fracture of the neck of the femur with complete displacement; the head is rotated and the limb is shortened and externally rotated. Garden classification would place this as:
- A Garden IV — completely displaced with loss of trabecular alignment in both fragments ✓
- B Garden I — incomplete, valgus impacted
- C Garden III — partially displaced, trabeculae misaligned but not completely displaced
- D Garden II — complete but undisplaced
Correct answer: A. Garden IV — completely displaced with loss of trabecular alignment in both fragments
Explanation
In Garden IV the femoral neck is completely displaced and the bony trabeculae of the head are re-aligned parallel to those of the acetabulum, indicating full displacement with no remaining trabecular continuity. This carries the highest risk of avascular necrosis of the femoral head. Surgical options for this elderly patient include hemiarthroplasty or total hip replacement.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.