What is the primary use of a knuckle bender splint?
What is the most common type of dislocation of the elbow joint?
What condition is primarily diagnosed using Von Rosen's view?
Tardy ulnar nerve palsy is specifically associated with which type of fracture?
Which of the following statements is true regarding supracondylar fractures of the humerus?
Which of the following describes grade 2 fracture neck femur?
Anterolateral decompression is primarily indicated for
Which of the following bone tumors characteristically presents with nocturnal pain relieved by NSAIDs and shows a radiolucent nidus surrounded by sclerotic bone?
What type of cast is primarily associated with the development of Cast syndrome?
Green stick fracture is
NEET-PG 2012 - Orthopaedics NEET-PG Practice Questions and MCQs
Question 21: What is the primary use of a knuckle bender splint?
- A. Ulnar nerve palsy (Correct Answer)
- B. Radial nerve palsy
- C. Median nerve palsy
- D. Axillary nerve palsy
Explanation: ***Ulnar nerve palsy*** - A knuckle bender splint is primarily used to counteract the characteristic **claw hand deformity** seen in ulnar nerve palsy [1] by maintaining the **metacarpophalangeal (MCP) joints** in flexion. - This splint helps improve function by preventing hyperextension of the MCP joints, which commonly occurs due to the unopposed action of the extensor muscles when the ulnar nerve is compromised. *Radial nerve palsy* - Radial nerve palsy typically results in **wrist drop** and an inability to extend the wrist and fingers, which is managed with wrist extension splints, not knuckle benders. - The primary goal of splinting in radial nerve palsy is to support the wrist in extension to facilitate grasping and carrying objects. *Median nerve palsy* - Median nerve palsy causes problems with thumb opposition and sensation in the first three and a half digits, often leading to an **ape hand deformity**. - Splints for median nerve palsy focus on maintaining the thumb in opposition, such as a **thumb spica splint**, which differs from a knuckle bender. *Axillary nerve palsy* - Axillary nerve palsy primarily affects the **deltoid muscle**, leading to weakness in shoulder abduction and external rotation. - Splinting for axillary nerve palsy typically involves shoulder immobilizers or abduction splints, which address shoulder joint positioning rather than hand function.
Question 22: What is the most common type of dislocation of the elbow joint?
- A. Posterior dislocation
- B. Posterolateral dislocation (Correct Answer)
- C. Posteromedial dislocation
- D. Lateral dislocation
Explanation: ***Posterolateral dislocation*** - This is the **most common type of elbow dislocation**, accounting for over 90% of cases. - The **radius and ulna displace posterior and lateral** relative to the humerus. *Posterior dislocation* - While common, **pure posterior dislocations are less frequent** than posterolateral disruptions. - In a pure posterior dislocation, the **forearm bones move directly backward**, without a significant lateral component. *Posteromedial dislocation* - This is a **less common type of elbow dislocation**, involving the ulna and radius displacing posterior and medial. - Often associated with **more complex soft tissue and bony injuries**. *Lateral dislocation* - **Pure lateral dislocations of the elbow are rare** and usually involve significant disruption of the medial collateral ligament. - It occurs when the **forearm bones move directly lateral** to the humerus.
Question 23: What condition is primarily diagnosed using Von Rosen's view?
- A. Congenital dislocation of the hip (CDH) (Correct Answer)
- B. Perthes disease
- C. Congenital Talipes Equinovarus (CTEV)
- D. None of the options
Explanation: ***Congenital dislocation of the hip (CDH)*** - **Von Rosen's view** is a specialized X-ray projection used specifically to assess for **developmental dysplasia of the hip (DDH)**, also known as CDH, in infants. - This view helps visualize the relationship between the **femoral head** and the **acetabulum** by positioning the infant's hips in extension, abduction, and internal rotation. *Perthes disease* - **Perthes disease** is an avascular necrosis of the femoral head, typically diagnosed with standard **frog-leg lateral** and **AP pelvic X-rays**. - While it affects the hip, Von Rosen's view is not the primary diagnostic imaging for this condition, which usually presents later in childhood. *Congenital Talipes Equinovarus (CTEV)* - **CTEV**, or **clubfoot**, is a deformity of the foot and ankle, not the hip. - It is primarily diagnosed clinically and then confirmed with **AP and lateral X-rays of the foot** to assess bone alignment. *None of the options* - This option is incorrect because **Congenital dislocation of the hip (CDH)** is indeed primarily diagnosed using Von Rosen's view, among other methods.
Question 24: Tardy ulnar nerve palsy is specifically associated with which type of fracture?
