Fractures: Rolando versus Bennett: 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.

Try it

Orthopaedics · Fractures: Rolando versus Bennett

Sample item

A boxer has a painful swollen thumb base. The radiograph shows a comminuted Y-shaped intra-articular fracture of the first metacarpal base. How does this differ from a Bennett fracture?

AIt is a simple two-part fracture with a volar lip fragmentBIt involves the base of the fifth metacarpalCIt is comminuted with three or more fragments and has a worse prognosisDIt is an extra-articular fracture of the neck

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

The answer and the reasoning

C. It is comminuted with three or more fragments and has a worse prognosis

A Rolando fracture is a comminuted, Y- or T-shaped fracture of the base of the first metacarpal that enters the carpometacarpal joint. Bennett fracture is a two-part fracture-dislocation in which a volar-ulnar fragment is held by the anterior oblique ligament. Rolando fractures have a poorer outcome because of comminution and joint surface damage.

Option by option

A. It is a simple two-part fracture with a volar lip fragment
A volar lip fragment with a two-part pattern describes Bennett fracture.
B. It involves the base of the fifth metacarpal
The fifth metacarpal base injury is a different fracture.
C. It is comminuted with three or more fragments and has a worse prognosis (correct)
Correct. Comminution of the intra-articular base defines Rolando fracture.
D. It is an extra-articular fracture of the neck
Extra-articular fractures at the neck do not enter the joint.

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, It is comminuted with three or more fragments and has a worse prognosis. A Rolando fracture is a comminuted, Y- or T-shaped fracture of the base of the first metacarpal that enters the carpometacarpal joint.

Why is "It is a simple two-part fracture with a volar lip fragment" not the answer?

A volar lip fragment with a two-part pattern describes Bennett fracture.

Why is "It involves the base of the fifth metacarpal" not the answer?

The fifth metacarpal base injury is a different fracture.

Why is "It is an extra-articular fracture of the neck" not the answer?

Extra-articular fractures at the neck do not enter the joint.

What concept does this question test?

It tests Fractures: Rolando versus Bennett in Orthopaedics. Bennett fracture is a two-part fracture-dislocation in which a volar-ulnar fragment is held by the anterior oblique ligament. Rolando fractures have a poorer outcome because of comminution and joint surface damage.

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 Fractures: Rolando versus Bennett?

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.