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Best Aid to Orthopedics
Pramod TK
1:
Orthopedic Trauma: An Introduction
Q. Define fracture. Discuss in detail the classification of the fracture.
Fracture definition:
Classification:
Q. List the physical signs of fracture.
Q. List indications for leaving a fracture untreated.
Q. Define compound or open fractures. Mention its types and complications.
Definition:
Types:
Complications:
Q. Define pathological fracture. Discuss the etiology, clinical features and management of the same.
Definition:
Etiology:
Clinical features:
Investigations:
Treatment:
Q. Define sprain/injury to ligaments. Discuss the classification and management of the same.
Definition:
Classification:
Investigation:
Treatment:
Q. Define Fracture disease. Discuss its features and treatment.
Q. Discuss Salter Harris fracture classification of epiphyseal injury.
Q. Discuss classification of epiphyseal injury.
Q. Define Ankylosis. Mention its causes. Describe its types and management.
Q. Differentiate between bony and fibrous ankylosis.
Etiology:
Types:
Q. Comparison of fracture in children and adults.
GLOSSARY OF ORTHOPEDIC TERMS
Q. List the fractures seen in fall from height.
2:
Anatomy of Bone and Fracture Healing
Q. Describe the parts of a young bone/ typical long bone.
Q. Epiphysis.
Before ossification the following parts are evident:
Epiphyseal plate of cartilage/ growth plate:
1. Woven bone or immature bone:
2. Lamellar bone or mature bone:
Structural composition of bone:
Blood supply of long bones:
Q. What is sesamoid bone? Discuss its features and its function.
Q. Discuss in detail fracture healing.
Q. Physiology of fracture healing.
Q. Discuss in detail stages of fracture healing.
Q. What is Callus?
Stage of hematoma:
Stage of granulation tissue:
Stage of callus:
Stage of remodeling:
Stage of modeling:
Q. List the factors affecting fracture healing.
Type of opposition:
This can be achieved by:
Q. Name the substances that promote bone formation.
Q. List the markers of bone resorption.
3:
General Principles in the Treatment of Fractures
Q. Discuss the management of open fractures.
Classification of open fracture (Gustilo and Andreson, 1976)
Treatment:
Principles of treatment:
Phase 1: Emergency care
Phase 2: Definitive care
Phase 3: Rehabilitation.
Phase 1: Emergency care
Phase 2: Definitive care
Wound care
Open reduction: Indications
Q. Give the chemical formula and list the uses and complications of a cast of Plaster of Paris.
Q. List the fundamental principles to be followed while applying a plaster cast.
Types of plaster bandage:
Slab:
Cast:
Fundamental principles to be remembered while applying a plaster cast:
Complications of the plaster treatment:
Q. Define cementation. Describe its mechanism of action, indications and contraindications and uses.
Indication:
Relative:
Advantages and Disadvantages and complication:
Q. Define external fixation. Mention its indications, advantages and disadvantages.
Choice of fracture fixation
Q. What is polytrauma? Write the management of the same.
Management:
Pitfalls and their solution in the phases of resuscitation:
4:
Splints and Traction
Q. Define splints. List the uses of the same.
Objectives/Uses of splints*
Some of the common splints and their uses are as follows:
Q. Cramer-wire splint.
Q. Thomas splint /Thomas knee bed splint.
Q. Bohler-Braun splint.
Q. Care of a patient in a splint.
Q. Discuss the objectives and types of traction.
Q. Skeletal traction.
Q. Skin traction.
Q. Discuss the daily cure of a patient on traction.
Q. Differentiate between skin and skeletal traction.
Objectives
Daily care of patients with traction
Some common traction:
5:
Recent Advances in the Treatment of Fractures
Q. Arbeitsgemeinschaft fur osteosynthesefragen/AO method.
Q. Dynamic compression plate.
Q. ASIF.
The following principles are used to achieve stable fixation:
Interfragmentary compression is of two types:
Splinting types:
Combination of compression and splinting.
Q. Discuss the principle, criteria and mechanism of functional bracing.
Such a brace:
Criteria to do functional bracing:
Q. Discuss the principle, advantages, disadvantages and uses of Ilizarov's technique.
Q. What is Corticotomy?
Basic principle behind Ilizarov's technique:
6:
Complications of Fracture
Q. Classification/ list the complications of fracture.
Q. Discuss etiology, clinical features, and management of fat embolism.
Fat embolism
A. Mechanical theory:
B. Physiochemical theory:
Clinical features:
Investigations:
Treatment:
Rule of 3:
Q. Define delayed union. Discuss etiology, clinical features, and management of delayed union.
Etiology:
Clinical features:
Treatment:
Q. Define nonunion. Discuss etiology, clinical features, and management of nonunion.
Etiology:
Clinical features:
Investigation: X-ray
Treatment:
Q. Define malunion. Discuss etiology, clinical features, and management of malunion.
Complications: (Mnemonic: A GOBI)
Treatment:
Q. What is cross union?
Q. Define AVN. Discuss etiology, clinical features, complications and management of AVN/avascular necrosis.
Etiology:
The bones liable for this are:
Complication:
Treatment:
Q. Define VIC. Discuss etiology, clinical features, and management of Volkmann's ischemia/Volkmann's ischemic contracture/VIC.
Q. What is Volkmann's sign?
Pathophysiology:
Volkmann's ischemia is clearly seen in supracondylar fracture of humerus:
Etiology:
Terms:
Volkmann's Ischemia:
Treatment:
Volkmann's contracture:
Treatment:
Q. List the arteries that are commonly damaged during fracture
Q. Define Sudeck's atrophy. Discuss etiology, clinical features, and management of the same.
Synonym: Sudeck's osteodystrophy
Pathogenesis:
Clinical features:
Treatment:
Q. Define myositis ossificans. Discuss etiology, clinical features, and management of myositis ossificans traumatica/myositis ossificans/traumatic subperiosteal ossification (MO).
