A 75-year-old woman is admitted to the hospital after falling in her bathroom. Radiographic examination reveals an extracapsular fracture of the femoral neck. Which artery is most likely at risk for injury?
**Core Concept:** Extracapsular fractures occur outside the joint capsule, while intracapsular fractures involve the joint itself. Femoral neck fractures are typically classified as either intracapsular or extracapsular. The femoral neck is a crucial artery-bearing area, as it contains the femoral artery which supplies blood to the lower limb.
**Why the Correct Answer is Right:** An extracapsular fracture of the femoral neck (Option C) is located outside the joint capsule, putting the femoral artery at risk due to the proximity of the fracture site. In contrast, an intracapsular fracture would involve the joint itself and not be the focus of this question.
**Why Each Wrong Option is Incorrect:**
A) Intracapsular fracture (Option B) is incorrect since the focus of this question is on extracapsular fractures and the risk to the femoral artery.
D) Intracapsular fracture of the humerus (Option D) is incorrect as it pertains to a different bone and does not involve the femoral artery.
**Why Option C is Right:** An extracapsular fracture of the femoral neck (Option C) places the femoral artery at risk due to the close proximity of the fracture site to the artery. In contrast, the femoral artery is protected by the joint capsule in intracapsular fractures and would not be at risk.
**Clinical Pearl:** In cases of femoral neck fractures, close attention should be paid to the patient's lower limb pulses to assess for potential arterial injury caused by the extracapsular fracture. This is crucial for timely management and preventing complications such as compartment syndrome, gangrene, or limb loss.
**Correct Answer:** Option C: Extracapsular fracture of the femoral neck
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**Core Concept:** Femoral artery is a crucial artery that supplies blood to the lower limb. It passes through the femoral neck area and is at risk in various conditions, including fractures.
**Why the Correct Answer is Right:** An extracapsular fracture of the femoral neck (Option C) places the femoral artery at risk due to the close proximity of the fracture site. In comparison, the femoral artery is protected by the joint capsule in intracapsular fractures, preventing it from being injured.
**Why Each Wrong Option is Incorrect:**
A) Intracapsular fracture of the femoral neck (Option B) is incorrect because the femoral artery is protected by the joint capsule in such fractures, reducing the risk of injury to the artery.
D) Intracapsular fracture of the humerus (Option D) is incorrect as it pertains to a different bone and does not involve the femoral artery, ensuring its safety from potential injury.
**Clinical Pearl:** Assessing the patient's lower limb pulses is crucial in cases of femoral neck fractures to identify any potential arterial injuries. This will guide prompt management and minimize complications like compartment syndrome, gangrene, or limb loss.