Neck of femur fractures are common orthopaedic emergencies requiring surgery within 36 to 48 hours. In this comprehensive masterclass, we cover everything from the critical blood supply and Garden classification to arthroplasty decisions, fixation techniquesand the key numbers you need to know. ⏱ Chapters 0:00 Intro 0:23 Essentials 0:50 Anatomy 1:24 Garden 1:46 Pauwels 2:08 Garden 2:36 Thr Criteria 3:02 Algorithm 3:30 Screws 3:54 Numbers 4:20 Clinical reasoning — Manage 4:44 Clinical reasoning — Pearls This video provides an in-depth look at the management of neck of femur fractures. We explore why intracapsular fractures uniquely threaten the femoral head's blood supply through the medial femoral circumflex artery, risking avascular necrosis and nonunion. We break down the Garden and Pauwels classifications, explaining how they dictate whether to fix an undisplaced fracture with cannulated screws or replace a displaced fracture with a hemiarthroplasty or total hip replacement. 🦴 IN THIS VIDEO YOU'LL LEARN • Why intracapsular femoral neck fractures threaten the blood supply of the femoral head • How to apply the Garden classification to determine fracture displacement • The difference between hemiarthroplasty and total hip replacement for elderly patients • Why the Pauwels classification predicts shear forces and fixation failure • How to correctly position cannulated screws in an inverted triangle construct • The critical 36 to 48 hour surgical timeframe to reduce mortality • Why young patients with displaced fractures require emergency reduction within 6 hours • The role of the lateral epiphyseal vessels from the medial femoral circumflex artery ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Garden I and II are undisplaced: fix them. Garden III and IV are displaced: replace them in the elderly. ✔️ Disruption of the medial femoral circumflex artery in displaced fractures causes avascular necrosis rates of up to 100 percent. ✔️ Surgery must occur within 36 to 48 hours to minimise complications and reduce one-year mortality. ✔️ Use the MIC rule for total hip replacement: Mobile outdoors, Intact cognition, Continued life expectancy. ✔️ Place the inferior cannulated screw along the calcar to prevent varus collapse and ensure interfragmentary compression. 👩⚕️ WHO THIS IS FOR This video is designed for orthopaedic trainees, medical students, junior doctorsand curious patients wanting a comprehensive understanding of hip fracture management. 📚 RELATED TOPICS: Intertrochanteric and extracapsular hip fractures · Avascular necrosis of the femoral head · Cannulated screw fixation technique · Hip hemiarthroplasty surgical approach · Pauwels classification of vertical femoral neck fractures 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #neckoffemur #femoralneckfracture #hipfracture #orthopaedicsurgery #traumaorthopaedics #gardenclassification #avascularnecrosis #hemiarthroplasty #totalsurgery #fracturefixation #medicalstudents