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Perception of Garden’s classification for femoral neck fractures: an international survey of 298 orthopaedic trauma surgeons

Archives of Orthopaedic and Trauma Surgery volume 125, pages 503–505 (2005)Cite this article

Abstract

The Garden classification is the most popular femoral neck fracture classification system. We surveyed orthopaedic surgeons about their preferences for femoral neck fracture classification systems and their belief about their ability to discriminate between the four different Garden fracture types. A questionnaire was developed to examine surgeons’ training and experience and their preferences for classification of femoral neck fractures by consulting five orthopaedic surgeons in Canada and the United States, and the previous literature. The Garden classification was the preferred femoral neck fracture classification for 72% of all the surveyed surgeons (n=298). Only 39% of all the surveyed surgeons believed they were able to distinguish all four Garden fracture types. However, 96% of the surgeons felt they could differentiate between undisplaced (Garden I/II) and displaced (Garden III/IV) fractures. High variability in the surgeons’ perceptions of the Garden classification system provides a rationale for discontinuing the use of this system in daily practice.

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Acknowledgements

This work was funded in part by a surgical research grant, McMaster University, a Regional Medical Associates Grant, McMaster University, and a Grant from AO North America, Paoli, Pennsylvania. These investigators are members of the International Hip Fracture Research Collaborative. For more information: http\\:www.ihfrc.ca.

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Affiliations

  1. Department of Surgery, McMaster University, Hamilton, ON, Canada

    Michael Zlowodzki

  2. Department of Surgery, University of Zurich, Zurich, Switzerland

    Marius Keel

  3. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Emil Schemitsch

  4. Department of Surgery, AO Clinical Investigation and Documentation, Davos, Switzerland

    Beate P. Hanson

  5. Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University Medical Center, 7 North, Suite 727, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada

    Mohit Bhandari

Authors
  1. Michael Zlowodzki
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  2. Mohit Bhandari
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  3. Marius Keel
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  4. Beate P. Hanson
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  5. Emil Schemitsch
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Corresponding author

Correspondence to Mohit Bhandari.

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Zlowodzki, M., Bhandari, M., Keel, M. et al. Perception of Garden’s classification for femoral neck fractures: an international survey of 298 orthopaedic trauma surgeons. Arch Orthop Trauma Surg 125, 503–505 (2005). https://doi.org/10.1007/s00402-005-0022-4

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  • DOI: https://doi.org/10.1007/s00402-005-0022-4

Keywords

  • Garden classification
  • Pauwels classification
  • Femoral neck fracture
  • Hip fracture
  • Survey