Hip: surgical approaches and nerve risk: 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 · Hip: surgical approaches and nerve risk

Sample item

After a total hip replacement through a direct lateral approach, a patient has a Trendelenburg gait. Which nerve was most likely injured by splitting the gluteus medius too far proximally?

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

The answer and the reasoning

C. Superior gluteal nerve

The superior gluteal nerve supplies gluteus medius, gluteus minimus and tensor fasciae latae. Splitting the gluteus medius more than about 5 cm above the greater trochanter in a direct lateral approach can injure it. The result is abductor weakness and a Trendelenburg gait.

Option by option

  • A. Sciatic nerve

    The sciatic nerve is at risk in the posterior approach, not the direct lateral approach.

  • B. Obturator nerve

    The obturator nerve supplies the adductors and does not cause a Trendelenburg gait.

  • C. Superior gluteal nerve (correct)

    Correct. Superior gluteal nerve injury weakens the abductors and causes a Trendelenburg gait.

  • D. Inferior gluteal nerve

    The inferior gluteal nerve supplies gluteus maximus, so injury weakens hip extension.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Superior gluteal nerve. The superior gluteal nerve supplies gluteus medius, gluteus minimus and tensor fasciae latae.

Why is "Sciatic nerve" not the answer?

The sciatic nerve is at risk in the posterior approach, not the direct lateral approach.

Why is "Obturator nerve" not the answer?

The obturator nerve supplies the adductors and does not cause a Trendelenburg gait.

Why is "Inferior gluteal nerve" not the answer?

The inferior gluteal nerve supplies gluteus maximus, so injury weakens hip extension.

What concept does this question test?

It tests Hip: surgical approaches and nerve risk in Orthopaedics. Splitting the gluteus medius more than about 5 cm above the greater trochanter in a direct lateral approach can injure it. The result is abductor weakness and a Trendelenburg gait.

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 Hip: surgical approaches and nerve risk?

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.