A 75-year-old woman is brought after a fall at home. She cannot bear weight and the right lower limb is shortened, externally rotated, and adducted. X-ray shows a subcapital fracture of the femoral neck. The most important reason to operate early is to prevent:

• A Osteoarthritis of the hip joint
• B Non-union of the fracture
• C Deep vein thrombosis from immobility
• D Avascular necrosis of the femoral head ✓

Explanation

The femoral head receives its blood supply primarily from the medial femoral circumflex artery via the retinacular vessels, which are torn in a displaced subcapital fracture. Early surgery — either fixation in undisplaced fractures or hemiarthroplasty in displaced fractures in the elderly — is critical to restore circulation and prevent avascular necrosis. In elderly patients with displaced fractures, hemiarthroplasty is preferred as AVN rates with fixation alone exceed 30%.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.