Orthopedics · Lower Limb Trauma (Hip, Femur, Knee, Tibia, Foot)

A 70-year-old woman with osteoporosis sustains a Garden Type III displaced intracapsular neck of femur fracture. The treatment of choice is:

  • A Hemiarthroplasty (cemented Thompson or Austin Moore prosthesis) ✓
  • B Garden screw fixation (cannulated screw fixation)
  • C Dynamic Hip Screw (DHS) fixation
  • D Skeletal traction for 6 weeks
Correct answer: A. Hemiarthroplasty (cemented Thompson or Austin Moore prosthesis)

Explanation

In elderly, low-demand patients with displaced intracapsular neck of femur fractures (Garden III/IV), hemiarthroplasty is the treatment of choice because the risk of avascular necrosis (disruption of the medial circumflex femoral artery's retinacular branches) and non-union with internal fixation is unacceptably high (30–40%). Cemented hemiarthroplasty provides immediate weight-bearing and lower reoperation rates. Total hip replacement may be preferred in physiologically active elderly patients with pre-existing acetabular arthritis. DHS is used for intertrochanteric fractures, not intracapsular. Skeletal traction alone is inadequate in older patients.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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