Explanation given to MO:
Pathology:
Clinical features:
Symptoms:
Investigation:
Differential diagnosis:
Treatment:
7:
Peripheral Nerve Injuries
Q. Classify nerve injury. Discuss in detail each type.
Q. Discuss Seddon's classification.
Q. What is neuropraxia? Discuss the etiology, pathogenesis, classification and management of the same.
Q. What is axonotmesis? Discuss the etiology, pathogenesis, classification and management of the same.
Q. What is neurotmesis? Discuss the etiology, pathogenesis, classification and management of the same.
Q. What is Tinel's sign?
Classification of nerve injury:
Seddon's classification:
Neuropraxia:
Axonotmesis:
Etiology:
Clinical features:
Treatment of axonotmesis:
Neurotmesis:
Etiology:
Pathogenesis:
Treatment:
Q. What is Electromyography (EMG)? List its uses.
EMG is useful in deciding the following:
Q. Explain the strength duration curve or SD curve
Interpretations
Q. Discuss the management of nerve injuries in general.
Surgical treatment:
Indications for surgery:
Q. Discuss the etiology, clinical features and management of radial nerve injury.
Q. What is crutch palsy?
Etiology:
■ At humeral level:
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features and management of median nerve injuries.
Q. What is Ape thumb deformity?
Q. What is simian hand?
Etiological factors:
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features and management of ulnar nerve injuries.
Q. What is claw hand?
Etiology:
Clinical features:
Injury at elbow:
Mnemonic: BCDEF of music
Treatment:
Q. List the causes of Tardy ulnar nerve palsy.
Q. Discuss the etiology, clinical features and management of brachial plexsus injury.
Etiology:
Classification:
Total brachial plexsus injury:
Q. What is Erb's palsy/ Erb-Duchenne paralysis? Discuss its clinical features and management.
Q. What is proximal brachial plexsus injury? Discuss its clinical features and management.
Q. What is Porter's/Waiter's/Policeman's tip hand? Discuss its clinical features and management.
Mode of injury:
Paralyzed muscles and nerves: (Mnemonic MANS)
Treatment:
Q. Discuss the etiology, clinical features and management of klumpke's palsy (distal brachial plexsus palsy).
Clinical features:
Treatment:
Q. What is intrinsidc minus deformity.
Clinical features:
Q. Discuss the etiology, clinical features and management of sciatic nerve injuries.
Etiology:
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features and management of lateral popliteal nerve injuries.
Etiology:
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features and management of entrapment neuropathy.
The following are some of the common nerve entrapment neuropathies:
Q. What is Tarsal Tunnel syndrome? How do you manage the same?
Clinical features:
Treatment:
8:
A General Review of Treatment of Orthopedic Disorders
Q. Define osteotomy. Discuss the indications and contraindications of the same.
Common osteotomies and their indications are:
Q. Define arthrodesis. Mention its indications and types of the same.
Types of arthrodesis:
Most common arthrodesis done is: Triple arthrodesis
Position of arthrodesis of different joints:
Q. Define arthroplasty. Mention its types, indications and contraindications.
Types: Three types
Q. Define bone grafting. Discuss its indications and types.
Q. What is Autogenous graft?
Q. What is Allograft?
Q. What is Xenograft?
Q. What is Vascularized graft?
Q. What is Cancellous graft?
Bone grafting
Definition:
Indications:
Types:
Autogenous graft:
Xenograft:
Artificial bone:
Allografts:
Q. What is shock wave diathermy?
9:
Injuries Around Shoulder
Q. Discuss the etiology, clinical features, management and complication of fracture of the clavicle.
Q. List the indications for open reduction in clavicular fracture.
Etiology:
Clinical features:
Treatment:
Complications:
Q. Discuss the etiology, clinical features, management and complication of dislocation of shoulder.
Q. Discuss the etiology, clinical features, management and complication of anterior dislocation of shoulder.
Q. Enumerate the types of shoulder dislocations.
Q. What is luxatio erecta? How do you manage the same?
Etiology:
Classification:
Symptoms:
Signs:
Complications:
Mnemonic: Read the story for remembering facts about shoulder dislocation:
Q. Define recurrent dislocation of shoulder. Discuss etiology, clinical features and management of the same.
Etiology:
Dislocation occurs through:
Clinical features:
Treatment:
Q. Discuss the etiology clinical features management and complications of fracture shaft of Humerus.
Etiology:
Pathoanatomy:
Clinical features:
Treatment:
Conservative management:
Q. Name the fractures which happen due to fall on an outstretched hand.
10:
Injuries Around Elbow
Q. What is three bony point relationship of elbow? Discuss the clinical importance of the same.
Clinical significance:
Q. What is carrying angle of the elbow? Mention its clinical significance.
Q. Discuss the mechanism, clinical features, management and complications of supracondylar fracture of humerus.
Q. Mention the complications of supracondylar fracture of humerus.
Mechanism:
Types:
Clinical features:
Signs of extension type:
Investigations:
Treatment:
Various procedures that can be done are:
Complications of supracondylar fracture:
Q. Discuss the mechanism, clinical features, management and complications of fracture of the lateral condyle of humerus.
Mechanism:
Displacements:
Clinical features:
Investigation: X-ray—AP view
Treatment:
Q. Discuss the mechanism, types, clinical features, management and complications dislocation of elbow.
Types:
Posterior dislocation in turn is divided in to two types:
Mechanism:
Clinical features:
Investigations: X-ray
Complications:
Treatment: Reduction under general anesthesia, followed by immobilization.
