Hip fractures: timing of surgery: 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 · Hip fractures: timing of surgery

Sample item

An 82-year-old with a displaced intracapsular hip fracture is medically stable apart from stable chronic conditions. What is the best approach to the timing of surgery?

ATreat with bed rest and traction for two weeksBSurgery within 24 to 48 hours after quick optimisationCDefer surgery until the swelling has settledDDelay for several days until all investigations are complete

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

The answer and the reasoning

B. Surgery within 24 to 48 hours after quick optimisation

Earlier surgery in hip fracture reduces pain, pressure sores, pneumonia, venous thromboembolism and mortality. Medical optimisation should be done quickly and not used to delay surgery unnecessarily. Conservative treatment carries a high mortality in the elderly.

Option by option

A. Treat with bed rest and traction for two weeks
Bed rest and traction cause immobility complications and are not preferred.
B. Surgery within 24 to 48 hours after quick optimisation (correct)
Correct. Prompt surgery after rapid optimisation gives the best outcomes.
C. Defer surgery until the swelling has settled
Swelling is not a reason to delay fixation of a hip fracture.
D. Delay for several days until all investigations are complete
Prolonged delay raises complications and mortality.

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.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Surgery within 24 to 48 hours after quick optimisation. Earlier surgery in hip fracture reduces pain, pressure sores, pneumonia, venous thromboembolism and mortality.

Why is "Treat with bed rest and traction for two weeks" not the answer?

Bed rest and traction cause immobility complications and are not preferred.

Why is "Defer surgery until the swelling has settled" not the answer?

Swelling is not a reason to delay fixation of a hip fracture.

Why is "Delay for several days until all investigations are complete" not the answer?

Prolonged delay raises complications and mortality.

What concept does this question test?

It tests Hip fractures: timing of surgery in Orthopaedics. Medical optimisation should be done quickly and not used to delay surgery unnecessarily. Conservative treatment carries a high mortality in the elderly.

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 Hip fractures: timing of surgery?

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.