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EPIDEMIOLOGY BIMODAL DISTRIBUTION 250,000 Hip fractures annually, expected  t o double by 2050,  Elderly  Doubles each decade beyond age 50,  Young   high energy trauma ANATOMY BLOOD SUPPLY GARDEN CLASSIFICATION •Poor interobserver reliability •Modified to: – Non-displaced •Garden I  (valgus impacted) •Garden II (non-displaced) – Displaced •Garden III and IV     I  Valgus impacted or   incomplete      II Complete  Non-displaced III   Complete      Partial displacement IV  Complete       Full displacement Pauwels Classification                                                                                     stable        less-stable        unstable PATIENTS FACTOR                     • Young (active)        High energy injuries Often multi-trauma  •  Elderly Lower energy injury (falls) Co-morbidities   Pre-existing hip disease TREATMENT GOALS Geriatric Patients • Mobilize •