Q. What is cubitus varus? How do you treat the same?
Q. What is gunstock deformity? How do you treat the same?
Treatment:
Q. What is cubitus valgus deformity? How do you treat the same?
Treatment:
Q. Discuss the etiology, clinical features, management and complications fracture of head of radius.
Pathoanatomy:
Mason's classification:
Clinical features:
Investigations: X-ray
Complications:
Q. What is pulled elbow/Nursemaid's elbow? Discuss the etiology, clinical features and management of the same.
Clinical features:
11:
Injuries of Forearm and Wrist
Q. Define Monteggia fracture dislocation. Mention the etiology, clinical features, management and complications of the same.
Mechanism:
Types (Bado's classification):
Cinical features:
Treatment:
Q. What is Greenstick fracture?
Q. Mention the etiology, clinical features, management and complications of Galeazzi fracture-dislocation.
Q. Discuss the Fracture lower end of radius.
Displacement:
Clinical features:
Treatment:
Q. Mention the etiology, clinical feature management and complications of Colles´ fracture.
Q. What is Dinner fork deformity? How do you manage the same?
Relevant anatomy:
Displacements seen are:
Following are the associated fractures seen with Colles´ fracture:
Clinical features:
Findings on X-ray:
Dorsal tilt:
Lateral tilt:
Treatment:
Essentially conservative:
Complications:
Q. Mention the etiology, clinical feature management and complications of scaphoid fracture.
Mechanism:
Important features:
Clinical features:
Scaphoid cast:
Complication:
Q. What is Smith's fracture? How do you manage the same?
Q. What is Barton's fracture? How do you manage the same?
Treatment:
12:
Hand Injuries
Q. Describe mechanism, clinical features management and complications of Bennett's fracture/Bennett's fracture dislocation (Bennett, was an Irish surgeon).
Clinical features:
Complications:
Q. What is Mallet finger or baseball finger? How do you manage the same.
Mechanism:
Clinical features:
Treatment:
13:
Pelvic Fracture
Q. Classify pelvic fracture. Discuss the etiology, clinical features, management and complications of pelvic fracture.
Q. List the complications of pelvic fracture.
Etiology:
Clinical features:
Investigations:
Treatment:
a. Treatment of injury with minimal or no displacement:
b. Treatment of injury with anterior opening of the pelvis (open book fracture)
Treatment of injury with vertical displacements is difficult to treat:
Complications:
14:
Injuries Around the Hip
Q. Discuss the blood supply of proximal femur (head and neck).
Q. Discuss the agewise blood supply of the femoral neck.
Q. What Medial longitudinal trabecular system of femur?
Q. Describe the classification, mechanism, clinical features, complications and management of dislocation of the hip.
Q. Describe the classification, mechanism, clinical features, complications and management of posterior dislocation of the hip.
Q. What is Dashboard injury? How do you manage the same?
Classification
Mechanism:
Clinical features:
Treatment:
Q. Describe the classification, mechanism, clinical features, complications and management of fracture neck of femur.
Pathoanatomy:
Classification:
Anatomical classification:
Pauwel's classification:
Gardner's classification:
Investigations:
The following are made out on X-ray
Treatment:
Available surgical options are as follows:
McMurray's osteotomy:
Hemiarthroplasty:
Meyer's procedure:
Pauwel's osteotomy:
Complications:
Q. Describe the classification, mechanism, clinical features, complications and management of subtrochanteric fracture.
Etiology:
Treatment:
Complications:
Q. Define intertrochanteric fracture. Describe the etiology clinical features management and complications of the same.
Mechanism:
Pathoanatomy:
Clinical features:
Treatment:
Q. What Bryant's triangle? Mention its clinical significance.
15:
Fracture Shaft of Femur
Q. Describe the mechanism, etiology, clinical features, complications and management of fracture shaft of femur.
Pathoanatomy:
Mechanism:
Displacements:
Clinical features:
Treatment:
Conservative treatment:
Operative treatment:
Interlocking nail:
Kuntscher clover leaf intramedullary nail
Plating is done if:
Treatment plan:
Complications:
16:
Injuries Around the Knee
Q. Describe the mechanism, clinical features, complications and management of fracture of the patella.
Mechanism:
Clinical features:
Treatment:
Complications:
Q. Discuss the mechanism, clinical features and management of knee ligament injury.
Investigations:
Treatment:
Conservative method:
Operative method:
Q. Discuss the mechanism, types, clinical features and management of meniscal injuries.
Mechanism:
Types:
Clinical features:
Investigations:
Treatment:
Treatments of acute meniscal tear:
Treatments of chronic meniscal tear:
Q. Discuss predisposing factors, clinical features and management of recurrent dislocation of the patella.
Patella may dislocate:
Predisposing conditions:
Clinical features:
Treatment:
Surgery:
Q. What is Pelligrini Stieda disease? How do you manage the same?
Clinical features:
Investigations:
17:
Injuries Around Ankle
Q. Describe the mechanism, clinical features and management of the fractures of tibia and fibula.
Pathoanatomy:
Clinical features:
Open fracture:
Technique of closed reduction:
Wedging:
Open reduction and internal fixation
Pott's fracture
Relevant anatomy of ankle
Ligaments of the ankle
Q. Describe the mechanism, etiology, clinical features, complications and management of ankle injuries.
Classification of ankle injuries: Lauge's Hansen
Clinical features:
Investigations:
The findings that are picked up are:
Treatment:
Complications:
Q. Define Jone's fracture (Robert Jones fracture). Discuss the etiology, clinical features and management of the same.
Q. Describe the mechanism, etiology, clinical features, complications and management of fracture march fracture/ fatigue fracture /stress fracture.
