FRCSOrthExam Education Viva
FRCS (T&O) VIVA TOPICS
Trauma
1) =Type 3 periprosthetic fracture around a THR
2) =THR presents with a first time dislocation
3) =Posterior dislocation with a fractured acetabulum
4) =Osteochondral fracture of the knee
5) =15 yr old boy club football player with acute ACL injury
6) =Segmental tibial fracture with ipsilateral tibial plateau fracture
7) =Open book pelvic fracture that is very haemodynamically unstable
8) =Draw me Hamilton Russell traction for a femoral fracture.
9) =Diagram of oblique fracture, Where do you place the lag screw and why
10) =Pelvis fracture and inferior dislocation of hip, pneumothorax
11) =18 yr old with subtalar dislocation
12) =32 yr old with midshaft tibial fracture and chest injury
13) =Clavicle fracture mid shaft in a young adult, Non-union
14) =Inferior shoulder dislocation
15) =Burst fracture T12, no neurology
16) =Treatment of distal biceps rupture and describe surgical approach.
17) =Mangled extremity. Limitations of MESS
18) =Spinal fracture. Need for steroids. NASCIS studies
19) =IM nails biomechanics.
20) =Displaced intracapsular NOF# in a 42 yr old, classification (Garden & Pauwell's angle)
21) =Lateral C-spine XR with C7/T1 subluxation, paraplegic, application of halo & discussion of respiration in C-spine injuries
22) =Pelvic fixator in place with pins not in the pelvis on one side
23) =anterior #/dislocation shoulder
24) =tibial tuberosity avulsion in a child
25) =Salter Harris II # of proximal phalanx of little finger
26) =Open comminuted tibial #
27) =Midshaft ulna #
28) =Volar Barton
29) =Torus versus greenstick
30) =Post fracture dislocation shoulder
31) =Distal radius with scaphoid fracture
32) =Segond
33) =Median nerve laceration
34) =Comminuted prox humerus fracture
35) =Distal femoral fracture in elderly
36) =Secondary prevention osteoporosis and effects on bone healing
37) =Clinical picture mangled leg
38) =Segmental loss tibia, Limb salvage versus reconstruction
39) =Weber C ankle
40) =Displaced intracapsular fracture in young male
41) =Elbow dislocation with radial head fracture
42) =Intracapsular NOF in a 70 year old
43) =Open supracondylar femoral fracture with pelvic fracture
44) =SH4 fracture prox phalanx great toe
45) =Grade 3 Ruedi tibial pilon fracture
46) =Transverse humeral fracture in a 2 month old
47) =Pelvic Fracture
48) =Acetabular fracture
49) =Distal Femoral fracture intra-articular
50) =Supracondylar elbow fracture/Baumann’s angle
51) =Compartment Syndrome
52) =Open fracture Gustilo C
53) =Lisfranc
54) =Shaft femur with neck of femur
55) =Periprosthetic fracture
56) =Ankle instability
57) =Compartment syndrome
58) =Unstable inter-trochanteric #
59) =Galeazzi #
60) =Patho # Humerus
Adult Pathology
1) =50 yr old man with symptomatic hip OA, failed conservative management. Which hip would you do and can you support this with any literature or joint registry findings
2) =Paget’s disease, THR
3) =Valgus rheumatoid knee
4) =X-ray appearances of OA, RhA and gout.
5) =Infected THR
6) =Osteochondroma proximal femur, differential, management, risks
7) =Meniscal injury and repair.
8) =Ankylosing spondylitis with painful bilateral hips with 30 degrees FFD
9) =
10) =Biopsy for a bone tumour.
11) =isolated renal metastases in the femur
12) =RSA analysis for implants
13) =Guidelines for doing MIS for hip surgery
14) =Bilateral mild hip dysplasia in 18 yr old
15) =Degenerative spine. What are worrying reg flag signs.
16) =MRI of PCL deficient knee.
