A 30-year-old motorcyclist sustains a high-energy femoral shaft fracture (AO 32-C2). Which of the following is the definitive treatment of choice in a haemodynamically stable patient?

• A Skeletal traction for 6 weeks
• B Plate osteosynthesis (ORIF with broad DCP)
• C External fixator as definitive management
• D Antegrade locked intramedullary nail ✓

Explanation

Antegrade locked intramedullary nailing is the gold standard for adult femoral shaft fractures; it provides rotational and axial stability, allows early weight-bearing, and has union rates exceeding 95%. Plate fixation is reserved for specific indications (very proximal or distal shaft fractures, existing intramedullary implant). Skeletal traction is an outdated primary treatment associated with prolonged hospitalisation, malunion, and complications. External fixator is used as damage-control in haemodynamically unstable polytrauma, then converted to IMN within 2 weeks.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.