Commonest complication of Trans-cervical fracture of femur is –
**Core Concept**
Trans-cervical fractures of the femur are a type of hip fracture that occurs in the femoral neck, just below the head of the femur. This region is rich in blood supply and contains a high concentration of cancellous bone, making it prone to fractures with significant displacement and potential for complications.
**Why the Correct Answer is Right**
The commonest complication of trans-cervical fractures of the femur is avascular necrosis (AVN) of the femoral head. This occurs due to the disruption of the blood supply to the femoral head, which is primarily provided by the medial and lateral circumflex femoral arteries. As a result, the bone tissue becomes ischemic and dies, leading to collapse and deformation of the femoral head. The risk of AVN is higher in trans-cervical fractures compared to other types of hip fractures due to the extensive damage to the surrounding bone and soft tissues.
**Why Each Wrong Option is Incorrect**
* **Option A:** Non-union is a possible complication of femoral neck fractures, but it is not the most common complication in trans-cervical fractures.
* **Option B:** Malunion is also a potential complication, but it is less common than AVN in trans-cervical fractures.
* **Option C:** Infection is a possible complication of any surgical procedure, but it is not the most common complication specifically associated with trans-cervical fractures of the femur.
**Clinical Pearl / High-Yield Fact**
The risk of AVN in trans-cervical fractures can be reduced by early surgical intervention, such as internal fixation or hemiarthroplasty, to restore blood flow to the femoral head and minimize damage to the surrounding bone and soft tissues.
**Correct Answer:** D.