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What is the Garden classification for femoral neck fractures?
The Garden classification system categorizes femoral neck fractures into four types based on displacement:
- Type I: Incomplete, impacted fracture
- Type II: Complete, non-displaced fracture
- Type III: Complete fracture with partial displacement
- Type IV: Complete fracture with full displacement
Source: Campbell's Operative Orthopaedics
When should I consider surgical management for an ankle fracture?
Surgical management is indicated for:
- Unstable fractures (bi-malleolar or tri-malleolar)
- Displaced fractures with >2mm talar shift
- Open fractures
- Syndesmotic disruption
- Failure of closed reduction
Conservative management may be appropriate for stable, minimally displaced fractures in select patients.
Compare ORIF vs IMN for femoral shaft fractures
Here's a comparison of Open Reduction Internal Fixation (ORIF) versus Intramedullary Nailing (IMN):
ORIF (Plate Fixation):
- ✓ Better for proximal/distal third fractures
- ✓ Allows anatomic reduction
- ✗ Larger incision, more soft tissue damage
- ✗ Higher infection risk
IMN:
- ✓ Gold standard for mid-shaft fractures
- ✓ Smaller incision, less soft tissue damage
- ✓ Load-sharing biomechanics
- ✗ Risk of knee pain (entry point)
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