17) =56 yr old with OA hip. What implant are you going to use and why.
18) =Conversion hip arthrodesis to THR
19) =C-spine x-ray. Destroyed C5, no neuro signs, 70 yr old male (Myeloma)
20) =Chronic osteomyelitis in adult tibia
21)=Fibrous dysplasia with Shepherds crook deformity.
22) =
23) =Unicortical # in a pt with Paget's. D/D & treatment (problems with nailing).
24) =Loose Charnley THR. Discussion of diagnosis, investigations and treatment
25) =Fibrous cortical defect in distal tibia
26) =Pelvic XR with diffuse lytic pelvic lesion & a sclerotic iliac lesion
27) =Bilateral varus knees, bone on bone
28) =Correctable Flat foot picture with too many toes sign
29)=Lytic lesion over greater trochanter
30) =Foot photo 6 mths after weber B fracture treated in POP with RSD
31) =Glass eye d/to retinoblastoma as a child. X ray of knee showed osteosarcoma
32) =Elbow with loose body
33) =Rheumatoid forefoot
34) =Lytic lesion femoral neck in a 32 year old woman
35) =Young patient pelvis with Cemented THR one side & severe dysplastic OA hip on other side
36) =Mechanism of loosening/wear/osteolysis
37) =Risks of allogenic bone graft
38) =Rotator cuff tear
39) =Rotator cuff arthropathy
40) =Meniscal tears, MRI features, types, structure of meniscus and blood supply
41) =Protrusio hips
42) =Rheumatoid foot
43) =Hallux valgus
44) =Dislocated MTPJ’s, management surgical
45) =Spondylolysis
46) =Gangrenous foot post-op
47) =Syme’s, Chopart’s and BK amputation, design of BK amputation prosthesis
48) =Chondrosarcoma
49) =Osteomyelitis
50) =Septic loosening
51) =Spondylolisthesis and spondyloptosis
52) =Acute calcific tendonitis of the shoulder
53) =Psoas abscess (on CT)
54) =AVN
55) =MM
56) =Looser’ s zones
57) =Synovial chondromatosis
58) =Paget’s with THR and protrusion
59) =Spinal stenosis
60) =
Basic Science
1) =Draw a hip free body diagram and explain why a walking stick is useful.
2) =Posterior hip-surgical approach
3) =Pathogenesis of osteoarthritis and rheumatoid arthritis.
4) =Biomechanics of hip fracture fixation devices.
5) =What would you do if you had 5 consecutive THR that became acutely infected whilst still an in patient.
6) =Survivorship curve
7) =Posterior approach to the knee
8) =Indications for disarticulation of the knee as an amputation.
9) =Define wear and give me examples.
10) =Define hoop stresses and give me some examples in the body.
11) =Biomechanical priciples and material properties of an Exeter & Charnley stem
12) =Problem in the 3M capital hip disaster.
13) =Summary of the 2nd National Joint registry report form September 2005 and tell me the features of the NJR compared with other joint registries.
14) =Draw the compressive and tensile trabecullae in the proximal femur
15) =What is a hypothesis.
16) =How do you go about setting up a clinical trial.
17) =What does central tendency mean (mean, median, mode)
18) =What is dispersion (SD, interquartile, range).
19) =Why do we use a p value of 5%
20) =When do you use a parametric test and when do you use a non parametric test.
21) =What is a meta analysis.
22) =Given diagram of a box and whisker plot, asked to describe all points , lines etc
23) =What is your DVT prophylaxis and why. What is the evidence behind it.
24) =Describe the different forms of lubrication.
25) =What properties of ceramic make it good for lubrication.
26) =How does MRI, X ray, US, CT, bone scan, DEXA scan work.
27) =X-ray on a 25 yr old pregnant female, steps you take to reduce the dose.
28) =How do you do an arthrogram. What are the C/I to using the contrast.
29) =Radiation dose they will get from an isotope bone scan
30) =Design a new plate for fracture fixation. What features in the plate will you incorporate into your design.
