Pelvis: vertical shear injury: 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 · Pelvis: vertical shear injury

Sample item

A construction worker falls from a scaffold and lands on his right leg. The right leg appears shortened and the pelvic radiograph shows upward displacement of the right hemipelvis with sacroiliac disruption. Which Young-Burgess pattern is this?

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

The answer and the reasoning

D. Vertical shear

Vertical shear injuries result from axial loading, such as a fall onto an extended leg, and displace the hemipelvis proximally. All ligaments of the ring on that side are torn or the sacrum is fractured. The injury is completely unstable and needs surgical fixation.

Option by option

  • A. Anteroposterior compression I

    APC I is a minor symphyseal widening with intact posterior ligaments.

  • B. Isolated pubic ramus fracture

    An isolated ramus fracture would not cause upward displacement of the hemipelvis.

  • C. Lateral compression I

    Lateral compression I is a stable impaction injury and does not cause vertical displacement.

  • D. Vertical shear (correct)

    Correct. Vertical displacement of the hemipelvis after a fall onto the leg is vertical shear.

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 D, Vertical shear. Vertical shear injuries result from axial loading, such as a fall onto an extended leg, and displace the hemipelvis proximally.

Why is "Anteroposterior compression I" not the answer?

APC I is a minor symphyseal widening with intact posterior ligaments.

Why is "Isolated pubic ramus fracture" not the answer?

An isolated ramus fracture would not cause upward displacement of the hemipelvis.

Why is "Lateral compression I" not the answer?

Lateral compression I is a stable impaction injury and does not cause vertical displacement.

What concept does this question test?

It tests Pelvis: vertical shear injury in Orthopaedics. All ligaments of the ring on that side are torn or the sacrum is fractured. The injury is completely unstable and needs surgical fixation.

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 Pelvis: vertical shear injury?

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.