Trauma: Chance fracture: practice question

A General Surgery 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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General Surgery · Trauma: Chance fracture

Sample item

A 30-year-old woman wearing a lap-only seat belt in a head-on collision has abdominal wall bruising across the lower abdomen and back pain. Lateral spine radiograph shows a horizontal fracture through the L2 vertebral body. Which associated injury must be actively excluded?

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

The answer and the reasoning

C. Small bowel or mesenteric injury

A Chance fracture is a flexion-distraction injury of the thoracolumbar spine caused by lap belts that act as a fulcrum over the abdomen. The seat-belt sign and this fracture are strongly associated with hollow viscus and mesenteric injuries, which may present late, so CT and close observation or exploration are warranted.

Option by option

  • A. Urinary bladder rupture

    Bladder injury can occur with pelvic trauma but is not the injury classically linked to this fracture pattern.

  • B. Oesophageal perforation

    Oesophageal perforation follows penetrating or iatrogenic injury, not lap-belt trauma.

  • C. Small bowel or mesenteric injury (correct)

    Correct. The lap-belt mechanism commonly injures small bowel and mesentery.

  • D. Splenic rupture

    Splenic injury is more typical of left lower chest or flank impact and is not specifically linked to Chance fracture.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Small bowel or mesenteric injury. A Chance fracture is a flexion-distraction injury of the thoracolumbar spine caused by lap belts that act as a fulcrum over the abdomen.

Why is "Urinary bladder rupture" not the answer?

Bladder injury can occur with pelvic trauma but is not the injury classically linked to this fracture pattern.

Why is "Oesophageal perforation" not the answer?

Oesophageal perforation follows penetrating or iatrogenic injury, not lap-belt trauma.

Why is "Splenic rupture" not the answer?

Splenic injury is more typical of left lower chest or flank impact and is not specifically linked to Chance fracture.

What concept does this question test?

It tests Trauma: Chance fracture in General Surgery. The seat-belt sign and this fracture are strongly associated with hollow viscus and mesenteric injuries, which may present late, so CT and close observation or exploration are warranted.

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 Trauma: Chance fracture?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.