Peripheral nerve injuries: peroneal palsy from cast pressure: 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 · Peripheral nerve injuries: peroneal palsy from cast pressure

Sample item

A man in a long-leg cast for a tibial fracture complains of numbness over the dorsum of the foot and cannot lift his toes. The cast fits tightly below the knee. What is the next step?

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

The answer and the reasoning

A. Split or remove the cast to relieve pressure over the fibular neck

The common peroneal nerve lies subcutaneously at the fibular neck, where a tight cast or padding can compress it and cause foot drop. The cast should be split to the skin and loosened, because early release usually leads to full recovery.

Option by option

  • A. Split or remove the cast to relieve pressure over the fibular neck (correct)

    Correct. Relieving the external pressure over the fibular neck is the urgent step.

  • B. Order a lumbar MRI

    A lumbar cause is unlikely when symptoms follow a tight cast at the fibular neck.

  • C. Increase the analgesia and review in a week

    Waiting allows prolonged compression to cause lasting nerve damage.

  • D. Immediate nerve graft

    Grafting is for divided nerves and not for a compressed nerve.

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 A, Split or remove the cast to relieve pressure over the fibular neck. The common peroneal nerve lies subcutaneously at the fibular neck, where a tight cast or padding can compress it and cause foot drop.

Why is "Order a lumbar MRI" not the answer?

A lumbar cause is unlikely when symptoms follow a tight cast at the fibular neck.

Why is "Increase the analgesia and review in a week" not the answer?

Waiting allows prolonged compression to cause lasting nerve damage.

Why is "Immediate nerve graft" not the answer?

Grafting is for divided nerves and not for a compressed nerve.

What concept does this question test?

It tests Peripheral nerve injuries: peroneal palsy from cast pressure in Orthopaedics. The cast should be split to the skin and loosened, because early release usually leads to full recovery.

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 Peripheral nerve injuries: peroneal palsy from cast pressure?

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.