Common Extracapsular Neck of Femur Fracture exam questions for medical finals, OSCEs and MRCP PACES

 

Question 1. Definition

What is an Extracapsular neck of femur fracture?

  • These are fractures of the neck of the femur which occur outside the capsule of the hip joint

 

Question 2. Femoral shaft fracture

When does an Extracapsular neck of femur fracture become a femoral shaft fracture?

  • When the main fracture line occurs 5cm below the lesser trochanter.

 

Will the patient have a shortened and externally rotated limb?

  • No, this is more a feature of intracapsular neck of femur fractures. There may be some shortening however if the distal fragment has moved proximally.

 

Is this fracture pattern likely to lead to avascular necrosis of the femoral head?

  • Again, no. This is more a feature of intracapsular neck of femur fractures

 

Question 3. Description of a neck of femur fracture

How do you describe a neck of femur fracture?

  • 1. Intertrochanteric or subtrochanteric
  • 2. Displacement and overall stability
  • 3. Involvement of the trochanters themselves
  • 4. Degree of shortening and degree of subtrochanteric extension where present

 

Question 4. Treatment of neck of femur fractures

What are the treatment options?

  • These are usually treated with a DHS or an I.M nail.