Fractures and dislocations: physeal bar: 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: physeal bar

Sample item

A boy had a displaced fracture through the epiphysis, physis and metaphysis of the distal femur into the knee joint. Two years later he has a progressive varus angulation of the knee. Which is the most likely cause and the treatment for a small, accessible lesion?

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

The answer and the reasoning

D. Partial physeal bridge, treated by bar resection with interposition material

A fracture crossing the physis (Salter-Harris type IV) can heal with a bony bridge that tethers part of the plate, so growth continues on the other side and an angular deformity develops. A small, accessible bar can be excised and the defect filled with fat or cement to allow normal growth.

Option by option

  • A. Chronic infection of the physis, treated by antibiotics

    Infection would be accompanied by pain, fever and raised inflammatory markers.

  • B. Failure of fracture union, treated by bone grafting

    Non-union would show a gap at the fracture and would not produce progressive angulation from asymmetric growth.

  • C. Rickets, treated with vitamin D

    Rickets produces a generalised deformity and not a single-sided change after a fracture.

  • D. Partial physeal bridge, treated by bar resection with interposition material (correct)

    Correct. A bony bridge tethers the physis, and resecting a small bar allows the rest of the plate to grow evenly.

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.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Partial physeal bridge, treated by bar resection with interposition material. A fracture crossing the physis (Salter-Harris type IV) can heal with a bony bridge that tethers part of the plate, so growth continues on the other side and an angular deformity develops.

Why is "Chronic infection of the physis, treated by antibiotics" not the answer?

Infection would be accompanied by pain, fever and raised inflammatory markers.

Why is "Failure of fracture union, treated by bone grafting" not the answer?

Non-union would show a gap at the fracture and would not produce progressive angulation from asymmetric growth.

Why is "Rickets, treated with vitamin D" not the answer?

Rickets produces a generalised deformity and not a single-sided change after a fracture.

What concept does this question test?

It tests Fractures and dislocations: physeal bar in Orthopaedics. A small, accessible bar can be excised and the defect filled with fat or cement to allow normal growth.

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: physeal bar?

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.