Fractures and dislocations: skeletal traction pin insertion: 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 · Fractures and dislocations: skeletal traction pin insertion

Sample item

A Steinmann pin is inserted through the proximal tibia for skeletal traction. In which direction and for what reason is it passed?

AFrom lateral to medial, to avoid the common peroneal nerveBFrom medial to lateral, to avoid the popliteal arteryCFrom lateral to medial, to avoid the great saphenous veinDFrom medial to lateral, to avoid the common peroneal nerve

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

The answer and the reasoning

A. From lateral to medial, to avoid the common peroneal nerve

A proximal tibial traction pin is inserted from the lateral side, which keeps the entry point away from the common peroneal nerve around the fibular neck; it exits medially. In contrast, a distal femoral pin is inserted from the medial side to protect the neurovascular bundle at the adductor hiatus.

Option by option

A. From lateral to medial, to avoid the common peroneal nerve (correct)
Correct. Lateral to medial entry keeps the pin away from the common peroneal nerve.
B. From medial to lateral, to avoid the popliteal artery
The popliteal artery lies well behind the proximal tibia at this level, and the pin direction is chosen to protect the peroneal nerve.
C. From lateral to medial, to avoid the great saphenous vein
The saphenous vein is a minor structure and is not the reason for the direction.
D. From medial to lateral, to avoid the common peroneal nerve
Medial to lateral entry would pass the sharp end toward the nerve at the fibular neck.

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, From lateral to medial, to avoid the common peroneal nerve. A proximal tibial traction pin is inserted from the lateral side, which keeps the entry point away from the common peroneal nerve around the fibular neck; it exits medially.

Why is "From medial to lateral, to avoid the popliteal artery" not the answer?

The popliteal artery lies well behind the proximal tibia at this level, and the pin direction is chosen to protect the peroneal nerve.

Why is "From lateral to medial, to avoid the great saphenous vein" not the answer?

The saphenous vein is a minor structure and is not the reason for the direction.

Why is "From medial to lateral, to avoid the common peroneal nerve" not the answer?

Medial to lateral entry would pass the sharp end toward the nerve at the fibular neck.

What concept does this question test?

It tests Fractures and dislocations: skeletal traction pin insertion in Orthopaedics. In contrast, a distal femoral pin is inserted from the medial side to protect the neurovascular bundle at the adductor hiatus.

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 Fractures and dislocations: skeletal traction pin insertion?

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.