- A. Lateral condyle fracture of the humerus (Correct Answer)
- B. Medial condyle fracture of the humerus
- C. Fracture of the humeral shaft
- D. Fracture of the radial shaft
Explanation: ***Lateral condyle fracture of the humerus*** - This fracture, especially in children, can lead to **cubitus valgus deformity** as a long-term complication if it heals incorrectly. - The resulting **valgus angulation** at the elbow abnormally stretches the ulnar nerve behind the medial epicondyle, causing **tardy ulnar nerve palsy** years after the initial injury. *Medial condyle fracture of the humerus* - While close to the ulnar nerve, medial condyle fractures are more likely to cause **immediate nerve damage** due to direct impingement, rather than delayed or "tardy" palsy from chronic stretching. - Complications typically involve varus deformity, which does not commonly stretch the ulnar nerve in the same manner as valgus. *Fracture of the humeral shaft* - This type of fracture is more commonly associated with **radial nerve injury** (e.g., wrist drop), especially in fractures of the mid-shaft. - It does not typically lead to long-term deformities at the elbow that would cause **delayed ulnar nerve compression**. *Fracture of the radial shaft* - Radial shaft fractures (e.g., Monteggia, Galeazzi) primarily affect the **radial nerve** or the **posterior interosseous nerve**. - They do not directly involve the elbow joint in a manner that would cause **tardy ulnar nerve palsy**.
Question 25: Which of the following statements is true regarding supracondylar fractures of the humerus?
- A. Extension type most common (Correct Answer)
- B. Flexion type is less common than extension type
- C. Both types are equally common
- D. More common in adults
Explanation: **Extension type most common** - **Extension-type supracondylar fractures** account for the vast majority (about 95%) of all supracondylar humerus fractures. - This type typically results from a fall on an **outstretched hand** with the elbow in extension, forcing the distal fragment posteriorly. *More common in adults* - **Supracondylar fractures of the humerus** are predominantly observed in children, especially between 5 and 10 years of age. - They are the **most common elbow fracture in children**, making this statement incorrect. *Flexion type is less common than extension type* - While flexion-type fractures do occur, they are significantly less common, representing only about 5% of all supracondylar fractures. - This type typically results from a direct blow to the posterior aspect of the elbow, with the distal fragment displaced anteriorly. *Both types are equally common* - As established, extension-type fractures are far more prevalent than flexion-type fractures, making them not equally common. - The significant disparity in incidence confirms that this statement is incorrect.
Question 26: Which of the following describes grade 2 fracture neck femur?
- A. Incomplete fracture, medial trabeculae intact
- B. Complete fracture with undisplaced neck (Correct Answer)
- C. Complete fracture with ischemic head
- D. Moderate displacement of neck, vascularity damaged
Explanation: ***Complete fracture with undisplaced neck*** - A **Garden Type II fracture** of the femoral neck is characterized by a **complete fracture line** through the femoral neck. - Despite the complete fracture, the **femoral head remains undisplaced** and in its anatomical position, indicating an intact or minimally disrupted posteromedial soft-tissue hinge. *Incomplete fracture, medial trabeculae intact* - This description corresponds to a **Garden Type I fracture**, which is an **incomplete fracture** of the femoral neck, usually impacted in valgus. - In such cases, the medial trabeculae are often intact, or show buckling on the lateral side, indicating a stable fracture. *Complete fracture with ischemic head* - The presence of an **ischemic head** is a complication that can occur with any displaced femoral neck fracture (Garden Type III or IV), but it's not a primary defining characteristic of a specific Garden grade. - **Avascular necrosis (AVN)** of the femoral head is a risk, especially with displacement, due to disruption of the blood supply. *Moderate displacement of neck, vascularity damaged* - This description is more consistent with a **Garden Type III fracture**, where there is a **complete fracture with moderate displacement** of the femoral head, usually with some varus angulation. - Such displacement significantly increases the risk of **vascular injury** to the femoral head, predisposing to avascular necrosis.
