Injuries: hinge fracture of the skull base: practice question

A Forensic Medicine 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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Forensic Medicine · Injuries: hinge fracture of the skull base

Sample item

A scooter rider struck from the side by a car has a fracture running transversely across the middle cranial fossa through the sella turcica, dividing the skull base into anterior and posterior halves. What is this fracture, and how is it produced?

AA pond fracture, from a fall in infancyBA hinge fracture, from a heavy lateral blow to the skullCA ring fracture, from a fall onto the feet or buttocksDA gutter fracture, from a tangential bullet

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

The answer and the reasoning

B. A hinge fracture, from a heavy lateral blow to the skull

A hinge fracture is a transverse fracture across the base of the skull, typically through the middle fossa and sella turcica, caused by a severe lateral blow such as a side impact in a road accident. It allows the two halves of the base to move like a hinge. It is often fatal.

Option by option

A. A pond fracture, from a fall in infancy
A pond fracture is a depressed dent in the pliable skull of an infant.
B. A hinge fracture, from a heavy lateral blow to the skull (correct)
Correct. A transverse middle fossa fracture from a side impact is a hinge fracture.
C. A ring fracture, from a fall onto the feet or buttocks
A ring fracture surrounds the foramen magnum and follows axial loading of the spine.
D. A gutter fracture, from a tangential bullet
A gutter fracture is a trough in the outer table made by a glancing missile.

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 Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, A hinge fracture, from a heavy lateral blow to the skull. A hinge fracture is a transverse fracture across the base of the skull, typically through the middle fossa and sella turcica, caused by a severe lateral blow such as a side impact in a road accident.

Why is "A pond fracture, from a fall in infancy" not the answer?

A pond fracture is a depressed dent in the pliable skull of an infant.

Why is "A ring fracture, from a fall onto the feet or buttocks" not the answer?

A ring fracture surrounds the foramen magnum and follows axial loading of the spine.

Why is "A gutter fracture, from a tangential bullet" not the answer?

A gutter fracture is a trough in the outer table made by a glancing missile.

What concept does this question test?

It tests Injuries: hinge fracture of the skull base in Forensic Medicine. It allows the two halves of the base to move like a hinge. It is often fatal.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Injuries: hinge fracture of the skull base?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.