Paediatric orthopaedics: femoral anteversion: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric orthopaedics: femoral anteversion

Sample item

A 5-year-old girl who sits in a W position walks with her feet turned in. Hip examination shows internal rotation of 90 degrees and limited external rotation. What is the usual course?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Excessive femoral anteversion that usually resolves spontaneously with growth

Increased femoral anteversion is the commonest cause of in-toeing in children aged 3 to 8 years, and is associated with W-sitting. Most cases remodel and resolve by about 8 to 10 years without treatment. Derotation osteotomy is rarely needed for severe persistent deformity with functional problems.

Option by option

  • A. Hip dysplasia needing immediate osteotomy

    Surgery is not indicated at this age for this common variant.

  • B. Excessive femoral anteversion that usually resolves spontaneously with growth (correct)

    Correct. Femoral anteversion usually resolves with growth and needs observation.

  • C. Cerebral palsy needing botulinum toxin

    Cerebral palsy would show other neurological features.

  • D. Perthes disease needing surgery

    Perthes disease causes a painful limp, not painless in-toeing.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Excessive femoral anteversion that usually resolves spontaneously with growth. Increased femoral anteversion is the commonest cause of in-toeing in children aged 3 to 8 years, and is associated with W-sitting.

Why is "Hip dysplasia needing immediate osteotomy" not the answer?

Surgery is not indicated at this age for this common variant.

Why is "Cerebral palsy needing botulinum toxin" not the answer?

Cerebral palsy would show other neurological features.

Why is "Perthes disease needing surgery" not the answer?

Perthes disease causes a painful limp, not painless in-toeing.

What concept does this question test?

It tests Paediatric orthopaedics: femoral anteversion in Orthopaedics. Most cases remodel and resolve by about 8 to 10 years without treatment. Derotation osteotomy is rarely needed for severe persistent deformity with functional problems.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric orthopaedics: femoral anteversion?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.