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Review Question - QID 7036

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QID 7036 (Type "7036" in App Search)
An 88-year-old nursing home resident is seen in the emergency department after a fall. At the time of admission, physical examination of the affected extremity reveals absent pulses and inadequate capillary refill. A radiograph is seen in Figure 48. Appropriate management includes which of the following?
  • A

Emergent open reduction and internal fixation of the fracture

1%

4/287

Emergent consultation with vascular surgery and a possible arteriogram

80%

230/287

Revision of the femoral component followed by vascular surgical consultation

3%

8/287

Open reduction and internal fixation of the fracture with intraoperative vascular consultation

8%

24/287

Release traction until surgical management is performed

6%

18/287

  • A

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The patient has a Vancouver type B3 periprosthetic femur fracture (fracture around a total hip prosthesis with a loose stem and poor proximal bone stock). This type of periprosthetic fracture necessitates revision of the femoral component as well as fracture fixation. This patient has diminished blood flow in the extremity that necessitates emergent vascular surgical evaluation.

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