Hip fractures: 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

Sample item

A 78-year-old woman who walked independently falls and has a displaced intracapsular fracture of the femoral neck (Garden type IV). Which is the most appropriate treatment?

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

The answer and the reasoning

D. Hemiarthroplasty or total hip replacement

In an elderly patient, a displaced femoral neck fracture has a high risk of avascular necrosis and non-union with fixation because of the tenuous blood supply, so replacement arthroplasty is preferred. It allows early weight bearing and reduces complications of prolonged recumbency.

Option by option

  • A. Closed reduction and cast immobilisation

    A cast cannot immobilise a hip fracture and would keep her bedridden.

  • B. Skeletal traction for twelve weeks

    Prolonged traction causes pneumonia, bed sores and thromboembolism.

  • C. Internal fixation with cancellous screws

    Screw fixation is used for undisplaced fractures or for displaced fractures in young patients.

  • D. Hemiarthroplasty or total hip replacement (correct)

    Correct. Arthroplasty bypasses the problem of the damaged blood supply.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Hemiarthroplasty or total hip replacement. In an elderly patient, a displaced femoral neck fracture has a high risk of avascular necrosis and non-union with fixation because of the tenuous blood supply, so replacement arthroplasty is preferred.

Why is "Closed reduction and cast immobilisation" not the answer?

A cast cannot immobilise a hip fracture and would keep her bedridden.

Why is "Skeletal traction for twelve weeks" not the answer?

Prolonged traction causes pneumonia, bed sores and thromboembolism.

Why is "Internal fixation with cancellous screws" not the answer?

Screw fixation is used for undisplaced fractures or for displaced fractures in young patients.

What concept does this question test?

It tests Hip fractures in Orthopaedics. It allows early weight bearing and reduces complications of prolonged recumbency.

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?

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.