Peripheral nerve injuries: entrapment: 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: entrapment

Sample item

A 50-year-old woman with long-standing carpal tunnel syndrome now has constant numbness, thenar wasting and a markedly prolonged distal motor latency on nerve conduction studies. What is the appropriate treatment?

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

The answer and the reasoning

B. Division of the flexor retinaculum

Thenar wasting and severe conduction block mean axonal damage, and conservative treatment will not reverse it. Carpal tunnel release by dividing the flexor retinaculum, open or endoscopic, is indicated.

Option by option

  • A. Local steroid injection alone

    A steroid injection gives temporary relief and is unsuitable with wasting.

  • B. Division of the flexor retinaculum (correct)

    Correct. Established axonal loss requires surgical decompression.

  • C. Decompression of the anterior interosseous nerve in the forearm

    The anterior interosseous nerve is not the site of compression in this condition.

  • D. Night splints for six more weeks

    Splinting is for mild early disease without wasting.

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, Division of the flexor retinaculum. Thenar wasting and severe conduction block mean axonal damage, and conservative treatment will not reverse it.

Why is "Local steroid injection alone" not the answer?

A steroid injection gives temporary relief and is unsuitable with wasting.

Why is "Decompression of the anterior interosseous nerve in the forearm" not the answer?

The anterior interosseous nerve is not the site of compression in this condition.

Why is "Night splints for six more weeks" not the answer?

Splinting is for mild early disease without wasting.

What concept does this question test?

It tests Peripheral nerve injuries: entrapment in Orthopaedics. Carpal tunnel release by dividing the flexor retinaculum, open or endoscopic, is indicated.

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 Peripheral nerve injuries: entrapment?

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.