Foot: peroneal tendon dislocation: 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: peroneal tendon dislocation

Sample item

A skier falls with forced dorsiflexion of the ankle and feels a snap behind the lateral malleolus. A radiograph shows a small fleck of bone off the posterolateral distal fibula. What is injured?

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

The answer and the reasoning

A. The superior peroneal retinaculum, with dislocation of the peroneal tendons

A fleck of avulsed distal fibula is a pathognomonic sign of tearing of the superior peroneal retinaculum, allowing the peroneal tendons to dislocate over the lateral malleolus. Pain, snapping and swelling behind the lateral malleolus follow. Acute cases in athletes are often repaired surgically.

Option by option

  • A. The superior peroneal retinaculum, with dislocation of the peroneal tendons (correct)

    Correct. The fleck sign indicates retinacular avulsion with peroneal tendon dislocation.

  • B. The anterior talofibular ligament

    An anterior talofibular ligament sprain does not avulse the posterior fibula.

  • C. The Achilles tendon

    Achilles rupture produces a calf gap and a positive Thompson test.

  • D. The tibialis posterior tendon

    Tibialis posterior injury affects the medial side.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, The superior peroneal retinaculum, with dislocation of the peroneal tendons. A fleck of avulsed distal fibula is a pathognomonic sign of tearing of the superior peroneal retinaculum, allowing the peroneal tendons to dislocate over the lateral malleolus.

Why is "The anterior talofibular ligament" not the answer?

An anterior talofibular ligament sprain does not avulse the posterior fibula.

Why is "The Achilles tendon" not the answer?

Achilles rupture produces a calf gap and a positive Thompson test.

Why is "The tibialis posterior tendon" not the answer?

Tibialis posterior injury affects the medial side.

What concept does this question test?

It tests Foot: peroneal tendon dislocation in Orthopaedics. Pain, snapping and swelling behind the lateral malleolus follow. Acute cases in athletes are often repaired surgically.

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: peroneal tendon dislocation?

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.