Clinical features:
Treament:
Q. Define metatarsalgia. Discuss the etiology, clinical features and management of the same.
Risk factors:
Clinical features:
Treatment:
Q. Define Callus. Discuss the etiology, clinical features and management of the same.
Treatment:
18:
Spinal Injuries
Q. Classify spinal injuries. Discuss the etiology, clinical features and management of spinal injuries.
Q. Describe the injuries of thoracic spine and their management.
Q. What is Whiplash injuries?
Q. Discuss Skull traction.
Q. What is Clay Shoveler's fracture?
Q. What is Chance fracture?
Q. What is Crutchfield tongs?
Biomechanics
Stable and unstable injuries:
Recent biomechanics studies have shown that from the view point of the stability, the spine can be divided into three columns (three column theory):
Classification based on the mechanism of injury
Clinical features:
Investigations:
Phase1: Emergency treatment
Phase 2: Definitive treatment in emergency department or ward
Treatment of the thoracic and lumbar spine injuries:
Following are the operative procedures that are followed:
19:
Traumatic Paraplegia
Q. Describe the etiology, pathology, clinical features, management and complications of Traumatic paraplegia. Commonest cause of traumatic paraplegia: Fracture dislocation due to flexion rotation type of injury.
Other spinal causes of spinal paraplegia:
Acute:
Subacute or chronic form:
Clinical features:
Investigations:
Treatment:
Definitive care:
Surgery:
Rehabilitation:
Complications:
20:
Infections of the Bone and Joints
Q. Define acute osteomyelitis. Discuss the etiology, classification, management and complications of acute osteomyelitis.
Q. Discuss the etiology, clinical features, management and compli-cations of acute hematogenous osteomyelitis.
Definitions
Classification
Relevant anatomy
Etiopathogenesis:
Pathology:
Out of the cortex:
In other direction:
Clinical features:
Investigations:
Synovial fluid analysis
Differential diagnosis:
Complications:
Secondary osteomyelitis
Q. Discuss the etiology, classification, management and complications of chronic osteomyelitis.
Q. List the complications of chronic osteomyelitis.
Q. What is Involucrum?
Chronic osteomyelitis secondary to acute osteomyelitis:
Seqestrum:
Involucrum:
Clinical features:
Pathogenesis:
Symptoms:
Signs:
Investigations:
Differential diagnosis:
Treatment
Principles of treatment:
Operative procedures:
Complications (mnemonic: A A B C C C D S)
Q. Discuss the etiology, classification, management of Brodie's abscess.
Etiopathogenesis:
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features, management of Garre's abscess.
Clinical features:
Treatment:
Q. Discuss the etiology, classification, management and complications of septic arthritis or pyogenic arthritis or suppurative arthritis.
Etiopathogenesis:
Routes of spread of infection:
Clinical feature:
Patient presents with following symptoms:
Signs:
Position of ease in different joints:
Treatment:
Differential diagnosis:
Treatment:
Complications
Q. What is sequestrum? Discuss its special types.
Special variety of sequestrum:
Ring sequestrum:
Colored sequestrum
Button sequestrum
Pinhole sequestra
Rice sequestrum
Q. List the deformities seen in leprosy. Discuss the management of the same management.
Prevention of deformities by (Mnemonic Detect pH):
Treatment
For paucibacillary disease: For 6 months
Correction of deformities
Trophic ulcers in leprosy:
Treatment:
Q. Discuss HIV and orthopedics.
21:
Tuberculosis of Bones and Joints
Q. Describe the clinical features, etiopathogenesis, complications and management of tuberculosis of spine.
Q. What is Gibbus?
Q. What is Kyphus?
Q. What is Knuckle?
Q. What is Cold abscess? How do you manage the same.
Q. List the Radiological features of TB spine.
Pathology:
Types of vertebral tuberculosis
Paradiscal
Central
Anterior
Posterior
Pathogenesis:
Cold abscess
Healing
Symptoms
Examination
The following are to be observed:
Investigations
Radiological findings of Pott's disease:
Findings:
Principles of treatments:
Treatment
Complications:
Q. Describe the types, clinical features, etiopathogenesis, complications and management Pott's paraplegia.
Pathology:
Types of Pott's paraplegia
Causes of paraplegia in TB spine
Clinical features:
Grades of Pott's paraplegia
Investigations
Principles of treatment
Conservative treatment consists of:
Operative management is required if:
Indications
Operative procedures
Costotransversectomy:
Anterolateral decompression:
Radical debridement and arthrodesis (Hongkong operation):
Q. Describe the clinical features, etiopathogenesis, complications and management tuberculosis of hip.
Pathology
Natural history of TB:
Healing: by
Symptoms:
Stages of TB hip:
Stage 1: Stage of synovitis/stage of apparent lengthening
Stage 2: Stage of arthritis/stage of apparent shortening
Stage 3: Stage of erosion
Investigations:
Some of the radiological features are as follows:
Treatment plan:
Conservative treatment consists of:
Operative treatment: Methods used are:
Q. Describe the clinical features, etiopathogenesis, complications and management tb of knee.
Q. What is triple dislocation of knee? Discuss the etiology, clinical featurs and management of the same.
Pathology:
Natural history:
Clinical features:
On examination:
Investigations:
Treatment:
Conservative line of treatment:
Operative treatment:
Q. Define TB dactylitis. Discuss the etiology, clinical features, management and complications of the same.
Q. What is Spina ventosa? How do you manage the same.
Etiopathogenesis:
Clinical features:
Investigations: X-ray
Treatment:
22:
Infections of the Hand
Q. Define acute paronychia. Discuss the etiology, clinical features, management and complications of the same.
Q. What is Floating nail? Discuss the etiology, clinical features, and management of the same.
Etiology
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features and management of chronic paronychia.
