Fractures: Pauwels classification: 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.

Try it

Orthopaedics · Fractures: Pauwels classification

Sample item

In the Pauwels classification of femoral neck fractures, which type is the most unstable and carries the highest risk of nonunion?

AType I, with the fracture line less than 30 degrees from the horizontalBAll types have the same stabilityCType III, with the fracture line more than 50 degrees from the horizontalDType II, with the fracture line 30 to 50 degrees from the horizontal

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

The answer and the reasoning

C. Type III, with the fracture line more than 50 degrees from the horizontal

Pauwels grades femoral neck fractures by the angle of the fracture line to the horizontal. The more vertical the line (type III, over 50 degrees), the greater the shear force across the fracture and the higher the risk of nonunion and failure of fixation.

Option by option

A. Type I, with the fracture line less than 30 degrees from the horizontal
Type I is nearly horizontal and is compressed by loading, so it is the most stable.
B. All types have the same stability
Stability differs by angle, which is the basis of the classification.
C. Type III, with the fracture line more than 50 degrees from the horizontal (correct)
Correct. A near-vertical fracture line produces maximal shear and instability.
D. Type II, with the fracture line 30 to 50 degrees from the horizontal
Type II has intermediate stability.

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 C, Type III, with the fracture line more than 50 degrees from the horizontal. Pauwels grades femoral neck fractures by the angle of the fracture line to the horizontal.

Why is "Type I, with the fracture line less than 30 degrees from the horizont…" not the answer?

Type I is nearly horizontal and is compressed by loading, so it is the most stable.

Why is "All types have the same stability" not the answer?

Stability differs by angle, which is the basis of the classification.

Why is "Type II, with the fracture line 30 to 50 degrees from the horizontal" not the answer?

Type II has intermediate stability.

What concept does this question test?

It tests Fractures: Pauwels classification in Orthopaedics. The more vertical the line (type III, over 50 degrees), the greater the shear force across the fracture and the higher the risk of nonunion and failure of fixation.

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: Pauwels classification?

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.