Fractures and dislocations: femoral fracture in a non-walking infant: 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 fracture in a non-walking infant

Sample item

A 7-month-old infant who cannot yet crawl is brought with a swollen, painful thigh. Radiographs show a spiral fracture of the femoral shaft. The parents say he rolled off a sofa onto a carpet. What is the most appropriate next step beyond treating the fracture?

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

The answer and the reasoning

C. Skeletal survey and child protection assessment

A long-bone fracture in a child who is not yet walking is highly suspicious for non-accidental injury, especially when the history does not match the injury. A skeletal survey for other fractures and referral to child protection services are required.

Option by option

  • A. Vitamin D supplementation alone

    Vitamin D alone does not address a possible injury or the safety of the child.

  • B. Reassurance, since this is a common mechanism

    A short fall onto a carpet rarely generates enough force to break an infant's femur.

  • C. Skeletal survey and child protection assessment (correct)

    Correct. A spiral femoral fracture in a non-ambulant infant with an inconsistent history requires a survey and protection review.

  • D. Repeat radiograph in 6 months

    Delay would leave the child at risk of further harm.

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, Skeletal survey and child protection assessment. A long-bone fracture in a child who is not yet walking is highly suspicious for non-accidental injury, especially when the history does not match the injury.

Why is "Vitamin D supplementation alone" not the answer?

Vitamin D alone does not address a possible injury or the safety of the child.

Why is "Reassurance, since this is a common mechanism" not the answer?

A short fall onto a carpet rarely generates enough force to break an infant's femur.

Why is "Repeat radiograph in 6 months" not the answer?

Delay would leave the child at risk of further harm.

What concept does this question test?

It tests Fractures and dislocations: femoral fracture in a non-walking infant in Orthopaedics. A skeletal survey for other fractures and referral to child protection services are required.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 fracture in a non-walking infant?

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.