American Board of Surgical Assistants (ABSA) Orthopedic Practice Test

Which complication following a fracture requires close observation of the patient?

1. Infection

2. Shock

3. Fat embolism

4. All of the above

The correct answer is: All of the above

When considering complications following a fracture, all listed options—infection, shock, and fat embolism—are significant and warrant close observation due to their potential impact on patient outcomes. Infection is a risk particularly in open fractures where the skin is breached, and bacteria can enter the fracture site. Post-surgical patients are also at risk for developing infections, which may lead to delayed healing or more severe systemic illness. Shock can occur as a result of significant blood loss from the fracture site, especially with pelvic or femur fractures where large blood vessels may be damaged. Hypovolemic shock can quickly escalate and is a life-threatening emergency requiring immediate intervention. Fat embolism syndrome is a serious complication that can arise, typically within 1 to 3 days following a fracture. It occurs when fat globules from the bone marrow enter the bloodstream and can lead to respiratory distress, neurological symptoms, and petechial rash. Early identification and management are critical for improving the prognosis. Given the potential severity of these complications, all of them necessitate careful monitoring of the patient to ensure prompt intervention if any signs or symptoms arise. This makes the choice of all of the above not only reasonable but also essential for comprehensive patient care following a fracture.