Question 1

Q: Avascular necrosis may develop in the following fractures except

Fracture of the calcaneum. ***Fracture of the calcaneum*** - The **calcaneum** (heel bone) has a rich and robust blood supply from multiple arteries, making it highly resistant to avascular necrosis (AVN) even after significant fractures. - While calcaneal fractures can lead to other complications like **subtalar arthritis** or wound issues, AVN is exceedingly rare due to its excellent vascularity. *Fracture of the talus* - The **talus** has a precarious blood supply, primarily from branches off the dorsalis pedis artery, peroneal artery, and posterior tibial artery, which enter at specific non-articular areas. - Fractures, especially those involving the **talus neck**, can disrupt these vital vascular channels, frequently leading to **avascular necrosis** of the talar body. *Subcapital fracture of the femoral neck* - **Subcapital fractures** occur within the hip joint capsule and often disrupt the **retinacular arteries** (medial and lateral circumflex femoral arteries), which are the main blood supply to the femoral head. - This interruption of blood flow to the femoral head is a very common cause of **avascular necrosis**, particularly in displaced fractures. *Fracture of the scaphoid* - The **scaphoid bone** has a unique blood supply where arteries typically enter the distal pole and travel proximally. - A fracture, especially in the **waist** or **proximal pole**, can easily disrupt this retrograde blood flow, leading to a high incidence of **avascular necrosis** in the proximal fragment. [Practice more Orthopaedics PYQs on OnCourse]

Question

Avascular necrosis may develop in the following fractures except

Accepted Answer

Fracture of the calcaneum

Answer

Fracture of the talus

Answer

Subcapital fracture of the femoral neck

Answer

Fracture of the scaphoid

UPSC-CMS 2012 — Orthopaedics