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INI-CET 2013 — Orthopaedics

Q: In a 2-year-old child, gallows traction is applied. The child is suffering from a fracture of which bone?

Fracture shaft of femur. ### Explanation **Correct Option: C. Fracture shaft of femur** **Gallows traction** (also known as **Bryant’s traction**) is a specific type of skin traction used primarily for the management of **femoral shaft fractures** in children. The underlying medical concept involves suspending the child’s lower limbs vertically using skin traction. The weight of the child’s body acts as the counter-traction. For this to be effective and safe, the child must weigh **less than 12–15 kg** and be **under 2 years of age**. The traction is applied such that the buttocks are just lifted off the bed (enough to pass a hand underneath), ensuring constant traction on the femur to maintain alignment and length. **Why other options are incorrect:** * **Neck of femur (A):** Pediatric femoral neck fractures are rare and are orthopedic emergencies usually requiring internal fixation (e.g., cannulated screws) due to the high risk of avascular necrosis (AVN). * **Greater trochanter (B):** Isolated fractures of the trochanter are usually avulsion injuries and do not require vertical suspension traction. * **Shaft of tibia (D):** Tibial fractures in toddlers are typically managed with an above-knee cast (e.g., Toddler’s fracture). Gallows traction is biomechanically designed for the femur. **High-Yield Clinical Pearls for NEET-PG:** * **Age/Weight Limit:** Strictly for children <2 years and <15 kg. * **Vascular Warning:** The most critical complication to monitor is **ischemia** of the feet. Frequent neurovascular checks are mandatory to prevent compartment syndrome or peroneal nerve palsy. * **Alternative:** For children older than 2 years with femur fractures, **Thomas splint** or **Spica casting** is preferred. * **Counter-traction:** Provided by the child's own body weight. [Practice more Orthopaedics PYQs on OnCourse]

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All Subjects Biochemistry (2)Forensic Medicine (1)Obstetrics and Gynecology (2)Ophthalmology (1)Orthopaedics (1)Pediatrics (2)Pharmacology (2)Surgery (1)

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In a 2-year-old child, gallows traction is applied. The child is suffering from a fracture of which bone?