Paediatric orthopaedics: tibial versus fibular hemimelia: 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 · Paediatric orthopaedics: tibial versus fibular hemimelia

Sample item

A newborn has absence of the tibia with a hindfoot held in marked varus and the fibula prominent at the knee. How does this differ from fibular hemimelia?

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

The answer and the reasoning

C. The foot is in varus with a missing tibia, whereas fibular hemimelia has a valgus foot

In tibial hemimelia the foot lies in equinovarus and the fibula migrates proximally, and knee function depends on the quadriceps. In fibular hemimelia the ankle is valgus with a shortened tibia, often with absent lateral rays. Both are managed according to limb length discrepancy and foot function.

Option by option

  • A. Tibial hemimelia has no foot deformity

    A deformed foot is expected in tibial hemimelia.

  • B. Tibial hemimelia always has a normal knee

    The knee is usually abnormal in tibial hemimelia.

  • C. The foot is in varus with a missing tibia, whereas fibular hemimelia has a valgus foot (correct)

    Correct. Varus with an absent tibia contrasts with the valgus foot of fibular hemimelia.

  • D. Both have a valgus foot with missing lateral rays

    The valgus foot with missing lateral rays describes fibular hemimelia only.

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 foot is in varus with a missing tibia, whereas fibular hemimelia has a valgus foot. In tibial hemimelia the foot lies in equinovarus and the fibula migrates proximally, and knee function depends on the quadriceps.

Why is "Tibial hemimelia has no foot deformity" not the answer?

A deformed foot is expected in tibial hemimelia.

Why is "Tibial hemimelia always has a normal knee" not the answer?

The knee is usually abnormal in tibial hemimelia.

Why is "Both have a valgus foot with missing lateral rays" not the answer?

The valgus foot with missing lateral rays describes fibular hemimelia only.

What concept does this question test?

It tests Paediatric orthopaedics: tibial versus fibular hemimelia in Orthopaedics. In fibular hemimelia the ankle is valgus with a shortened tibia, often with absent lateral rays. Both are managed according to limb length discrepancy and foot function.

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 Paediatric orthopaedics: tibial versus fibular hemimelia?

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.