![]() These four stages, which can also be simplified into nondisplaced (types I and II) and displaced (types III and IV), rank the fracture from most to least stable and are often used to direct the approach to treatment. Garden type IV fractures are completely displaced, and there is no contact between the femoral head and femoral neck. In Garden type III fractures, the displacement is such that the femoral head is still in some contact with the femoral neck. Garden type II fractures are complete, but with minimal to no displacement. Garden type I fractures involve a lateral fracture line that does not cross the medial cortex, and are thus considered incomplete fractures. Specific consideration was also given to bone cement implantation syndrome.Įxample radiographs demonstrating Garden classification: ( a) Garden I ( b) Garden II ( c) Garden III ( d) Garden IV. uncemented arthroplasty were also explored. The objective of this review was to evaluate the existing literature and elucidate the advantages and disadvantages associated with different surgical treatment options available for the various types of FNF, particularly displaced FNFs. Numerous studies have been undertaken over the decades to determine the optimal intervention to improve patient outcomes and decrease mortality. ![]() The ultimate goal of treatment for these hip fractures is to allow early mobilization, which often necessitates surgical procedures to fix or replace the joint. Despite this, it is likely that hip fracture treatment will continue to comprise a large part of the orthopedic surgeon’s workload. Some population-based studies from North America and Europe have even reported decreases in the number of hip fractures. However, more recent evidence has suggested that the incidence may have reached a plateau. From 1986 to 1995, the average annual incidence was approximately 950 per 100,000 for women and 415 per 100,000 for men, with greater increases seen for individuals over age 75 than for those ages 65 to 74, and the worldwide incidence was estimated to be over six million by 2050. Prior epidemiological studies have predicted that as the geriatric population increases, the hip fracture incidence will increase as well. ![]() Other risk factors are often related to aging, which, in turn, are usually associated with increased risk of falls-these include muscle weakness, deficits in balance or coordination, deteriorating eyesight, and medication side effects. Modifiable or lifestyle risk factors include low body mass index (<18.5), smoking, alcohol abuse, poor nutritional status, and low levels of baseline physical activity. Well-established nonmodifiable risk factors for sustaining hip fractures include female sex, increasing age, ethnic origin, and family history of osteoporotic fragility fractures. In general, hip fractures most commonly occur in elderly female patients, particularly in white populations of North America and Europe, and the incidence increases exponentially with age. Hip fracture, including femoral neck fracture (FNF), is a cause for concern in this group, as they are one of the most common traumatic injuries in elderly patients and are associated with high rates of mortality and functional loss. The geriatric population, defined as those aged 65 and older, is the fastest growing demographic in the world.
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