Nerve injuries: ulnar paradox: 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 · Nerve injuries: ulnar paradox

Sample item

In the ulnar paradox, a lesion at which site produces less claw deformity than a distal lesion?

AA median nerve lesion at the wristBA radial nerve lesion at the spiral grooveCA high ulnar nerve lesion at the elbow, with flexor digitorum profundus paralysedDA low lesion at the wrist

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

The answer and the reasoning

C. A high ulnar nerve lesion at the elbow, with flexor digitorum profundus paralysed

In a high ulnar lesion, the ulnar half of flexor digitorum profundus is paralysed, so the ring and little fingers cannot flex at the DIP and the claw is less obvious. In a low lesion, profundus is intact and pulls the fingers into a pronounced claw.

Option by option

A. A median nerve lesion at the wrist
A median nerve lesion does not produce an ulnar claw.
B. A radial nerve lesion at the spiral groove
A radial lesion causes wrist drop.
C. A high ulnar nerve lesion at the elbow, with flexor digitorum profundus paralysed (correct)
Correct. A high lesion paralyses FDP and reduces the claw.
D. A low lesion at the wrist
A low lesion spares FDP and gives a marked claw.

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.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, A high ulnar nerve lesion at the elbow, with flexor digitorum profundus paralysed. In a high ulnar lesion, the ulnar half of flexor digitorum profundus is paralysed, so the ring and little fingers cannot flex at the DIP and the claw is less obvious.

Why is "A median nerve lesion at the wrist" not the answer?

A median nerve lesion does not produce an ulnar claw.

Why is "A radial nerve lesion at the spiral groove" not the answer?

A radial lesion causes wrist drop.

Why is "A low lesion at the wrist" not the answer?

A low lesion spares FDP and gives a marked claw.

What concept does this question test?

It tests Nerve injuries: ulnar paradox in Orthopaedics. In a low lesion, profundus is intact and pulls the fingers into a pronounced claw.

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 Nerve injuries: ulnar paradox?

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.