**Question:** March fracture involves -

A. Femoral neck
B. Proximal humerus
C. Distal humerus
D. Proximal tibia

**Core Concept:**
The March fracture is a specific type of low-energy, periarticular osteoporotic fracture that occurs in the elderly population. It is named after its discoverer, Dr. William March, and is characterized by a fracture around a joint (articular), typically involving a weight-bearing bone.

**Why the Correct Answer is Right:**
The correct answer is D, proximal tibia, because the March fracture is primarily seen in the knee joint, specifically the patellofemoral joint, where the patella articulates with the femur. These fractures occur due to a combination of factors, including decreased bone density, muscle weakness, and reduced ability to absorb the force generated during daily activities.

**Why Each Wrong Option is Incorrect:**
A) Femoral neck: This option is incorrect because the femoral neck fracture is a different type of fracture, specifically involving the neck of the femur, not the knee joint.
B) Proximal humerus: This option is incorrect as it refers to a fracture around the shoulder joint, which is not the primary site of March fractures.
C) Distal humerus: Similar to option B, this option refers to a fracture around the shoulder joint, not the knee joint where March fractures occur.

**Clinical Pearl:**
The March fracture demonstrates the vulnerability of elderly individuals to low-energy fractures due to osteoporosis. It highlights the importance of early diagnosis and intervention to prevent complications like malunion, non-union, or post-traumatic arthritis. It also emphasizes the significance of maintaining bone health through regular weight-bearing exercises, calcium, and vitamin D supplementation, and monitoring bone density in high-risk individuals.