UPSC-CMS 2020 — Orthopaedics
2 Previous Year Questions with Answers & Explanations
Which one of the following statements about Compartment Syndrome is NOT correct?
Kohler's disease is avascular necrosis of :
UPSC-CMS 2020 - Orthopaedics UPSC-CMS Practice Questions and MCQs
Question 1: Which one of the following statements about Compartment Syndrome is NOT correct?
- A. Pain is on active movement but not on passive movement of muscles (Correct Answer)
- B. Fasciotomy is the treatment of choice
- C. It is commonest in a closed fracture
- D. Volkmann's Ischaemic contracture is a late complication
Explanation: ***Pain is on active movement but not on passive movement of muscles*** - This statement is incorrect because pain in compartment syndrome is characteristically **out of proportion to the injury** and is **exacerbated by passive stretching of the muscles** within the affected compartment. - While active movement can cause pain, the hallmark sign related to pain is its intensification with passive stretching due to increased pressure. *Fasciotomy is the treatment of choice* - **Fasciotomy** is indeed the definitive surgical treatment for compartment syndrome to relieve pressure and prevent irreversible tissue damage. - It involves incising the fascia to decompress the affected muscle compartment. *It is commonest in a closed fracture* - Compartment syndrome most frequently occurs after a **closed fracture**, particularly in the tibia and forearm, because the intact fascial compartments restrict expansion, leading to increased pressure. - The swelling and hemorrhage associated with the fracture are contained, causing pressure to rise rapidly. *Volkmann's Ischaemic contracture is a late complication* - **Volkmann's ischemic contracture** is a severe and debilitating late complication of unresolved or undertreated compartment syndrome, primarily affecting the forearm muscles. - It results from prolonged ischemia, causing muscle necrosis, fibrosis, and subsequent shortening and contracture.
Question 2: Kohler's disease is avascular necrosis of :
- A. Navicular (Correct Answer)
- B. First metatarsal head
- C. Capitellum of humerus
- D. Lunate
Explanation: ***Navicular*** - **Kohler's disease** specifically refers to **osteochondrosis** or **avascular necrosis** of the **navicular bone** in the foot. - It primarily affects **children** and is characterized by pain and tenderness over the medial aspect of the foot. *First metatarsal head* - Avascular necrosis of the first metatarsal head is known as **Freiberg's infraction**. - This condition typically affects **adolescent girls** and causes pain in the forefoot, especially during weight-bearing. *Capitellum of humerus* - Avascular necrosis of the capitellum of the humerus is called **Panner's disease**. - It is an **osteochondrosis** that primarily affects **young athletes** involved in repetitive overhead activities, leading to elbow pain and stiffness. *Lunate* - Avascular necrosis of the lunate bone in the wrist is known as **Kienbock's disease**. - This condition typically affects **adults** and is associated with wrist pain, stiffness, and weakness.