Paediatric orthopaedics: congenital radioulnar synostosis: 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: congenital radioulnar synostosis

Sample item

A 6-year-old boy has difficulty turning door handles. His right forearm is fixed in pronation, painless, with no history of injury, and a radiograph shows fusion of the proximal radius and ulna. What is the diagnosis?

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

The answer and the reasoning

C. Congenital proximal radioulnar synostosis

Congenital radioulnar synostosis is a failure of separation of the radius and ulna, producing a fixed pronated forearm with absent rotation. It is often bilateral and managed by observation, with rotational osteotomy considered for a severely hampered position.

Option by option

  • A. Madelung deformity

    Madelung deformity affects the distal radius with ulnar head prominence at the wrist.

  • B. Radial longitudinal deficiency

    Radial longitudinal deficiency is a missing or hypoplastic radius with a radially deviated hand.

  • C. Congenital proximal radioulnar synostosis (correct)

    Correct. Failed segmentation of the proximal forearm bones fixes the forearm in pronation.

  • D. Radial head subluxation

    Radial head subluxation occurs after a pull injury and causes acute pain and refusal to use the arm.

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, Congenital proximal radioulnar synostosis. Congenital radioulnar synostosis is a failure of separation of the radius and ulna, producing a fixed pronated forearm with absent rotation.

Why is "Madelung deformity" not the answer?

Madelung deformity affects the distal radius with ulnar head prominence at the wrist.

Why is "Radial longitudinal deficiency" not the answer?

Radial longitudinal deficiency is a missing or hypoplastic radius with a radially deviated hand.

Why is "Radial head subluxation" not the answer?

Radial head subluxation occurs after a pull injury and causes acute pain and refusal to use the arm.

What concept does this question test?

It tests Paediatric orthopaedics: congenital radioulnar synostosis in Orthopaedics. It is often bilateral and managed by observation, with rotational osteotomy considered for a severely hampered position.

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: congenital radioulnar synostosis?

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.