Classification of medial fractures of the femoral neck.

In order to regularize the classification of medial fractures of the femoral neck a retrospective analysis was made of fractures in adult patients treated in the University Hospital in Turku and also in the Municipal Hospital in the same city between 1964 and 1971. There were 446 cases of medial fracture of the femoral neck, 75 of which occurred in male patients and 368 in female patients. Medial fractures of the femoral neck were classified according to the scheme laid down by Garden (8) and Pauwels (18) and in addition, the situation of the level of the fracture in the femoral neck was determined according the method proposed by Brown and Abrami (3). No correlation could be found between either the division made by Garden and that made by Pauwels or between the situation of the level of the fracture in the femoral neck and the degree of primary dislocation in the fracture. Following Garden's classification, dislocated (stage 3 or stage 4) fractures were more common among women than men. Pauwels' figures showed that there were relatively more unstable fractures (groups 3--4) among men than among women. Among women patients the situation of the level of the fracture was, on the average, more medial than among men. The healing of fractures was evaluated according to the calssifications of Garden and Pauwels. That of Garden proved to be much more logical and from the point of view of prognosis of recovery, more reliable. The present authors recommend the classification made by Garden in cases of medial fracture of the femoral neck.