Fractures and dislocations: ankle fracture reduction principle: 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 · Fractures and dislocations: ankle fracture reduction principle

Sample item

A patient has a displaced bimalleolar ankle fracture with the talus subluxed laterally. Why is anatomical reduction and stable fixation of the lateral malleolus emphasised?

ALateral malleolus carries all of the body weightBThe fibula is the main weight bearing bone of the legCUnion is impossible without fixing the fibulaDA small talar shift reduces joint contact area and leads to early arthritis

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

The answer and the reasoning

D. A small talar shift reduces joint contact area and leads to early arthritis

A lateral talar shift of even a few millimetres markedly reduces the contact area of the tibiotalar joint and raises contact stress, leading to post-traumatic arthritis. The fibula, by holding the talus in the mortise, must be restored to its length and rotation.

Option by option

A. Lateral malleolus carries all of the body weight
The tibia carries most of the weight, and the fibula carries little.
B. The fibula is the main weight bearing bone of the leg
The fibula bears only a small share of the load, with the tibia as the main weight bearing bone.
C. Union is impossible without fixing the fibula
Fractures can unite without fixation, but the joint would heal malaligned.
D. A small talar shift reduces joint contact area and leads to early arthritis (correct)
Correct. Talar displacement concentrates load on a smaller area and causes early degeneration.

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 D, A small talar shift reduces joint contact area and leads to early arthritis. A lateral talar shift of even a few millimetres markedly reduces the contact area of the tibiotalar joint and raises contact stress, leading to post-traumatic arthritis.

Why is "Lateral malleolus carries all of the body weight" not the answer?

The tibia carries most of the weight, and the fibula carries little.

Why is "The fibula is the main weight bearing bone of the leg" not the answer?

The fibula bears only a small share of the load, with the tibia as the main weight bearing bone.

Why is "Union is impossible without fixing the fibula" not the answer?

Fractures can unite without fixation, but the joint would heal malaligned.

What concept does this question test?

It tests Fractures and dislocations: ankle fracture reduction principle in Orthopaedics. The fibula, by holding the talus in the mortise, must be restored to its length and rotation.

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: ankle fracture reduction principle?

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.