NEET-PG 2013 - Orthopaedics PYQs Practice Questions

Q: True about proximal fragment in subtrochanteric fracture is?

All of the options. ***All of the options*** - In a subtrochanteric fracture, the **proximal fragment** is under the influence of several strong muscle groups, leading to a characteristic displacement. - The **iliopsoas muscle** causes **flexion**, the **gluteus medius and minimus** cause **abduction**, and the **short external rotators** cause **external rotation**. *Flexion* - The powerful **iliopsoas muscle** inserts on the lesser trochanter and acts to flex the hip. - This muscle pulls the proximal fragment anteriorly and superiorly, resulting in a **flexion deformity**. *Abduction* - The **gluteus medius and minimus muscles** attach to the greater trochanter and exert a strong abducting force. - This action pulls the proximal fragment away from the midline, causing **abduction**. *External rotation* - The **short external rotators** (e.g., piriformis, obturators, gemelli) insert around the greater trochanter. - These muscles collectively cause the proximal fragment to rotate outwards, resulting in **external rotation**. [Practice more Orthopaedics PYQs on OnCourse]

Q: In an extension type of supracondylar fracture, what is the usual direction of displacement?

Posterolateral. ***Posterolateral*** - In an **extension type supracondylar fracture**, the distal fragment (forearm and hand) is typically displaced **posteriorly and laterally**. - This common displacement pattern is often caused by a **fall on an outstretched hand** with the elbow in extension, forcing the olecranon against the humerus. *Anteromedial* - This is an **uncommon displacement** in supracondylar fractures and is not characteristic of the extension type. - While displacement can have a medial or lateral component, the primary displacement in extension type is posterior. *Anterolateral* - Displacement in an anterior direction is typically seen in **flexion-type supracondylar fractures**, which are much rarer. - Even in flexion-type fractures, the lateral component of displacement is less common than medial. *Posteromedial* - While posterior displacement is characteristic of extension supracondylar fractures, a **posteromedial displacement** is encountered, but **posterolateral** is the *most common* pattern. - The varus force often involved in these injuries tends to promote lateral displacement of the distal fragment. [Practice more Orthopaedics PYQs on OnCourse]

Q: What is a late complication of elbow dislocation?

Myositis ossificans. **Myositis ossificans** - **Myositis ossificans** is the abnormal formation of **heterotopic bone** within muscle or other soft tissues, often developing weeks to months after joint trauma such as an elbow dislocation. - It typically presents as a painful, firm mass with restricted joint movement, especially **flexion** and **extension** at the elbow. *Median nerve injury* - **Median nerve injury** can occur at the time of the initial elbow dislocation (an **acute complication**), but it is not typically considered a late complication that develops over weeks or months. - Symptoms include numbness in the thumb, index, and middle fingers, as well as weakness in **thumb opposition** and **flexion** of the index finger. *Brachial artery injury* - **Brachial artery injury** is an **acute complication** of severe elbow dislocation, leading to compromise of distal blood flow. - Signs include absence of pulses, pallor, paresthesia, and pain in the forearm and hand, requiring immediate surgical intervention. *None of the options* - This option is incorrect because **myositis ossificans** is a well-recognized late complication of elbow dislocation. [Practice more Orthopaedics PYQs on OnCourse]

Q: Which of the following is NOT a complication of elbow dislocation?

Radial nerve injury. ***Radial nerve injury*** - The **radial nerve** is rarely injured in an elbow dislocation due to its anatomical course, which is less exposed to the shearing forces involved in this type of injury. - While other nerves like the ulnar and median nerves are more susceptible, significant stretching or compression of the radial nerve is **uncommon** in typical elbow dislocations. *Vascular injury* - The **brachial artery** runs in close proximity to the elbow joint and can be torn or compressed during a dislocation, leading to **ischemia** if not promptly recognized and treated. - This complication can result in **Volkmann's ischemic contracture** if perfusion is not restored. *Median nerve injury* - The **median nerve** passes anterior to the elbow joint and is vulnerable to injury from stretching or direct compression during dislocation. - Injury can manifest as **sensory deficits** in the distribution of the median nerve and **weakness** of forearm pronation and thumb flexion/opposition. *Myositis ossificans* - This is a common chronic complication of elbow dislocations, particularly in cases of **delayed reduction** or aggressive physical therapy. - It involves the **abnormal ossification** of soft tissues around the joint, commonly in the brachialis muscle, leading to **pain and restricted range of motion**. [Practice more Orthopaedics PYQs on OnCourse]

Question 1

True about proximal fragment in subtrochanteric fracture is?

Accepted Answer

All of the options

Answer

Flexion

Answer

Abduction

Answer

External rotation

Question 2

In an extension type of supracondylar fracture, what is the usual direction of displacement?

Accepted Answer

Posterolateral

Answer

Anteromedial

Answer

Anterolateral

Answer

Posteromedial

Question 3

What is the Essex-Lopresti lesion in the upper limb?

Accepted Answer

Comminuted radial head fracture with interosseous membrane disruption and DRUJ instability

Answer

Isolated radial head fracture without soft tissue involvement

Answer

Radial shaft

Answer

Radial shaft and radio-ulnar joint fracture

Question 4

What is a late complication of elbow dislocation?

Accepted Answer

Myositis ossificans

Answer

Median nerve injury

Answer

Brachial artery injury

Answer

None of the options

Question 5

Which of the following is NOT a complication of elbow dislocation?

Accepted Answer

Radial nerve injury

Answer

Vascular injury

Answer

Median nerve injury

Answer

Myositis ossificans

Question 6

Most commonly recommended cast position for proximal forearm fractures is ?

Accepted Answer

Supinated position

Answer

Pronated flexion

Answer

Neutral position

Answer

Position does not matter

Question 7

Which type of supracondylar fracture of the femur is classified as extra-articular?

Accepted Answer

Type A

Answer

Type B

Answer

Type C

Answer

Type D

Question 8

What is the characteristic feature of Barton's fracture?

Accepted Answer

Intra-articular fracture of the distal end radius with carpal bone subluxation and joint involvement

Answer

Extra-articular fracture of the distal end radius

Answer

Intra-articular fracture of the distal end radius without carpal bone subluxation

Answer

Intra-articular fracture of the distal end radius with carpal bone subluxation

Question 9

Madelung's deformity is characterized by an abnormality in which bone?

Accepted Answer

Distal radius

Answer

Humerus

Answer

Proximal ulna

Answer

Carpals

Question 10

What is the most common type of shoulder dislocation?

Accepted Answer

Answer

Subcoracoid

Answer

Subclavicular

Answer

Posterior

NEET-PG 2013 — Orthopaedics