Foot: Coleman block 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 · Foot: Coleman block test

Sample item

A teenager has cavovarus feet with a plantarflexed first ray and hindfoot varus. When a block is placed under the lateral heel and lateral border, with the first metatarsal head allowed to drop off, the hindfoot corrects to neutral. What does this show?

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

The answer and the reasoning

C. The hindfoot varus is flexible and secondary to the forefoot, so surgery can be limited to the forefoot

The Coleman block test removes the effect of the plantarflexed first ray. If the hindfoot corrects, the varus is forefoot-driven and flexible, so a first metatarsal dorsiflexion osteotomy with soft tissue procedures may be enough. If it does not correct, the hindfoot is rigid and needs a calcaneal osteotomy or arthrodesis.

Option by option

  • A. The deformity is paralytic

    The test does not diagnose paralytic deformity.

  • B. The hindfoot is fixed and needs a triple arthrodesis

    Failure to correct, not correction, indicates a rigid hindfoot needing hindfoot surgery.

  • C. The hindfoot varus is flexible and secondary to the forefoot, so surgery can be limited to the forefoot (correct)

    Correct. Correction on blocking shows flexible, forefoot-driven hindfoot varus.

  • D. The deformity is due to a talocalcaneal coalition

    A coalition gives a rigid hindfoot that would not correct.

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 C, The hindfoot varus is flexible and secondary to the forefoot, so surgery can be limited to the forefoot. The Coleman block test removes the effect of the plantarflexed first ray.

Why is "The deformity is paralytic" not the answer?

The test does not diagnose paralytic deformity.

Why is "The hindfoot is fixed and needs a triple arthrodesis" not the answer?

Failure to correct, not correction, indicates a rigid hindfoot needing hindfoot surgery.

Why is "The deformity is due to a talocalcaneal coalition" not the answer?

A coalition gives a rigid hindfoot that would not correct.

What concept does this question test?

It tests Foot: Coleman block test in Orthopaedics. If the hindfoot corrects, the varus is forefoot-driven and flexible, so a first metatarsal dorsiflexion osteotomy with soft tissue procedures may be enough. If it does not correct, the hindfoot is rigid and needs a calcaneal osteotomy or arthrodesis.

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 Foot: Coleman block 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.