Spine: unilateral facet dislocation: 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 · Spine: unilateral facet dislocation

Sample item

After a rotational flexion injury in a road accident, a 28-year-old has neck pain, a fixed rotated head posture and radiating pain in one arm, with a normal cord examination. The lateral radiograph shows anterior slip of C5 of about a quarter of the body width with a bow-tie appearance of the facets. What is the injury?

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

The answer and the reasoning

C. Unilateral facet dislocation

A unilateral locked facet follows a combined flexion and rotation force. The vertebra slips less than 50 percent, the facets appear as a bow-tie on the lateral view, and the root rather than the cord is usually involved.

Option by option

  • A. Hangman fracture

    A hangman fracture is a pars fracture of C2, not a slip at C5-C6.

  • B. Bilateral facet dislocation

    Both facets locked gives a slip over half the body width with frequent cord damage.

  • C. Unilateral facet dislocation (correct)

    Correct. About 25 percent slip with a bow-tie facet pattern and a root lesion fits one locked facet.

  • D. Clay-shoveler fracture

    A clay-shoveler fracture is an avulsion of a spinous process and causes no vertebral slip.

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 C, Unilateral facet dislocation. A unilateral locked facet follows a combined flexion and rotation force.

Why is "Hangman fracture" not the answer?

A hangman fracture is a pars fracture of C2, not a slip at C5-C6.

Why is "Bilateral facet dislocation" not the answer?

Both facets locked gives a slip over half the body width with frequent cord damage.

Why is "Clay-shoveler fracture" not the answer?

A clay-shoveler fracture is an avulsion of a spinous process and causes no vertebral slip.

What concept does this question test?

It tests Spine: unilateral facet dislocation in Orthopaedics. The vertebra slips less than 50 percent, the facets appear as a bow-tie on the lateral view, and the root rather than the cord is usually involved.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Spine: unilateral facet dislocation?

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.