Fractures and dislocations: complications: 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 and dislocations: complications

Sample item

Two days after a closed femoral shaft fracture, a young man becomes confused and breathless with SpO2 of 88%. There are petechiae over the axillae and conjunctivae, and a CT head is normal. What is the best management?

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

The answer and the reasoning

D. Oxygen and respiratory support with early fracture stabilisation

Hypoxia, neurological change and petechiae after a long bone fracture form the triad of fat embolism syndrome. Treatment is supportive, with oxygenation or ventilation and early fixation of the fracture.

Option by option

  • A. Therapeutic heparin infusion

    Heparin is not a treatment for fat embolism and may bring bleeding risk.

  • B. Prolonged high-dose broad-spectrum antibiotics

    There is no infection to treat, and antibiotics do not alter fat embolism.

  • C. Intravenous alteplase

    Thrombolysis is for proven thromboembolism and does not dissolve fat globules.

  • D. Oxygen and respiratory support with early fracture stabilisation (correct)

    Correct. Care is supportive, with respiratory support and early stabilisation.

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 D, Oxygen and respiratory support with early fracture stabilisation. Hypoxia, neurological change and petechiae after a long bone fracture form the triad of fat embolism syndrome.

Why is "Therapeutic heparin infusion" not the answer?

Heparin is not a treatment for fat embolism and may bring bleeding risk.

Why is "Prolonged high-dose broad-spectrum antibiotics" not the answer?

There is no infection to treat, and antibiotics do not alter fat embolism.

Why is "Intravenous alteplase" not the answer?

Thrombolysis is for proven thromboembolism and does not dissolve fat globules.

What concept does this question test?

It tests Fractures and dislocations: complications in Orthopaedics. Treatment is supportive, with oxygenation or ventilation and early fixation of the fracture.

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 and dislocations: complications?

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.