Metabolic bone disease: postmenopausal osteoporosis fracture pattern: 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 · Metabolic bone disease: postmenopausal osteoporosis fracture pattern

Sample item

In the first decade after the menopause, accelerated loss of trabecular bone leads mostly to which fractures?

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

The answer and the reasoning

D. Vertebral crush and distal radius fractures

Oestrogen deficiency raises osteoclast activity and removes trabecular bone first, so sites rich in trabecular bone such as the vertebrae and distal radius fail early. Hip fractures mostly occur later, in the senile type that involves both cortical and trabecular loss.

Option by option

  • A. Clavicle and scapular fractures

    Clavicle and scapular fractures do not follow low-energy falls in osteoporosis.

  • B. Intertrochanteric and femoral neck fractures

    Hip fractures belong to the senile type of osteoporosis that occurs after the age of about 70.

  • C. Femoral shaft and tibial shaft fractures

    Shaft fractures are cortical injuries mostly caused by high-energy trauma.

  • D. Vertebral crush and distal radius fractures (correct)

    Correct. Trabecular-rich vertebrae and distal radius are affected first after menopause.

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, Vertebral crush and distal radius fractures. Oestrogen deficiency raises osteoclast activity and removes trabecular bone first, so sites rich in trabecular bone such as the vertebrae and distal radius fail early.

Why is "Clavicle and scapular fractures" not the answer?

Clavicle and scapular fractures do not follow low-energy falls in osteoporosis.

Why is "Intertrochanteric and femoral neck fractures" not the answer?

Hip fractures belong to the senile type of osteoporosis that occurs after the age of about 70.

Why is "Femoral shaft and tibial shaft fractures" not the answer?

Shaft fractures are cortical injuries mostly caused by high-energy trauma.

What concept does this question test?

It tests Metabolic bone disease: postmenopausal osteoporosis fracture pattern in Orthopaedics. Hip fractures mostly occur later, in the senile type that involves both cortical and trabecular loss.

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 Metabolic bone disease: postmenopausal osteoporosis fracture pattern?

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.