Fracture complications: surgery for Volkmann contracture: 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 · Fracture complications: surgery for Volkmann contracture

Sample item

A 12-year-old has a moderate established Volkmann contracture of the forearm flexors with fixed finger flexion and intact sensation. Which operation addresses the shortened flexor muscles directly?

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

The answer and the reasoning

C. Slide of the flexor-pronator origin from the medial epicondyle and ulna

In the Max Page type of operation the common flexor origin is detached from the medial epicondyle and the ulna and allowed to slide distally, lengthening the flexor muscles. Tendon lengthening or transfers are used in other grades, and salvage procedures are kept for severe cases. Release of the carpal tunnel alone does not lengthen fibrotic muscle.

Option by option

  • A. Release of the carpal tunnel alone

    Carpal tunnel release treats nerve compression, not muscle contracture.

  • B. Wrist arthrodesis in extension for all patients

    Arthrodesis is a salvage option and does not treat the muscle shortening.

  • C. Slide of the flexor-pronator origin from the medial epicondyle and ulna (correct)

    Correct. The flexor origin slide lengthens the contracted muscles.

  • D. Camitz opponensplasty

    Camitz opponensplasty restores thumb opposition in low median palsy.

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, Slide of the flexor-pronator origin from the medial epicondyle and ulna. In the Max Page type of operation the common flexor origin is detached from the medial epicondyle and the ulna and allowed to slide distally, lengthening the flexor muscles.

Why is "Release of the carpal tunnel alone" not the answer?

Carpal tunnel release treats nerve compression, not muscle contracture.

Why is "Wrist arthrodesis in extension for all patients" not the answer?

Arthrodesis is a salvage option and does not treat the muscle shortening.

Why is "Camitz opponensplasty" not the answer?

Camitz opponensplasty restores thumb opposition in low median palsy.

What concept does this question test?

It tests Fracture complications: surgery for Volkmann contracture in Orthopaedics. Tendon lengthening or transfers are used in other grades, and salvage procedures are kept for severe cases. Release of the carpal tunnel alone does not lengthen fibrotic muscle.

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 Fracture complications: surgery for Volkmann contracture?

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.