Neck of femur fracture classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
There are multiple classifications available for neck of femur fracture. The most common classification systems for neck of femur fracture include Anatomical, Garden's, Pauwel's and AO/OTA classification.
Classification
There are multiple classifications available for neck of femur fracture. The most common classification systems for neck of femur fracture include Anatomical, Garden's, Pauwel's and AO/OTA classification.[1][2]
Anatomical Classification
 |
| Schatzker Classification | |
|---|---|
| Type I | Supcapital fracture |
| Type II | Transcervical fracture |
| Type III | Basicervical fracture |
Garden's Classification
- Garden's classification of neck of femur fracture is most commonly used classification.[5]
- It is based on anterioposterior (AP) radiographs and does not consider lateral or sagittal plane alignment.
| Garden's Classification | |
|---|---|
| Type I | Incomplete, valgus impacted fracture |
| Type II | Complete, nondisplaced fracture |
| Type III | Complete, partially displaced fracture |
| Type IV | Complete, fully displaced fracture |
Pauwel's Classification
- Pauwel's classified for neck of femur fracture is based on vertical orientation of fracture line.[6]
- Pauwel's angle is defined as the angle formed between the line of a fracture of the neck of the femur and the horizontal on an anterioposterior radiograph.
- The greater the angle, the more unstable the fracture and thus worse the prognosis.
| Pauwel's Classification | |
|---|---|
| Type I | < 30 degree from horizontal |
| Type II | 30 to 50 degree from horizontal |
| Type III | > 50 degree from horizontal |
OTA System
- AO/ASIF classification is also a widely accepted classification.[7]
- Proximal femur is given the number 31 based on the classification.
- It is further subdivided as:
| OTA System | ||
|---|---|---|
| A | Femoral Trochanteric fractures | |
| A1 | Simple peritrochanteric | |
| A2 | Multifragmentary peritrochanteric, lateral wall incompetent (< 20.5 mm) | |
| A3 | Intertrochanteric (reverse obliquity) | |
| B | Femoral Neck fractures | |
| B1 | Subcapital | |
| B2 | Transcervical | |
| B3 | Basicervical | |
| C | Femoral Head fractures | |
| C1 | Split fracture | |
| C2 | Depression fracture | |
References
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
- ↑ Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br 1961;43-B:647-63.
- ↑ Pauwels F. Der Schenkelhalsbruch, ein mechanisches problem. Stuttgart: F. Enke; 1935.
- ↑ ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.