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: Pilon fracture is

Distal tibia Intraarticular fracture. ***Distal tibia Intraarticular fracture*** - A **pilon fracture** specifically refers to an **intra-articular fracture of the distal tibia**, involving the weight-bearing surface of the **ankle joint**. - These fractures typically result from high-energy axial loading mechanisms, driving the talus into the plafond and causing extensive articular damage. *Bimalleolar fracture* - A **bimalleolar fracture** involves fractures of both the **medial malleolus** (distal tibia) and the **lateral malleolus** (distal fibula). - While it involves the ankle, it does not necessarily involve the **tibial plafond** articular surface in the same destructive manner as a pilon fracture. *Trimalleolar fracture* - A **trimalleolar fracture** includes fractures of the medial, lateral, and **posterior malleolus** (a portion of the distal tibia). - Like bimalleolar fractures, it primarily describes the involvement of the malleoli rather than the intra-articular surface load-bearing portion of the distal tibia. *Proximal tibia fracture* - This term refers to a fracture occurring in the **upper part of the tibia**, near the knee joint. - It does not involve the **distal end of the tibia** or the ankle joint, which is characteristic of a pilon fracture. [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]

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

Type A. ***Type A*** - **Type A supracondylar fractures** are defined as those that do not involve the joint surface, making them **extra-articular**. - These fractures typically occur proximal to the condyles without extending into the knee articulation. *Type B* - **Type B supracondylar fractures** are considered **partial articular**, meaning they involve only a portion of the articular surface. - While they affect the joint, they are not completely intra-articular in nature. *Type C* - **Type C supracondylar fractures** are classified as **complete articular** fractures. - This type implies that the fracture line extends through the entire joint surface and separates the articular segment from the metaphysis. *Type D* - The classification of supracondylar femoral fractures generally uses A, B, and C types to denote extra-articular, partial articular, and complete articular involvement, respectively. - **Type D** is not a standard classification used to define an extra-articular supracondylar femoral fracture in common orthopedic systems like the Orthopaedic Trauma Association (OTA) classification. [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

Pilon fracture is

Accepted Answer

Distal tibia Intraarticular fracture

Answer

Bimalleolar fracture

Answer

Trimalleolar fracture

Answer

Proximal tibia fracture

Question 3

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 4

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

Accepted Answer

Posterolateral

Answer

Anteromedial

Answer

Anterolateral

Answer

Posteromedial

Question 5

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 6

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 7

What is the most common type of shoulder dislocation?

Accepted Answer

Answer

Subcoracoid

Answer

Subclavicular

Answer

Posterior

Question 8

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 9

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 10

Whiplash injury is a tear of which ligament?

Accepted Answer

Post. longitudinal ligament

Answer

Ligamenta flava

Answer

Supraspinal ligament

Answer

Anterior longitudinal ligament

NEET-PG 2013 — Orthopaedics