Spine: Chance 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.

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Orthopaedics · Spine: Chance fracture

Sample item

A passenger wearing a lap seat belt has an abdominal bruise and back pain after a frontal collision. Radiographs show a horizontal fracture through the L1 vertebral body and posterior elements. Which injury should be actively excluded?

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

The answer and the reasoning

D. Intra-abdominal injury such as bowel or mesenteric tear

A Chance fracture is a flexion-distraction injury across all three columns caused by a lap belt acting as a fulcrum. It is closely associated with hollow viscus, mesenteric and pancreatic injuries. The belt sign of abdominal wall bruising raises suspicion.

Option by option

  • A. Skull fracture

    Skull fracture is not specifically linked.

  • B. Radial head fracture

    Radial head fracture is not linked.

  • C. Ankle ligament injury

    Ankle injury is not linked.

  • D. Intra-abdominal injury such as bowel or mesenteric tear (correct)

    Correct. Seat belt flexion-distraction fractures often come with intra-abdominal injuries.

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, Intra-abdominal injury such as bowel or mesenteric tear. A Chance fracture is a flexion-distraction injury across all three columns caused by a lap belt acting as a fulcrum.

Why is "Skull fracture" not the answer?

Skull fracture is not specifically linked.

Why is "Radial head fracture" not the answer?

Radial head fracture is not linked.

Why is "Ankle ligament injury" not the answer?

Ankle injury is not linked.

What concept does this question test?

It tests Spine: Chance fracture in Orthopaedics. It is closely associated with hollow viscus, mesenteric and pancreatic injuries. The belt sign of abdominal wall bruising raises suspicion.

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 Spine: Chance 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.