Hip fractures: fascia iliaca block: 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: fascia iliaca block

Sample item

An 85-year-old with a hip fracture is waiting for surgery and has severe pain, and opioids have caused confusion. Which analgesic technique is most suitable?

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

The answer and the reasoning

C. Fascia iliaca or femoral nerve block

A regional block of the femoral and lateral femoral cutaneous nerves provides good analgesia and spares opioids, which reduces the risk of delirium in the elderly. It can be given in the emergency department. Opioids at high doses worsen confusion and respiratory depression.

Option by option

  • A. Higher doses of intramuscular opioids

    More opioid increases confusion and respiratory risk.

  • B. Skeletal traction through the tibia

    Traction does not provide pain relief for hip fractures in this setting.

  • C. Fascia iliaca or femoral nerve block (correct)

    Correct. A regional block gives analgesia while limiting opioid-related delirium.

  • D. Intra-articular steroid injection

    Steroid injections do not treat fracture pain.

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, Fascia iliaca or femoral nerve block. A regional block of the femoral and lateral femoral cutaneous nerves provides good analgesia and spares opioids, which reduces the risk of delirium in the elderly.

Why is "Higher doses of intramuscular opioids" not the answer?

More opioid increases confusion and respiratory risk.

Why is "Skeletal traction through the tibia" not the answer?

Traction does not provide pain relief for hip fractures in this setting.

Why is "Intra-articular steroid injection" not the answer?

Steroid injections do not treat fracture pain.

What concept does this question test?

It tests Hip fractures: fascia iliaca block in Orthopaedics. It can be given in the emergency department. Opioids at high doses worsen confusion and respiratory depression.

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: fascia iliaca block?

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.