Trauma: damage control orthopaedics: 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 · Trauma: damage control orthopaedics

Sample item

A polytrauma patient with a femoral fracture is in shock, is hypothermic and has coagulopathy. What is the preferred initial orthopaedic strategy?

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

The answer and the reasoning

A. Damage control orthopaedics with temporary external fixation, then definitive fixation later

In unstable polytrauma patients, early prolonged surgery adds a second hit and increases the risk of acute respiratory distress and multiple organ failure. Damage control orthopaedics stabilises fractures rapidly with external fixators, then resuscitation in the ICU is followed by definitive fixation when physiology improves, typically days 5 to 10.

Option by option

  • A. Damage control orthopaedics with temporary external fixation, then definitive fixation later (correct)

    Correct. Temporary external fixation followed by delayed definitive surgery is the strategy.

  • B. Immediate reamed intramedullary nailing

    Reamed nailing adds a second hit in an unstable patient.

  • C. Delay all stabilisation for 2 weeks

    Delaying all stabilisation increases pain, bleeding and pulmonary complications.

  • D. Skin traction alone for 6 weeks

    Prolonged skin traction is not appropriate for adults with femoral fractures.

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 A, Damage control orthopaedics with temporary external fixation, then definitive fixation later. In unstable polytrauma patients, early prolonged surgery adds a second hit and increases the risk of acute respiratory distress and multiple organ failure.

Why is "Immediate reamed intramedullary nailing" not the answer?

Reamed nailing adds a second hit in an unstable patient.

Why is "Delay all stabilisation for 2 weeks" not the answer?

Delaying all stabilisation increases pain, bleeding and pulmonary complications.

Why is "Skin traction alone for 6 weeks" not the answer?

Prolonged skin traction is not appropriate for adults with femoral fractures.

What concept does this question test?

It tests Trauma: damage control orthopaedics in Orthopaedics. Damage control orthopaedics stabilises fractures rapidly with external fixators, then resuscitation in the ICU is followed by definitive fixation when physiology improves, typically days 5 to 10.

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 Trauma: damage control orthopaedics?

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.