Fractures and dislocations: rotator cuff tear with shoulder dislocation: 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: rotator cuff tear with shoulder dislocation

Sample item

A 62-year-old woman has a first anterior dislocation of the shoulder, reduced in the emergency department. Three weeks later she still cannot lift the arm and has a drop-arm sign, though the axillary nerve works. Which injury is most likely?

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

The answer and the reasoning

A. Rotator cuff tear

In patients older than about 40 years, an anterior shoulder dislocation is often accompanied by a rotator cuff tear, whereas in young patients the usual associated lesion is a labral (Bankart) tear. Persistent inability to abduct after dislocation with intact deltoid function suggests a cuff tear and calls for ultrasound or MRI.

Option by option

  • A. Rotator cuff tear (correct)

    Correct. Cuff tears accompany dislocation in older adults and cause persistent weakness of abduction.

  • B. Bankart lesion alone

    A Bankart lesion causes instability and apprehension, not a drop-arm weakness, and is more typical of young patients.

  • C. Frozen shoulder

    Frozen shoulder causes stiffness of passive motion, whereas this patient has weakness.

  • D. Axillary nerve neurapraxia

    The stem states that axillary nerve function is intact.

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 Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Rotator cuff tear. In patients older than about 40 years, an anterior shoulder dislocation is often accompanied by a rotator cuff tear, whereas in young patients the usual associated lesion is a labral (Bankart) tear.

Why is "Bankart lesion alone" not the answer?

A Bankart lesion causes instability and apprehension, not a drop-arm weakness, and is more typical of young patients.

Why is "Frozen shoulder" not the answer?

Frozen shoulder causes stiffness of passive motion, whereas this patient has weakness.

Why is "Axillary nerve neurapraxia" not the answer?

The stem states that axillary nerve function is intact.

What concept does this question test?

It tests Fractures and dislocations: rotator cuff tear with shoulder dislocation in Orthopaedics. Persistent inability to abduct after dislocation with intact deltoid function suggests a cuff tear and calls for ultrasound or MRI.

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 Fractures and dislocations: rotator cuff tear with shoulder dislocation?

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.