31) =You have been asked to design a new hip replacement / knee replacement. What features will you incorporate into your design.
32) =DCP plate is very strong. Why does it need to be this strong.
33) =What are the material properties of tendon & ligament
34) =How is polyethelene manufactured.
35) =Draw the structure of a nerve and what do you repair in a digital nerve repair and a median nerve repair.
36) =Name some outcome scores used in orthopaedics.
37) =What do you know about metal on metal articulation. How do the current generation of implants differ from those used in the 70's (McKee Farrar).
38) =Tourniquets. How to apply and use.
39) =Screws, describe different types and how they work etc.
40) =Locking plates, principles.
41) =Humeral plating, why done posteriorly, principles tension band.
42) =Draw brachial plexus.
43) =set up a bone bank (Consent, testing, storage etc)
44) =X-sectional anatomy of carpal tunnel.
45) =Chronic regional pain syndrome.
46) =Creep and stress relaxation curves
47) =Zones of growth plate, blood supply & relevance to osteomyelitis
48) =Types of ossification & bones in which these occur
49) =Shown unmarked axial drawing of a vertebra
50) =Lumbar discogram with normal discogram at L3/4 & abnormal at L4/L5
51) =Structure of intervertebral disc & what happened with age
52) =Shown a drawing of the ulna bursa in the hand
53) =Hysteresis loops (one for elastin and one for collagen)
54) =Cross section of nerve. Tell me about the structure of a nerve
55) =How does the nerve vary along its course
56) =Nerve Conduction Studies
57) =OI
58) =Dwarfism
59) =Torticollis
60) =OO
61) =Syringomyelia
62) =Horner’s syndrome
63) =Rickets
64) =Fracture healing
65) =Nerve injuries
66) =Piriformis muscle anatomy
67) =Prosthesis, A/K prosthesis
68) =Bone grafts
69) =Tourniquets
70) =Screw design and function/ lag screw principle
71) =Structure peripheral nerve/nerve conduction studies
73) =Henry approach to radius
74) =Course of Axillary nerve & muscles innervated
75) =Design of knee brace for valgus deformity
76) =Four bar linkage mechanism of ACL/PCL
77) =Difference between osteoporosis and osteomalacia
78) =Causes of secondary tumours to bone and mechanism of metastases
79) =Parts of a THR
80) =Ceramic-mechanical properties
81)=Stainless steel -mechanical properties, manufacture
82) =Titanium -mechanical properties
83) =Draw X-section anatomy at mid thigh level
84) =Course of the sciatic nerve from roots to foot
85) =Course of the lateral cutaneous nerve of thigh
86)=Draw articular cartilage, viscoelasticity, lubrication, laceration, loading and unloading
87) =Articular cartilage defects and repair methods
88) =Draw osteoclast
89) =Meniscus structure/function/biomechanics/discussion on hoop stresses.
90) =Structure of proteoglycan
91) =Mendelian inheritance, sex-linked recessive/dominant.
92) =Theatre design (Laminar flow, Ex flow, air changes, HEPA filter, size of particles)
93) =Failure mechanisms prostheses. Interfaces.
94) =Bacterial organisms. Use of prophylactic antibiotics and mechanism of action.
95) =Open fractures
96) =Gas gangrene
97) =talus & calcaneum to describe anatomy
98) =Bone graft substitutes properties
99) =Confidence intervals and relative risk.
