Bone tumours: pathological fracture in enchondroma: 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 · Bone tumours: pathological fracture in enchondroma

Sample item

A 35-year-old has a painful swollen finger after a minor knock. The radiograph shows a well-defined lytic lesion with stippled calcification in the proximal phalanx and a pathological fracture. What is the best management?

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

The answer and the reasoning

D. Allow the fracture to heal, then curettage and bone grafting

Enchondroma is the commonest tumour of the small bones of the hand and often presents with a pathological fracture. The fracture is allowed to heal, after which curettage and grafting is done if symptoms or weakened bone persist. Malignant change is rare in the hand.

Option by option

  • A. Chemotherapy followed by amputation

    Chemotherapy is not used for enchondroma.

  • B. Radiotherapy to the lesion

    Radiotherapy is not used for benign cartilage tumours.

  • C. Immediate wide excision and amputation

    Amputation is not needed for a benign lesion.

  • D. Allow the fracture to heal, then curettage and bone grafting (correct)

    Correct. Healing first and then curettage with grafting is standard.

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, Allow the fracture to heal, then curettage and bone grafting. Enchondroma is the commonest tumour of the small bones of the hand and often presents with a pathological fracture.

Why is "Chemotherapy followed by amputation" not the answer?

Chemotherapy is not used for enchondroma.

Why is "Radiotherapy to the lesion" not the answer?

Radiotherapy is not used for benign cartilage tumours.

Why is "Immediate wide excision and amputation" not the answer?

Amputation is not needed for a benign lesion.

What concept does this question test?

It tests Bone tumours: pathological fracture in enchondroma in Orthopaedics. The fracture is allowed to heal, after which curettage and grafting is done if symptoms or weakened bone persist. Malignant change is rare in the hand.

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 Bone tumours: pathological fracture in enchondroma?

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.