Question 27: Anterolateral decompression is primarily indicated for
- A. Spinal tuberculosis (Pott's disease) (Correct Answer)
- B. Lumbar disc herniation
- C. Ankylosing spondylitis
- D. Spinal metastasis
Explanation: ***Spinal tuberculosis (Pott's disease)*** - **Anterolateral decompression** is crucial for **Pott's disease** to remove infected bone and pus, relieve pressure on the spinal cord, and facilitate fusion. - This approach allows direct access to the anterior spinal column, which is commonly affected by the destructive process of **tuberculosis**. *Spinal metastasis* - While spinal metastasis can cause compression, **anterolateral decompression** is less common as a primary approach; often, surgical treatment involves posterior decompression, stabilization, and adjuvant therapies like radiation. - The goal is often **pain management** and neurological preservation in the context of advanced disease. *Lumbar disc herniation* - **Lumbar disc herniation** is typically addressed by posterior approaches like **microdiscectomy** or laminectomy, which directly access the posterior aspect of the disc. - **Anterolateral decompression** is generally not indicated as the primary treatment for standard disc herniations. *Ankylosing spondylitis* - Surgical intervention in **ankylosing spondylitis** is usually reserved for severe kyphosis or spinal fractures, employing osteotomies and stabilization techniques, often through posterior approaches. - **Anterolateral decompression** is not a standard procedure for the typical manifestations or complications of **ankylosing spondylitis**.
Question 28: Which of the following bone tumors characteristically presents with nocturnal pain relieved by NSAIDs and shows a radiolucent nidus surrounded by sclerotic bone?
- A. Osteoid osteoma (Correct Answer)
- B. Chondrosarcoma
- C. Enchondroma
- D. None of the options
Explanation: ***Osteoid osteoma*** - This benign bone tumor is characterized by **nocturnal pain** that is typically **relieved by NSAIDs**, a highly distinctive clinical feature due to prostaglandin production within the nidus. - Radiographically, it presents as a small **radiolucent nidus** (less than 1.5 cm) surrounded by a significant margin of **sclerotic bone**. *Chondrosarcoma* - This is a **malignant cartilage-forming tumor** that usually presents with a dull, aching pain that is often **not relieved by NSAIDs** and may worsen over time. - Radiographically, it appears as a **large, destructive lesion with calcifications**, not a small nidus with surrounding sclerosis. *Enchondroma* - An enchondroma is a **benign cartilaginous tumor** that is typically found in the medullary cavity of long bones, often in the small bones of the hands and feet. - It is usually **asymptomatic** and discovered incidentally, and on imaging, it appears as a **well-circumscribed lytic lesion** without the prominent sclerotic rim or specific nocturnal pain pattern seen in osteoid osteoma. *None of the options* - This option is incorrect because **osteoid osteoma** perfectly matches the clinical and radiographic description provided in the question.
Question 29: What type of cast is primarily associated with the development of Cast syndrome?
- A. Full arm cast
- B. Short arm cast
- C. Hip spica cast (Correct Answer)
- D. Above knee cast
Explanation: ***Hip spica cast*** - A **hip spica cast** encases the trunk and one or both legs, increasing intra-abdominal pressure due to its extensive coverage. - This pressure can compress the **superior mesenteric artery** against the **duodenum**, leading to Cast syndrome (also known as superior mesenteric artery syndrome). *Full arm cast* - A full arm cast does not cover the abdomen and therefore does not exert pressure on the **superior mesenteric artery** or duodenum. - It is associated with complications like compartment syndrome or nerve impingement in the upper extremity, but not Cast syndrome. *Short arm cast* - Similar to a full arm cast, a short arm cast is limited to the forearm and hand and poses no risk for **abdominal compression**. - Complications are localized to the distal upper limb, such as carpal tunnel syndrome or skin breakdown. *Above knee cast* - An above knee cast covers the lower leg and thigh but does not extend to the abdomen. - It does not contribute to the increased intra-abdominal pressure necessary for the development of **superior mesenteric artery syndrome**.
Question 30: Green stick fracture is
- A. Fracture in adults
- B. Complete fracture
- C. Fracture spine
- D. Incomplete fracture (Correct Answer)
Explanation: ***Incomplete fracture*** - A **greenstick fracture** is an **incomplete fracture** where the bone bends and cracks but does not break all the way through. - This type of fracture commonly occurs in children because their bones are more flexible and softer than adult bones. *Fracture in adults* - While adults can experience various types of fractures, a **greenstick fracture** is rare in adults due to their more rigid and brittle bones. - Adult bones tend to sustain **complete fractures** or other complex fracture patterns instead of bending partially. *Complete fracture* - A **complete fracture** denotes a break in the bone that severs it into two or more distinct pieces. - **Greenstick fractures** are by definition incomplete, meaning the bone is still partially intact. *Fracture spine* - A **spinal fracture** specifically refers to a break in one or more vertebrae in the spinal column. - While spinal fractures can be complete or incomplete, the term **greenstick fracture** is not typically used to describe fractures of the spine.