Lower limb: hip fracture: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Lower limb: hip fracture

Sample item

A 78-year-old woman falls at home and has groin pain and inability to bear weight. Radiographs show a displaced subcapital fracture of the femoral neck. How does the affected limb lie?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Shortened and externally rotated

In a displaced fracture of the neck of the femur the limb is shortened by upward pull of the thigh muscles on the distal fragment and externally rotated because the lateral rotators and the weight of the limb are unopposed. Posterior dislocation instead gives a shortened, flexed, adducted and internally rotated limb. The retinacular branches of the medial circumflex femoral artery are at risk, causing avascular necrosis.

Option by option

  • A. Flexed, abducted and internally rotated

    This does not match any typical posture of femoral neck fracture; abduction and internal rotation are not seen.

  • B. Shortened, flexed, adducted and internally rotated

    This posture describes posterior dislocation of the hip, not a neck fracture.

  • C. Lengthened and externally rotated

    A lengthened limb does not occur when the fracture allows the femur to ride upward.

  • D. Shortened and externally rotated (correct)

    Correct. Shortening with external rotation is the classic posture of a displaced femoral neck fracture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Shortened and externally rotated. In a displaced fracture of the neck of the femur the limb is shortened by upward pull of the thigh muscles on the distal fragment and externally rotated because the lateral rotators and the weight of the limb are unopposed.

Why is "Flexed, abducted and internally rotated" not the answer?

This does not match any typical posture of femoral neck fracture; abduction and internal rotation are not seen.

Why is "Shortened, flexed, adducted and internally rotated" not the answer?

This posture describes posterior dislocation of the hip, not a neck fracture.

Why is "Lengthened and externally rotated" not the answer?

A lengthened limb does not occur when the fracture allows the femur to ride upward.

What concept does this question test?

It tests Lower limb: hip fracture in Anatomy. Posterior dislocation instead gives a shortened, flexed, adducted and internally rotated limb. The retinacular branches of the medial circumflex femoral artery are at risk, causing avascular necrosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lower limb: hip fracture?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.