A 28-year-old motorcyclist sustains a closed femoral shaft fracture. Intramedullary nailing is planned. According to the AO/OTA classification, the fracture pattern that carries the WORST prognosis for healing with unreamed nailing is:
- A Type 32-A1 (simple spiral)
- B Type 32-B2 (wedge, comminuted)
- C Type 32-C3 (complex, irregular) ✓
- D Type 32-A2 (simple oblique)
Correct answer: C. Type 32-C3 (complex, irregular)
Explanation
AO/OTA Type 32-C3 represents a complex, irregular (multifragmentary) femoral shaft fracture with extensive comminution, carrying the worst prognosis because bone contact is minimal and biological repair is impaired. Simple patterns (A1, A2) and single-wedge patterns (B) retain a contiguous cortical column supporting early stability. Unreamed nailing in C3 patterns has higher rates of non-union due to inadequate stability and poor endosteal blood supply.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.