Fractures and dislocations: isolated lesser trochanter fracture in an adult: 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: isolated lesser trochanter fracture in an adult

Sample item

A 68-year-old man with prostate cancer has thigh pain after a minor stumble. Radiographs show an isolated avulsion of the lesser trochanter. What should be suspected?

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

The answer and the reasoning

C. Pathological fracture through a metastatic deposit

An isolated lesser trochanter avulsion in an adult is rare, as it needs a strong iliopsoas pull. In adolescents it is an apophyseal avulsion, but in an older adult with a minor injury it is regarded as a pathological fracture until a lesion is excluded, which means MRI or bone imaging and a search for the primary.

Option by option

  • A. Simple iliopsoas strain

    A strain would not avulse bone from the femur.

  • B. Normal variant of the apophysis

    An unfused apophysis is seen in adolescents and not in a 68-year-old.

  • C. Pathological fracture through a metastatic deposit (correct)

    Correct. This pattern in an older adult with known cancer suggests a metastatic lesion weakening the bone.

  • D. Stress fracture from running

    A stress fracture would involve the femoral neck or shaft after repetitive loading, and the history gives no such activity.

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 C, Pathological fracture through a metastatic deposit. An isolated lesser trochanter avulsion in an adult is rare, as it needs a strong iliopsoas pull.

Why is "Simple iliopsoas strain" not the answer?

A strain would not avulse bone from the femur.

Why is "Normal variant of the apophysis" not the answer?

An unfused apophysis is seen in adolescents and not in a 68-year-old.

Why is "Stress fracture from running" not the answer?

A stress fracture would involve the femoral neck or shaft after repetitive loading, and the history gives no such activity.

What concept does this question test?

It tests Fractures and dislocations: isolated lesser trochanter fracture in an adult in Orthopaedics. In adolescents it is an apophyseal avulsion, but in an older adult with a minor injury it is regarded as a pathological fracture until a lesion is excluded, which means MRI or bone imaging and a search for the primary.

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: isolated lesser trochanter fracture in an adult?

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.