Etiopathogenesis:
Clinical features:
Investigation
Treatment:
Q. Define apical subungual infection. Discuss the etiology, clinical features, management and complications of the same.
Clinical features:
Complications:
Q. Discuss terminal pulp space infection/ felon/ whitlow and its management
Q. Discuss the etiology, clinical features, management and complications of terminal pulp space infection.
Clinical features:
Investigations:
Treatment:
Complications:
Q. Discuss the etiology, clinical features, management and complications of middle volar space infection.
Clinical features:
Treatment:
Complications:
Q. Discuss the etiology, clinical features and management of proximal volar space infection.
Clinical features
Q. Discuss the etiology, clinical features, management and complications of web space infection.
Surgical anatomy
Etiology:
Clinical features:
Treatment:
Q. Discuss the etiology, clinical features, management and complications of deep palmar abscess.
Etiology:
Clinical features:
Treatment:
Complications:
Q. Discuss the etiology, clinical features, management and complications of acute suppurative tenosynovitis.
Q. What is Kanavel's sign?
Surgical anatomy:
Etiology:
Clinical features:
Treatment:
Complications:
23:
Congenital Talipes Equinovarus
Q. Define congenital talipes equinovarus. Discuss the etiology, clinical features and management of the same.
Q. Compare and contrast primary and secondary clubfoot.
Q. Describe the screening test for CTEV?
Q. What is Clubfoot? Discuse the etiology, clinical features and management of the same.
Anatomy:
The joints related to the etiology of clubfoot:
Foot is divided into:
Associated ligaments:
Etiology:
Pathoanatomy:
Clinical feauters presenting complaints:
Examination:
Diagnosis:
Treatment:
Maintainance of correction:
24:
Congenital Dislocation of Hip and other Malformations
Q. Define congenital dislocation of hip (CDH). Describe in detail etiology, clinical features and management of congenital dislocation of hip.
Q. Discuss Clincal tests useful in diagnosis of CDH.
Q. Describe Barlow test in detail.
Q. Describe Ortolani test in detail.
Q. Describe Galeazzi test.
Q. List Radiological features of CDH.
Genetic theory:
Hormonal factors:
Uterine malposition:
Racial customs:
Pathoanatomy:
Clinical features:
Clinical tests useful in diagnosis of CDH:
Barlow test has two parts:
Interpretation:
Ortolani's test
In older children the following signs are noted:
Investigations:
Principles of treatment:
Treatment
Salter's osteotomy:
Chiari pelvic displacement osteotomy:
Palmerton's pericapsular osteotomy:
Mnemonic:
Q. Define Sprengel's shoulder. Discuss the etiology clinical features and management of the same.
Clinical features:
Treatment:
Woodward procedure:
Methods of maintaining reduction:
Q. Define Radioulnar synostosis. Discuss the etiology clinical features and management of the same.
Clinical features:
Treatment:
Indications for surgery:
Surgery:
Q. Define Madelung's deformity (MD). Discuss the etiology, clinical features and management of the same.
Etiology:
Clinical features:
Treatment:
Following are the treatment options available:
Q. Define and classify congenital pseudarthrosis of tibia. Discuss the etiology clinical features and management of the same.
Clinical features:
Treatment:
25:
Polio and Musculoskeletal Disorders
Q. Discuss in detail etiology, clinical features, stages and management of poliomyelitis.
Q. Discuss the surgical options in correcting deformities in polio.
Epidemiology:
Mode of transmission:
Clinical features:
Pathogenesis:
Convalescence:
Clinical types:
Lab diagnosis:
CSF:
Isolation of virus:
Management:
Preparalytic stage:
Paralytic stage:
Convalescent stage:
Regional survey:
Stabilization of flail joint:
Ilizarov's method in management of postpolio paralysis deformities:
Q. Discuss the orthopedic aspects of cerebral palsy (Little's disease, john little, orthopedic surgeon).
Q. Discuss the deformities in cerebral palsy and their management.
Q. Discuss the role of surgery in treatment of cerebral palsy.
Management:
Indications:
Operative strategies:
Regional survey:
Upper limb:
Lower limb:
Q. Discuss the etiopathogenesis, clinical features and management of spina bifida occulta.
Q. Discuss the etiopathogenesis, clinical features and management of Meningocele.
Q. Discuss the etiopathogenesis, clinical features and management of meningomyelocele.
Clinical features:
Types of spina bifida cystica:
Treatment of meningocele:
26:
Bone Tumors
Q. Give WHO classification of bone tumors.
Q. Define osteoma. Discuss the clinical features and management of the same.
Clinical features:
Treatment:
Q. Define osteoid osteoma. Discuss the pathology, clinical features and management of the same.
Clinical features:
Investigations:
Q. Describe the pathology, clinical features and management of osteoclastoma /giant cell tumor.
Q. What is soap-bubble appearance?
Q. List radiological features of giant cell tumor.
Pathology:
Clinical features:
Symptoms:
Signs:
Findings are:
Differential diagnosis
Treatment:
Q. Define and classify Osteosarcoma. Describe the pathology, clinical features and management of osteosarcoma/osteogenic sarcoma.
Q. Describe the pathology, clinical features and management of primary osteosarcoma.
Q. Describe the pathology, clinical features and management of secondary osteosarcoma.
Q. List radiological features of osteosarcoma.
Q. What is periosteal reaction?
Q. What is codman's triangle?
Q. What is Sunray appearance?
Pathology:
Based on the clinical setting
Based on dominant histopathology
Primary osteosarcoma
Clinical features:
Symptoms:
Signs on examination:
Investigations:
Serum alkaline phosphates level:
Biopsy:
X-ray:
Treatment plan:
Local control:
Role of chemotherapy:
Chemotherapy:
Immunotherapy:
Control of micro-and macrometastasis:
Secondary osteosarcoma:
Parosteal osteosarcoma:
Q. Describe the pathology, clinical features, management of Ewing's sarcoma.
Q. List radiological appearance of Ewing's tumor.
Pathology:
Bones that are affected are:
Gross:
Histopathology:
Clinical features:
Treatment:
Q. Describe the pathology, clinical features, management of multiple myeloma.
Q. What are Bence-Jones proteins?
Pathology:
Clinical features:
Investigations:
Treatment:
Q. Define condrosarcoma. Describe the pathology, clinical features, management of the same.
Classification:
Pathology:
Clinical features:
Investigations:
Treatment:
Q. Describe the pathology, clinical features, management and osteochondroma.
Clinical features:
Treatment:
Q. Define enchondroma. Describe the pathology, clinical features, management of the same.
Pathology:
Clinical features:
Treatment:
Uncommon presentation of enchondromas:
Q. Define simple bone cyst. Describe the pathology, clinical features, differential diagnosis and management of simple bone cyst.
