Fractures and dislocations: femoral shaft nailing: 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 and dislocations: femoral shaft nailing

Sample item

A 30-year-old man has a closed, displaced, transverse fracture of the mid-shaft of the femur after a motorcycle crash. Which is the standard definitive fixation?

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

The answer and the reasoning

D. Reamed interlocking intramedullary nail

The femoral shaft in an adult is best treated with a locked intramedullary nail, which shares load, controls length and rotation, and allows early mobilisation. A nail through the medullary canal does not strip the periosteal blood supply, which favours union.

Option by option

  • A. Dynamic hip screw

    A dynamic hip screw is for fractures of the trochanteric region.

  • B. Ilizarov ring fixator as the first choice

    A ring fixator is used for complex or infected cases and not as routine first choice.

  • C. Plaster hip spica for 12 weeks

    A hip spica is used in young children and not in adult shaft fractures.

  • D. Reamed interlocking intramedullary nail (correct)

    Correct. A locked nail gives stable load-sharing fixation and early weight bearing.

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 D, Reamed interlocking intramedullary nail. The femoral shaft in an adult is best treated with a locked intramedullary nail, which shares load, controls length and rotation, and allows early mobilisation.

Why is "Dynamic hip screw" not the answer?

A dynamic hip screw is for fractures of the trochanteric region.

Why is "Ilizarov ring fixator as the first choice" not the answer?

A ring fixator is used for complex or infected cases and not as routine first choice.

Why is "Plaster hip spica for 12 weeks" not the answer?

A hip spica is used in young children and not in adult shaft fractures.

What concept does this question test?

It tests Fractures and dislocations: femoral shaft nailing in Orthopaedics. A nail through the medullary canal does not strip the periosteal blood supply, which favours union.

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 and dislocations: femoral shaft nailing?

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.