Nerve injuries: Ochsner clasping test: 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 · Nerve injuries: Ochsner clasping test

Sample item

A patient is asked to clasp the hands together with fingers interlocked. The index finger of the right hand stays straight and cannot flex. Which lesion does this suggest?

ARadial nerve lesion at the spiral grooveBPosterior interosseous nerve lesionCHigh median nerve lesion above the elbowDLow ulnar nerve lesion at the wrist

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

The answer and the reasoning

C. High median nerve lesion above the elbow

Ochsner's clasping test is positive in a high median nerve palsy, where flexor digitorum profundus to the index finger and flexor pollicis longus are paralysed. The index finger cannot flex when the hands are clasped. A low median palsy spares these long flexors.

Option by option

A. Radial nerve lesion at the spiral groove
A radial lesion causes wrist and finger drop and does not impair finger flexion.
B. Posterior interosseous nerve lesion
A posterior interosseous lesion causes finger drop, not loss of finger flexion.
C. High median nerve lesion above the elbow (correct)
Correct. Failure of index flexion on clasping indicates a high median palsy.
D. Low ulnar nerve lesion at the wrist
A low ulnar lesion causes claw hand and weak interossei and spares index flexion.

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.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, High median nerve lesion above the elbow. Ochsner's clasping test is positive in a high median nerve palsy, where flexor digitorum profundus to the index finger and flexor pollicis longus are paralysed.

Why is "Radial nerve lesion at the spiral groove" not the answer?

A radial lesion causes wrist and finger drop and does not impair finger flexion.

Why is "Posterior interosseous nerve lesion" not the answer?

A posterior interosseous lesion causes finger drop, not loss of finger flexion.

Why is "Low ulnar nerve lesion at the wrist" not the answer?

A low ulnar lesion causes claw hand and weak interossei and spares index flexion.

What concept does this question test?

It tests Nerve injuries: Ochsner clasping test in Orthopaedics. The index finger cannot flex when the hands are clasped. A low median palsy spares these long flexors.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Nerve injuries: Ochsner clasping test?

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.