NEET-PG 2015 - Orthopaedics Practice Questions

Q: Flexor Digitorum Profundus tendon avulsion injury leads to -

Jersey Finger. ***Jersey Finger*** - **Jersey finger** is a common name for an avulsion injury of the **flexor digitorum profundus (FDP) tendon** from its insertion on the distal phalanx. - This injury typically occurs when the finger is forcibly extended while the FDP tendon is contracting, often seen in sports where a player grabs an opponent's jersey. *Extensor tendon injury* - An **extensor tendon injury** involves the tendons on the dorsal side of the hand, responsible for extending the fingers. - This is distinct from a **flexor tendon injury**, which involves tendons on the palmar side. *Ulnar collateral ligament injury* - An **ulnar collateral ligament (UCL) injury** most commonly affects the thumb's metacarpophalangeal (MCP) joint, often called **"skier's thumb"**. - This injury involves damage to the ligament supporting the joint, not an avulsion of a flexor tendon. *Central slip injury* - A **central slip injury** affects the middle slip of the extensor digitorum communis tendon over the proximal interphalangeal (PIP) joint. - Untreated, it can lead to a **Boutonnière deformity**, which is characterized by PIP joint flexion and distal interphalangeal (DIP) joint hyperextension.

Q: The K nail can be used for all of the following types of fractures except -

Intertrochanteric fractures. ***Intertrochanteric fractures*** - The K nail (specifically, the Kuntscher nail) is a **straight intramedullary nail** primarily designed for diaphyseal fractures. - It is **not suitable for intertrochanteric fractures** as these are metaphyseal and involve the proximal femur, requiring implants that offer greater stability in this region, such as cephalomedullary nails or plates. *Isthmic femur shaft fractures* - The **Kuntscher nail** was originally developed for and is well-suited for **isthmic femur shaft fractures** due to the narrow canal providing good cortical fixation. - Its design as a straight, broad nail fits snugly in the isthmus, providing excellent stability. *Low subtrochanteric fractures* - While more challenging, **K nails can be used for low subtrochanteric fractures**, especially if the fracture extends into the diaphyseal region. - However, newer implants like **cephalomedullary nails** are often preferred due to better biomechanical stability in this region. *Distal femur shaft fractures* - **K nails can be employed for distal femoral shaft fractures** if the fracture pattern allows for adequate fixation distal to the isthmus without compromising knee joint function. - The nail must be long enough to achieve stability, and the lack of proper locking mechanisms in traditional K nails may be a limiting factor compared to locked intramedullary nails.

Q: What is luxatio erecta ?

Inferior shoulder dislocation. ***Inferior shoulder dislocation*** - Luxatio erecta is a rare type of shoulder dislocation where the humeral head is displaced **inferiorly** and the arm is fixed in an **elevated position**, often described as looking as if the patient is "waving hello." - This dislocation typically results from **hyperabduction** of the arm, forcing the humeral head out of the glenoid fossa. *Anterior shoulder dislocation* - This is the most common type of shoulder dislocation, where the humeral head is displaced **anteriorly** and **inferiorly** beneath the coracoid process. - The arm is typically held in **abduction** and **external rotation**, not a sustained elevation. *Posterior hip dislocation* - This involves the displacement of the **femoral head** out of the acetabulum in a **posterior direction**, often due to high-energy trauma dashboard injuries. - The leg typically presents in **internal rotation**, adduction, and flexion. *Anterior hip dislocation* - This less common hip dislocation involves the femoral head displacing **anteriorly** relative to the acetabulum. - The affected leg is usually held in **external rotation**, abduction, and slight flexion.

Question 1

Flexor Digitorum Profundus tendon avulsion injury leads to -

Accepted Answer

Jersey Finger

Answer

Extensor tendon injury

Answer

Ulnar collateral ligament injury

Answer

Central slip injury

Question 2

The K nail can be used for all of the following types of fractures except -

Accepted Answer

Intertrochanteric fractures

Answer

Isthmic femur shaft fractures

Answer

Low subtrochanteric fractures

Answer

Distal femur shaft fractures

Question 3

What is luxatio erecta ?

Accepted Answer

Inferior shoulder dislocation

Answer

Anterior shoulder dislocation

Answer

Posterior hip dislocation

Answer

Anterior hip dislocation

NEET-PG 2015 — Orthopaedics