Fractures: limb posture in extracapsular hip fracture: practice question

A Orthopaedics 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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Orthopaedics · Fractures: limb posture in extracapsular hip fracture

Sample item

An elderly woman falls and the leg lies in marked external rotation with the lateral border of the foot resting on the bed. There is bruising over the trochanteric region. Which fracture is most likely?

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

The answer and the reasoning

C. Intertrochanteric fracture

In extracapsular fractures the capsule does not restrain rotation, so the limb falls into marked external rotation, often to 90 degrees, with shortening and trochanteric bruising. Intracapsular fractures show less rotation because the capsule limits it. A posterior dislocation gives flexion, adduction and internal rotation.

Option by option

  • A. Fracture of the pubic ramus

    A pubic ramus fracture does not usually produce marked limb rotation.

  • B. Posterior hip dislocation

    Posterior dislocation causes internal rotation and adduction.

  • C. Intertrochanteric fracture (correct)

    Correct. Marked external rotation with trochanteric bruising suggests an intertrochanteric fracture.

  • D. Undisplaced subcapital fracture

    An undisplaced subcapital fracture often has little deformity.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Intertrochanteric fracture. In extracapsular fractures the capsule does not restrain rotation, so the limb falls into marked external rotation, often to 90 degrees, with shortening and trochanteric bruising.

Why is "Fracture of the pubic ramus" not the answer?

A pubic ramus fracture does not usually produce marked limb rotation.

Why is "Posterior hip dislocation" not the answer?

Posterior dislocation causes internal rotation and adduction.

Why is "Undisplaced subcapital fracture" not the answer?

An undisplaced subcapital fracture often has little deformity.

What concept does this question test?

It tests Fractures: limb posture in extracapsular hip fracture in Orthopaedics. Intracapsular fractures show less rotation because the capsule limits it. A posterior dislocation gives flexion, adduction and internal rotation.

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 Fractures: limb posture in extracapsular hip fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.