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 | Lateral split fracture |
| Type II | Lateral Split-depressed fracture |
| Type III | Lateral Pure depression fracture |
| Type IV | Medial plateau fracture |
| Type V | Bicondylar fracture |
| Type VI | Metaphyseal-diaphyseal dissociation |
Garden's Classification
- Garden's classification of neck of femur fracture is most commonly used classification.[5]
| Garden's Classification | |
|---|---|
| Type I | Coronal split fracture |
| Type II | Entire condylar fracture |
| Type III | Rim avulsion fracture of lateral plateau |
| Type IV | Rim compression fracture |
| Type V | Four-part 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 | |
|---|---|
| Zero-column fracture | Pure articular depression |
| 1 Column fracture | Lateral column fracture |
| 2 Column fracture | Lateral and posterior column fracture |
| 3 Column fracture | Bicondylar fracture dividing into three fragments |
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 | Extra-articular fractures | |
| A1 | Avulsion | |
| A2 | Metaphyseal simple | |
| A3 | Metaphyseal multifragmentary | |
| B | Partial articular fractures | |
| B1 | Pure split | |
| B2 | Pure depression | |
| B3 | Split depression | |
| C | Complete articular fractures | |
| C1 | Articular simple + metaphyseal simple | |
| C2 | Articular simple, metaphyseal multifragmentary | |
| C3 | Articular multifragmentary | |
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.