Clinical features:
Differential diagnosis of the solitary cyst of bone:
Investigations: X-ray
Treatment:
Q. Define aneurysmal bone cyst (ABC). Describe the pathology, clinical features, management of the same.
Pathology:
Clinical features:
Treatment:
Q. List the causes of lytic bone lesions.
Q. Define cryosurgery. Mention its indications, contraindications and complications.
Indications:
Advantages:
Complications:
Q. List the common primary bone tumors which have tendency for metastases to bone.
27:
Prolapsed Intervertebral Disk
Prolapsed Intervertebral Disk (PIVD)
Relevent anatomy:
The nucleus pulposes
Q. Define intervertebral disk prolapse. Describe the etiology, clinical features, secondary changes, complications and management of the same.
Q. What is root cut-off sign?
Commenest site:
Clinical features:
Lower backache:
Sciatic pain:
Neurological symptoms:
On examination
Investigations:
Treatment:
Q. Discuss the clinical features and management of cervical disk prolapse.
Treatment:
28:
Scoliosis and other Spinal Deformities
Q. Define and classify scoliosis. Describe the etiology, clinical features and management of the same.
Q. List radiological features of scoliosis.
Q. What is Cobb's angle?
Q. What is Reisser's sign?
Pathology:
Clinical features:
Radiological features:
Methods of treatment:
Indications:
Q. Define and classify kyphosis. Describe the etiology, clinical features and management of the same.
Q. What is Knuckle?
Causes:
Treatment:
29:
Back Pain
Q. Mention the common causes of lower back pain.
Q. List the warning signs in back pain.
Treatment:
Q. Define Sciatica? How do you manage the same?
Etiology:
Differential diagnosis of back pain:
Sciatica prevention and relief:
30:
Arthritis and Related Diseases
Q. List the differential diagnosis of arthritis.
Q. Discuss the etiology clinical features and management of rheumatoid arthritis.
Q. What is swan-neck deformity?
Q. What is Boutonniere or buttonhole deformity?
Q. What is rheumatoid factor?
Q. What is DMARDs?
Q. Surgical options in rheumatoid arthritis.
Q. Crieteria for diagnosis of rheumatoid arthritis.
Q. List the deformities seen in rheumatoid arthritis. Discuss the management of the same.
Q. Felty's syndrome.
Etiology:
Crieteria for diagnosis:
Clinical features:
Investigations:
Treatment:
Q. Differentiate between rheumatoid arthritis and osteoarthritis.
Q. Define ankylosing spondylitis. Discuss the etiology clinical features and management of the same.
Q. Discuss the etiology clinical features and management of rheumatoid spondylitis or
Q. Discuss the etiology clinical features and management of Marie-Strumpell disease.
Q. What is Schober test?
Clinical features:
Investigations:
Radiological manifestations include:
Treatment:
Q. Define Gout. Discuss the etiology, clinical features and management of gout.
Clinical features:
Etiology of gout:
Diagnosis:
Treatment:
Drugs used are:
Remember the mnemonic ‘PAS’ for drugs:
Q. What is Pseudogout? Discuss the clinical feature and management of the same.
Treatment:
Q. What is alkaptonuric arthritis? How do you manage the same?
Q. What is Orocronosis? How do you manage the some?
Clinical features:
Investigations:
Treatment same as Osteoarthritis
Q. What is neuropathic joint or charcot's joint? How do you manage the same?
Q. List the causes of monoarthritis.
31:
Degenerative Diseases
Q. Describe the etiology, types, pathology, clinical features and management of osteoarthritis/osteoarthrosis.
Types:
Any age can be affected:
Pathology:
Clinical features:
Symptoms:
Signs:
Investigations:
Treatment:
Mnemonic for treatment in short of OA: OSTEOAR
Q. Describe the etiology, pathogenesis, clinical features and management of cervical spondylosis.
Pathology:
Clinical features:
Common in:
Patient presents with the following symptoms:
On examination:
Investigations:
Treatment:
Treatment can be remembered as ‘3R’
Q. Define lumbar spondylosis describe the etiology, types, pathology, clinical features and management of the same.
Etiology:
Pathology:
Clinical features:
Treatment:
32:
Affections of the Soft Tissue
Q. Define bursitis. Discuss types, clinical features and management of the same.
Q. What is house maid's knee? How do you manage the same?
Q. What is student's elbow? How do you manage the same?
Q. What is Bunion? How do you mange the same?
Types:
Clinical features:
Common bursitis:
Treatment:
Q. List the bursae around the knee.
Q. Define tenosynovitis. Discuss types, clinical features management and complications of the same.
Etiology:
Clinical features:
Complications:
Treatment:
Q. Define tennis elbow. Discuss types, clinical features and management of the same.
Q. What is lateral epicondylitis? How do you manage the same?
Q. What is Cozen's test?
Clinical features:
Clinical signs:
Treatment:
Q. Define golfer's elbow. Discuss types, clinical features and management of the same.
Q. Discuss the medial epicondylitis.
Q. Define Dupuytren's contracture. Discuss types, clinical features and management of the same.
Causes:
Pathology:
Clinical features: (Mnemonic of 7P's created by Pramod)
Treatment:
