Paediatric orthopaedics: posteromedial bowing of the tibia: 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: posteromedial bowing of the tibia

Sample item

A newborn has posteromedial bowing of the lower leg with the foot held dorsiflexed in valgus against the tibia. The bowing is smooth and there is no fracture. What is the expected course?

ASpontaneous improvement, with later limb-length discrepancy to watchBProgressive deformity needing urgent bypass graftingCAssociation with neurofibromatosis and fractureDEarly amputation because of fibular absence

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

The answer and the reasoning

A. Spontaneous improvement, with later limb-length discrepancy to watch

Posteromedial bowing of the tibia is a benign intrauterine positional deformity that usually remodels over several years. A residual shortening of the limb may need later management, so growth is monitored. Anterolateral bowing, in contrast, suggests neurofibromatosis and pseudarthrosis.

Option by option

A. Spontaneous improvement, with later limb-length discrepancy to watch (correct)
Correct. The deformity remodels, but the shorter limb needs growth monitoring.
B. Progressive deformity needing urgent bypass grafting
Progression with fracture is the course of anterolateral bowing.
C. Association with neurofibromatosis and fracture
Association with neurofibromatosis is typical of anterolateral bowing, not posteromedial.
D. Early amputation because of fibular absence
Absent fibula is associated with anteromedial bowing and a different limb deficiency.

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.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Spontaneous improvement, with later limb-length discrepancy to watch. Posteromedial bowing of the tibia is a benign intrauterine positional deformity that usually remodels over several years.

Why is "Progressive deformity needing urgent bypass grafting" not the answer?

Progression with fracture is the course of anterolateral bowing.

Why is "Association with neurofibromatosis and fracture" not the answer?

Association with neurofibromatosis is typical of anterolateral bowing, not posteromedial.

Why is "Early amputation because of fibular absence" not the answer?

Absent fibula is associated with anteromedial bowing and a different limb deficiency.

What concept does this question test?

It tests Paediatric orthopaedics: posteromedial bowing of the tibia in Orthopaedics. A residual shortening of the limb may need later management, so growth is monitored. Anterolateral bowing, in contrast, suggests neurofibromatosis and pseudarthrosis.

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: posteromedial bowing of the tibia?

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.