Question 11: Which nerve is commonly damaged in fracture of neck of fibula?
- A. Tibial
- B. Common peroneal (Correct Answer)
- C. Superficial peroneal
- D. Deep peroneal
Explanation: ***Common peroneal***
- The **common peroneal nerve** (also known as the **common fibular nerve**) wraps superficially around the **neck of the fibula**, making it highly vulnerable to injury in fractures of this region.
- Damage to this nerve typically results in **foot drop** and sensory loss over the dorsum of the foot and lateral leg, due to impaired dorsiflexion and eversion.
*Tibial*
- The **tibial nerve** lies in the posterior compartment of the leg and is generally well-protected, making it less susceptible to injury from a fibular neck fracture.
- Injury to the tibial nerve would primarily affect plantarflexion of the foot and sensation to the sole.
*Superficial peroneal*
- The **superficial peroneal nerve** is a branch of the common peroneal nerve that descends along the lateral compartment of the leg.
- While it originates from the common peroneal, a direct fracture of the fibular neck is more likely to injure the main common peroneal trunk rather than just this specific branch, leading to a broader deficit.
*Deep peroneal*
- The **deep peroneal nerve** is another branch of the common peroneal nerve that runs through the anterior compartment of the leg.
- Similar to the superficial peroneal nerve, a fracture at the fibular neck is more likely to affect the main **common peroneal nerve** directly.
Question 12: Most common complication of extra capsular fracture of neck of femur is:
- A. Malunion
- B. Ischemic necrosis
- C. Pulmonary complications
- D. Non union (Correct Answer)
Explanation: ***Non union***
- **Non-union** is a common complication in extracapsular femoral neck fractures due to the **disrupted blood supply** and mechanical forces across the fracture site.
- The **fracture fragments** may fail to heal properly, leading to persistent pain, instability, and functional impairment.
*Malunion*
- **Malunion** occurs when the fracture heals in an **unacceptable anatomical position**, causing deformity or altered biomechanics.
- While it can be a complication, **non-union** is generally more prevalent and problematic in extracapsular femoral neck fractures.
*Ischemic necrosis*
- **Ischemic necrosis** (or avascular necrosis) is less common in extracapsular femoral neck fractures compared to intracapsular fractures.
- This is because the **extracapsular location** often spares the crucial blood supply to the femoral head, which is frequently compromised in intracapsular injuries.
*Pulmonary complications*
- **Pulmonary complications** (e.g., pneumonia, pulmonary embolism) are significant risks in elderly patients with hip fractures due to prolonged immobility and surgery.
- However, direct fracture-related complications like **non-union** are distinct and represent issues specifically with bone healing.