Sports injuries: anterior tibial stress fracture: 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 · Sports injuries: anterior tibial stress fracture

Sample item

A basketball player has anterior shin pain on jumping. A lateral radiograph shows a thin horizontal lucent line in the anterior tibial cortex. What is the concern with this lesion?

AHigh risk of nonunion because it is on the tension side, and it may need nailingBIt signals osteoid osteomaCIt heals reliably with a few days of restDIt is a benign cortical variant needing no treatment

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

The answer and the reasoning

A. High risk of nonunion because it is on the tension side, and it may need nailing

The anterior tibial cortex is under tension in jumping athletes, so a stress fracture there, known as the dreaded black line, heals slowly and is prone to nonunion or complete fracture. Management is prolonged rest, and persistent cases may require intramedullary nailing. Medial stress fractures heal more easily.

Option by option

A. High risk of nonunion because it is on the tension side, and it may need nailing (correct)
Correct. The tension-side location means poor healing and a possible need for nailing.
B. It signals osteoid osteoma
Osteoid osteoma shows a nidus and night pain relieved by aspirin.
C. It heals reliably with a few days of rest
Rapid healing is expected for compression-side fractures only.
D. It is a benign cortical variant needing no treatment
A lucent line with pain is not a normal variant.

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 A, High risk of nonunion because it is on the tension side, and it may need nailing. The anterior tibial cortex is under tension in jumping athletes, so a stress fracture there, known as the dreaded black line, heals slowly and is prone to nonunion or complete fracture.

Why is "It signals osteoid osteoma" not the answer?

Osteoid osteoma shows a nidus and night pain relieved by aspirin.

Why is "It heals reliably with a few days of rest" not the answer?

Rapid healing is expected for compression-side fractures only.

Why is "It is a benign cortical variant needing no treatment" not the answer?

A lucent line with pain is not a normal variant.

What concept does this question test?

It tests Sports injuries: anterior tibial stress fracture in Orthopaedics. Management is prolonged rest, and persistent cases may require intramedullary nailing. Medial stress fractures heal more easily.

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 Sports injuries: anterior tibial stress fracture?

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.