Changes in radiological parameters during reduction of femoral neck fractures: A radiographic evaluation of cadavers

Abstract Objective To investigate changes in the Garden index and other radiological parameters during reduction of femoral neck fractures. Methods Ten healthy, human femoral specimens were obtained. A 2.0 mm diameter Kirschner wire was implanted in the centre of the femoral head. A perpendicular osteotomy was made in the middle of the femoral neck. The distal osteotomy surface was used as the angle of rotation (pronation and supination up to 90° at 10° intervals). Anterior-posterior and lateral view radiographs were taken at different angles. The Garden index and other relevant data were analysed using the picture archiving and communication system. Changes in the area of the femoral head fovea at different rotation angles were measured. Results There were no significant differences in the Garden index between 0–30° of pronation and supination (p > .05). For angles of 40–90°, there were statistically significant differences in the Garden index (p  Conclusions The Garden index does not change significantly if the angle of fracture rotation is 0–30° (in either pronation or supination) during femoral neck fracture reduction. Therefore, it is impossible to judge the rotation of fracture in this range of angles. The Garden index can detect the rotation of fracture for rotation angles of 40–90° (in either pronation or supination). Changes in the area of the femoral head fovea can help determine the rotation of femoral neck fractures. Level of Evidence Level V.