Fractures: Holstein-Lewis fracture: 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.

Try it

Orthopaedics · Fractures: Holstein-Lewis fracture

Sample item

A spiral fracture at the junction of the middle and distal thirds of the humeral shaft is associated with which complication?

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

The answer and the reasoning

D. Radial nerve palsy due to entrapment at the fracture site

Holstein-Lewis fracture is a spiral distal-third humeral shaft fracture where the radial nerve is trapped or tethered as it pierces the lateral intermuscular septum. It produces wrist drop and is more likely to need exploration than the radial palsy of a mid-shaft fracture.

Option by option

  • A. Median nerve palsy

    The median nerve is not the characteristic nerve here.

  • B. Brachial artery thrombosis

    Arterial injury is typical of supracondylar fractures, not this pattern.

  • C. Axillary nerve palsy

    The axillary nerve is related to the surgical neck.

  • D. Radial nerve palsy due to entrapment at the fracture site (correct)

    Correct. The radial nerve is classically involved in this pattern.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Radial nerve palsy due to entrapment at the fracture site. Holstein-Lewis fracture is a spiral distal-third humeral shaft fracture where the radial nerve is trapped or tethered as it pierces the lateral intermuscular septum.

Why is "Median nerve palsy" not the answer?

The median nerve is not the characteristic nerve here.

Why is "Brachial artery thrombosis" not the answer?

Arterial injury is typical of supracondylar fractures, not this pattern.

Why is "Axillary nerve palsy" not the answer?

The axillary nerve is related to the surgical neck.

What concept does this question test?

It tests Fractures: Holstein-Lewis fracture in Orthopaedics. It produces wrist drop and is more likely to need exploration than the radial palsy of a mid-shaft fracture.

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: Holstein-Lewis fracture?

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.