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Femoral shaft fracture with haemorrhage — MCCQE Part 1 MCQ

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ModerateFractures/TraumaFemoral shaft fracture with haemorrhageMCCQE Part 1

A 40-year-old man with a displaced midshaft femur fracture after motorcycle collision. Hb drops from 130 to 90 over 4 hours. BP maintained. Most likely source of blood loss?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Haemorrhage into the thigh from the fracture

Closed femoral shaft fracture: 1-1.5L blood loss into thigh. Drop of ~40 g/L is consistent. If exceeds expected loss, investigate additional sources with FAST and CT.

Reference: ATLS / Orthopaedic Trauma Guidelines