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.
Keywords Garden classification - Pauwels classification - Femoral neck fracture - Hip fracture - Survey