100) =Wear mechanisms
101) =Subsurface delamination
102)=Traction
103)=MRI principle
104)=Stress-strain curve
105)=Phyeal injuries
106)=Palacos cement
107)=HCL poly
108)=Ex-fix construct
Hands and Paeds
1) =Finger tip injury with bone exposed
2) =Radial club hand
3) =Madelung’s deformity of distal radius
4) =# 4th and 5th Metacarpals minimally displaced
5) =Bilateral club foot
6) =Neurofibromatosis I & II and pseudoarthrosis of tibia
7) =Tibia vara
8) =Blounts disease
9) =Acute displaced scaphoid fracture
10) =Kienbock’s
11) =STT OA
12) =Clinical slide hypothenar eminence haemangioma
13) =Clinical slide recurrent Dupuytrens
14) =Boutonniere deformity
15) =Tibial spine avulsion
16) =Arthrogram in a 18 month old DDH
17) =Clinical picture anterolateral bowing tibia toddler with café au lait spot
18) =Clinical photograph adolescent pes planus
19) =Calcaneonavicular tarsal coalition
20) =Extra-articular distal radius fracture management options
21) =UCL thumb injury and management
22) =Mucous cyst
23) =Monteggia Fracture dislocation with unreduced radial head
24) =Scapholunate ligament injury and management – acute vs chronic, Kirk-Watson’s instability test
25) =LLD and causes, Management of predicted 9cm LLD in a normal child
26) =Management of missed DDH in 18 month old
27) =DDH in newborn
28) =Perthes’ disease
29) -SUFE
30) -CTEV
31) -Cavovarus foot
32) -Physiological variants
33) -Neuromuscular disease
34) -Limb lengthening and deformity correction
35) -Juvenile Arthritis
36) -Non Accidental Injury
37) -Paediatric knee
38) -Skeletal Dysplasias
39) -Spinal disorders
40) -Oncology
41) -Infection
42) =Supracondylar fracture
43) =Lateral condyle
44) =Mallet finger
45) =Fight bite
47) =EPL rupture
48) =De Quervain’s
49) =SL dissociation
50) =OCD knee
51) =UCL injury
52) =Dorsal PIPJ fracture dislocation
53) =Undisplaced scaphoid fracture
54) =Pes cavus with claw toes
55) =Grease gun injury
56) =Old Monteggia
57) =Bipartite patella
58) =Galeazzi
59) =
60) =Boutonniere and swan neck deformities
61) =Examiner puts glove on. Draw on the glove and talk about incisions for the hand
62)=Management of 1st MTPJ OA. Conservative and operative.
63) =How do you repair a flexor tendon injury in Zone 2, different post op regimes.
64) =Describe the zones for flexor and extensor tendon injuries of fingers and thumb
65) =Picture of winging scapula. What are causes.
66) =Menigococcal septicaemia.
67) =Diaphyseal aclasia
68) =Scaphoid non union.
69) =Gross crush injury to hand. Management fasciotomies
70)=Enchondroma PP with #, Treatment
71) =Climber with rupture of all flexor pulleys of finger. Reconstruction principles
72) =Clinical photo of a nail bed injury
73) =Malunited Frykman VIII distal radial #, options for DRUJ reconstruction (osteotomies), Darrach's, Suave-Kapandje & ulna head replacement.
74) =Clinical photo of a traumatic amputation through MCPJ's of all fingers
75) =Asked about the different types of grip
76) =Between proportionate and non proportionate dwarfism.
77) =Principles in the management of CP.
78) =Three ways bone form and grow.
79) =Physes in the hand metacarpals, and phalanges.
80) =AVN rate in pavlic
81) =Basic requirements for a good screening test.
82) =What screening do we have for DDH in the
83) =Gait analysis, gait cycle, and what are the prerequisites for normal gait.
84) =Causes of bowing of tibia.
85) =Osteogenesis imperfecta, and draw me a genetic table demonstrating the genetics.
86) =Differences in medial and anterior approaches for DDH
87) =Setting up a pavlik harness
88) =Picture of congenital vertical talus. What are the associations
89) =Cavo varus foot.
90) =Changes in Childs knee varus and valgus with age (Selenius graph)
91) =SUFE, causes, classification, management. Discussion about recent review from
92) =Fibular hemimelia and PFFD
93) =Clinical photo of pair of varus knees in 2 yr old
94) =Picture of Gallows traction