Paediatric orthopaedics: Pavlik harness complication: 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 · Paediatric orthopaedics: Pavlik harness complication

Sample item

A 2-month-old in a Pavlik harness for hip dislocation has lost active knee extension on the treated side, with a flaccid quadriceps. What is the complication, and what is the likely cause?

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

The answer and the reasoning

C. Femoral nerve palsy from excessive hip flexion

Excessive hip flexion stretches the femoral nerve under the inguinal ligament and paralyses the quadriceps. It usually recovers when the harness is loosened or paused, and flexion is reduced to the recommended range. Avascular necrosis is caused by forced abduction and is a different complication.

Option by option

  • A. Obturator nerve palsy from hyperabduction

    Obturator palsy would weaken the adductors.

  • B. Avascular necrosis from forced abduction

    Avascular necrosis does not paralyse the quadriceps.

  • C. Femoral nerve palsy from excessive hip flexion (correct)

    Correct. Loss of knee extension indicates femoral nerve palsy from hyperflexion.

  • D. Sciatic nerve palsy from hip extension

    Sciatic palsy would affect the hamstrings and the foot, not knee extension.

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, Femoral nerve palsy from excessive hip flexion. Excessive hip flexion stretches the femoral nerve under the inguinal ligament and paralyses the quadriceps.

Why is "Obturator nerve palsy from hyperabduction" not the answer?

Obturator palsy would weaken the adductors.

Why is "Avascular necrosis from forced abduction" not the answer?

Avascular necrosis does not paralyse the quadriceps.

Why is "Sciatic nerve palsy from hip extension" not the answer?

Sciatic palsy would affect the hamstrings and the foot, not knee extension.

What concept does this question test?

It tests Paediatric orthopaedics: Pavlik harness complication in Orthopaedics. It usually recovers when the harness is loosened or paused, and flexion is reduced to the recommended range. Avascular necrosis is caused by forced abduction and is a different complication.

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 Paediatric orthopaedics: Pavlik harness complication?

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.