Q. Define De Quervain's tenovaginitis. Discuss types, clinical features and management of the same.
Etiology:
Clinical features:
On examination:
Treatment:
Q. Define trigger finger/trigger thumb. Discuss types, clinical features and management of the same.
Q. Discuss stenosing tenovaginitis
Clinical features:
Treatment:
Q. Define ganglion. Discuss types, clinical features and management of ganglion.
Common sites:
Clinical features:
On examination:
Treatment:
Q. Discuss types, clinical features and management of compound palmar ganglion.
Etiology:
Clinical features:
Treatment:
For TB: ATT
Q. Define Carpal-Tunnel syndrome. Discuss types, clinical features and management of Carpal-Tunnel syndrome.
Etiology:
Clinical features:
Diagnosis
Treatment
Mnemonic:
Q. Discuss types, clinical features and management of frozen shoulder or periarthritis shoulder or adhesive capsulitis.
Pathology:
Clinical features:
Treatment:
Q. Discuss clinical features and management of plantar fasciitis.
Clinical features:
Treatment:
Q. List the common causes of heel pain.
Q. What is painful arc syndrome? Discuss types, clinical features and management of the same.
Etiology:
Pathogenesis:
Clinical features:
Treatment:
Q. What is Fibrositis? How do you manage the same?
Q. What is Fibromyalgia? How do you manage the same?
Treatment:
Q. What is meralgia paresthetica? Discuss the management of the same.
Treatment:
33:
Metabolic Bone Diseases
Q. Discuss the Regulation of calcium and phosphorus metabolism.
Q. Classify rickets. Discuss the clinical features and management of the same.
Q. Describe Radiological features of rickets.
Classification:
Incidence of rickets:
Clinical features:
Mnemonic for clinical features: RICKETS
Investigations:
Treatment
Q. Discuss the features and management hypervitaminosis D.
Symptoms:
Diagnosis:
Treatment:
Q. Define osteomalacia. Describe the etiology, clinical features and management of the same.
Q. List radiological features of osteomalacia.
Etiology:
Clinical features:
Investigation:
Treatment:
Q. Discuss the etiology, clinical features and management of osteoporosis.
Q. List radiological features of osteoporosis.
Etiology:
Clinical features:
Laboratory investigations:
Treatment:
Medical treatment:
Orthopedic treatment:
Mnemonic for treatment of osteoporosis: ABCDEFG
Comparison of Osteoporosis and Osteomalacia
Common features of osteoporosis and osteomalacia:
Q. Define Scurvy. Discuss the etiology, clinical features and management of scurvy.
Q. List radiological features of scurvy.
Factors precipitating vitamin C deficiency:
Types:
Adult type:
Infantile type:
Radiological features of scurvy:
Treatment:
Q. Discuss the clinical features and management of flurosis.
Q. List radiological features of flurosis.
Clinical features:
Investigations:
Treatment:
Q. Define renal osteodystropy/renal bone disease. Discuss the etiology, types, clinical features and management of the same.
Q. List radiological features of renal osteodystropy.
Etiology:
Pathogenesis:
Types of renal osteodystropy:
Clinical features:
Radiological features:
Treatment:
34:
Miscellaneous Affection of the Bone
Q. Discuss the clinical features and management of achondroplasia.
Pathology:
Genetics:
Clinical features:
Investigations:
Treatment:
Q. Discuss the clinical features and management of Osteogenisis imperfecta(OI) or fragilitans ossium or brittle bone disease.
Genetics:
Pathology:
Clinical features:
Investigation:
Treatment:
Q. Discuss the clinical features and management of diaphysial aclasis or hereditary multiple exostoses.
Genetics:
Clinical features:
Investigations:
Treatment:
Q. Discuss the pathogenesis, clinical features and management of Paget's disease or osteitis deformans.
Etiology:
Pathogenesis:
Pathology:
Clinical features:
PANICS and 4Ls
Investigations:
Complications:
Treatment:
Q. Define avascular necrosis (AVN). Discuss the etiology, clinical features and management of AVN of femoral head.
Mnemonic: I PAASSED RROC
Pathogenesis:
Clinical features:
Investigations:
Q. Define Perthes' disease or coxa plana or pseudocoxalgia. Discuss the etiology, clinical features and management of the same.
Etiology:
Pathogenesis:
Clinical features:
Investigation:
Treatment:
Q. Define Osteopetrosis or Marble bones or Albers-Schonberg disease. Discuss the etiology, clinical features and management of the same.
Genetically two distinct conditions are noted:
Treatment:
Q. Define eosinophilic granuloma. Discuss the etiology, clinical features and management of the same.
Clinical features:
Investigations:
Treatment:
Q. List the features of nail patella syndrome.
Congenital anomalies noted in this condition are:
Q. Define Osteochondritis/osteochondrosis. Discuss the etiopathogenesis, clinical features and management of the same.
Q. Perthes’ osteochondritis.
Etiopathogenesis:
Some of the common osteochondritis are:
Treatment:
Q. What is Osgood's Schlatte's disease? Discuss the clinical features and management of the same.
Clinical features:
Treatment:
Q. What is stress fracture? Discuss the etiology, clinical features and management of the same.
Q. Discuss runner's fracture.
Clinical features:
Treatment:
Q. List skeletal affections in neurofibromatosis.
Treatment:
Q. List the common causes of tendency for easy fracture.
Q. List the common causes of dwarfism.
35:
Miscellaneous Regional Diseases
Q. What is torticollis/Wryneck? Describe the types, clinical features and management of the same.
Types:
Congenital torticollis:
Deformity:
Secondary changes seen are:
Clinical features:
Investigations:
Prophylaxsis:
Treatment:
Secondary torticollis:
Treatment:
Q. Define observation hip or transient synovitis. Discuss its clinical features and management.
Clinical features:
Investigations:
Treatment:
