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Orthopaedics · Fractures: intertrochanteric fracture fixation
Sample itemAn elderly woman has a stable two-part intertrochanteric fracture. Which implant is the standard fixation?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Dynamic hip screw with a side plate
Intertrochanteric fractures are extracapsular and the head blood supply is preserved, so fixation rather than replacement is appropriate. A dynamic hip screw allows controlled sliding and compression in stable patterns, while cephalomedullary nails suit unstable and reverse oblique types.
Option by option
A. Austin Moore hemiarthroplasty
Hemiarthroplasty is for displaced intracapsular neck fractures in the elderly.
B. Dynamic hip screw with a side plate (correct)
Correct. A dynamic hip screw is standard for stable intertrochanteric fractures.
C. Total hip replacement
Total hip replacement is not needed for an extracapsular fracture.
D. Cannulated cancellous screws
Cannulated screws are used for undisplaced femoral neck fractures.
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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