Fractures in children: femoral shaft fracture at 8 years: 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.

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Orthopaedics · Fractures in children: femoral shaft fracture at 8 years

Sample item

An 8-year-old boy has a closed transverse midshaft femoral fracture after a fall from a tree. He weighs 28 kg. Which treatment is most appropriate?

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

The answer and the reasoning

C. Flexible intramedullary nails

In children of about 6 to 11 years, flexible (elastic) intramedullary nails allow early mobilisation and good alignment with a low complication rate. Hip spica is used in younger children, and a rigid antegrade nail through the piriformis fossa risks damage to the femoral head blood supply in the skeletally immature. Prolonged traction is rarely used.

Option by option

  • A. Rigid antegrade intramedullary nail through the piriformis fossa

    A rigid piriformis nail risks avascular necrosis in children.

  • B. Immediate hip spica only

    Spica casting suits younger children and loses alignment in heavier older children.

  • C. Flexible intramedullary nails (correct)

    Correct. Elastic nails suit a school-age child with a transverse fracture.

  • D. Skin traction for six weeks

    Prolonged traction needs hospital stay and is seldom used.

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.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Flexible intramedullary nails. In children of about 6 to 11 years, flexible (elastic) intramedullary nails allow early mobilisation and good alignment with a low complication rate.

Why is "Rigid antegrade intramedullary nail through the piriformis fossa" not the answer?

A rigid piriformis nail risks avascular necrosis in children.

Why is "Immediate hip spica only" not the answer?

Spica casting suits younger children and loses alignment in heavier older children.

Why is "Skin traction for six weeks" not the answer?

Prolonged traction needs hospital stay and is seldom used.

What concept does this question test?

It tests Fractures in children: femoral shaft fracture at 8 years in Orthopaedics. Hip spica is used in younger children, and a rigid antegrade nail through the piriformis fossa risks damage to the femoral head blood supply in the skeletally immature. Prolonged traction is rarely used.

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 Fractures in children: femoral shaft fracture at 8 years?

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.