Q. Define Coxa vera. Discuss its clinical features and management.
Types:
Infantile:
Treatment:
Q. What is Slipped capital femoral epiphysis? Discuss the etiology, clinical features, pathogenesis and management.
Etiology:
Clinical features:
Pathogenesis:
Symptoms:
Signs:
AP view:
Treatment:
Q. Definition genu valgum. Discuss the etiology, clinical features and management.
Q. What is Knock knee? How do you manage the same?
Etiology:
Clinical features:
Treatment:
Q. Define genu varum. Discuss the etiology, clinical features and management.
Q. What is Bow leg? How do you manage the same?
Etiology:
Clinical features:
Treatment:
Q. What is Genu recurvatum? How do you manage the same.
Types:
Treatment:
Q. What is Morrant Baker's cyst/popliteal cyst? Discuss the etiology, clinical features and management the same.
Clinical features:
Investigations:
Treatment:
Q. Discuss the etiology, clinical features and management of Loose bodies in the knee.
Classification:
Clinical features:
Investigation:
Differential diagnosis:
Treatment:
Q. Define hallus valgus. Discuss the etiology, clinical features and management.
Etiology:
Pathology:
Clinical features:
Treatment:
Surgical options available:
Q. Define hallus rigidus. Discuss the etiology, clinical features and management.
Etiology:
Clinical features:
Radiological findings:
Treatment:
Q. Define hammer toe. Discuss the etiology, clinical features and management.
Etiology:
Treatment:
Q. List differential diagnosis of painful heel.
Q. What is Policeman's heel?
Q. What is Stove in chest or flail chest? How do you manage the same?
Q. Define flatfoot. Discuss the etiology, clinical features and management of the same.
Etiology:
Clinical features:
Treatment:
36:
Amputations, Prosthesis and Orthotics
Q. Define amputation and disarticulation. Mention the common indications of amputations and describe its types.
Q. Surgical principle for closed amputation.
Q. After treatment of the stump.
Q. List characters of a good stump.
Q. List the complications of amputation.
Q. What is Phantom limb? How do you manage the same management
Q. What is Chopart's amputation?
Q. What is Lisfranc's amputation?
Q. What is Below knee amputation?
Definition:
Indications:
Types:
Open/Guillotine amputation
Closed amputation
Amputations in children:
Nomenclature of amputations by levels
After treatment of the stump:
Characters of a good stump:
Complications:
Phantom sensation/ Phantom limb:
Q. Discuss the procedure of Syme's amputation.
Q. Prosthesis in orthopedics. Mention their uses.
Q. What is prosthetics?
Q. What is prosthesis? Mention its parts indications and uses of the same.
Q. What is Jaipur foot?
Q. What is SACH foot?
Q. Differentiate between Jaipur foot and SACH foot.
Q. Discuss below knee prosthesis.
Uses of prosthesis:
Prosthesis can be:
Parts of prosthesis:
Terminal device
Jaipur foot
Jaipur foot vs SACH foot
Q. What is orthosis? What are its uses?
Uses of orthosis:
37:
Sports Surgery and Arthroscopic Surgery
Q. What is arthroscopy? Mention the indications, advantages, disadvantages and complications of the same.
Q. What is diagnostic arthroscopy? Mention the indications for the same.
Q. Mention the advantages and disadvantages of arthroscopy.
Q. Mention complications of arthroscopic surgery.
Definition:
Indications:
Complications:
Procedure of knee arthroscopy:
Q. List the common sports associated injuries.
38:
Joint Replacement Surgery
Q. What is joint replacement surgery? Describe hemiarthroplasty.
Q. List the features of ideal joint replacement procedure.
Definition:
Hemiarthroplasty/partial joint replacement:
Prosthesis can be:
Following are the features of ideal joint replacement prosthesis:
Q. What is total hip replacement? Mention the indications, contraindications and complications of total hip replacement.
Q. What is total joint replacement?
Total joint replacement:
Total hip replacement:
Prosthesis commonly used for hip replacement are:
Q. What is total knee replacement. Mention the indications, contraindications and complications of the same.
39:
Instruments and Implants
INSTRUMENTS
Periosteum Elevator
Bone Lever
Bone Nibbler
Bone Cutter
Osteotome
Bone Chisel
Mallet
Bone Curette
Curettage is performed for:
Bone Gouge
Bone awl
Bone Holding Forceps
Plate Holding Forceps
These are of 2 types:
Gigle Saw
Ilizarov's Apparatus
Medical Tourniquet
Hand Drill
External fixator
Hexagonal screw drivers
SS wire
TRACTION INSTRUMENTS
Kirschner wire
Steinmann pin
Bohler's Stirrup
Uses
K-wire stirrup and tensioner
Skull traction tongs
IMPLANTS
Kuntscher's cloverleaf intramedullary nail
Determination of the size of K-nail
Introduction of the nail can be done in two ways
Complications of K nailing
Smith-Petersen nail (SP nail)
Dynamic hip screws (DHS)
PLATES AND SCREWS
PROSTHESIS
Austin-Moore prosthesis
Thompson prosthesis
Charnley's total hip prosthesis
Muller's total hip prosthesis
Total knee prosthesis
40:
Important Clinical Tests
Q. Describe Trendelenburg test.
Procedure:
Explanation:
Q. Describe Thomas test.
Procedure:
Procedure in case of bilateral hip disease
Problems encountered while doing the test:
Q. Discuss the procedure of telescopy/telescoping sign test.
Procedure:
A positive telescoping is seen in the case of:
Q. Tests to check the intergrity of the anterior cruciate ligament.
Q. Discuss anterior drawer test.
Q. What is lachmann's test?
Q. Discuss posterior drawer test?
Anterior drawer test
Interpretation:
Lachmann's test
Q. What are the tests for Meniscal injury?
Interpretation:
Q. Describe straight leg raising test.
Part 1 procedure:
Inference:
Part 2 of the test:
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