Fractures and dislocations: complications: 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 · Fractures and dislocations: complications

Sample item

A man develops a tense, swollen calf after tibial nailing. He has severe pain on passive toe extension, but distal pulses and capillary refill are normal. What should be done?

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

The answer and the reasoning

B. Urgent four-compartment fasciotomy

Compartment syndrome is a clinical diagnosis, with pain on passive stretch an early sign. Pulses are lost late, so waiting for pulselessness costs muscle and nerve; fasciotomy is the treatment.

Option by option

  • A. Observe until the pulses disappear

    Pulselessness is a late sign and waiting leads to irreversible damage.

  • B. Urgent four-compartment fasciotomy (correct)

    Correct. Clinical suspicion with pain on stretch warrants early fasciotomy.

  • C. Elevate the limb above the heart and review in the morning

    Elevation lowers arterial inflow and can worsen perfusion in a compartment syndrome.

  • D. Doppler study and defer action until it is normal

    A normal Doppler does not exclude compartment syndrome and delays decompression.

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, Urgent four-compartment fasciotomy. Compartment syndrome is a clinical diagnosis, with pain on passive stretch an early sign.

Why is "Observe until the pulses disappear" not the answer?

Pulselessness is a late sign and waiting leads to irreversible damage.

Why is "Elevate the limb above the heart and review in the morning" not the answer?

Elevation lowers arterial inflow and can worsen perfusion in a compartment syndrome.

Why is "Doppler study and defer action until it is normal" not the answer?

A normal Doppler does not exclude compartment syndrome and delays decompression.

What concept does this question test?

It tests Fractures and dislocations: complications in Orthopaedics. Pulses are lost late, so waiting for pulselessness costs muscle and nerve; fasciotomy is the treatment.

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 Fractures and dislocations: complications?

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.