Lower Limb Fractures: NEET PG High-Yield
| Fracture | High-Yield Clinical Pearl |
|---|---|
| Hip (Neck of Femur) | Garden’s classification is the gold standard for prognosis. High risk of AVN and non-union in displaced fractures. |
| Femur (Shaft) | Intramedullary nailing is the gold standard. Watch for Fat Embolism Syndrome. |
| Patella | Transverse fractures require tension band wiring (TBW). Loss of active knee extension is diagnostic. |
| Tibia (Shaft) | The most common long bone fracture, high rate of open fractures, and Compartment Syndrome. |
| Calcaneum | “Don Juan” syndrome (Lover’s fracture). Always check for associated Lumbar Spine fractures. |
Exam Essentials
- Garden’s Classification (Neck of Femur): Stage I/II (nondisplaced) get internal fixation; Stage III/IV (displaced) often require arthroplasty in the elderly.
- Tibia Fracture: The anterior-medial aspect is subcutaneous; hence, highly prone to open injuries.
- Calcaneum (Essex-Lopresti classification): Bohler’s angle (normal 20°–40°) decreases in intra-articular calcaneal fractures.
- Compartment Syndrome: Most commonly seen in Tibia fractures. Remember the 5 P’s (Pain out of proportion, Pallor, Paresthesia, Pulselessness, Paralysis).
- Patella: If the extensor mechanism is intact, non-operative management is possible. If disrupted, ORIF is required.