FRCSOrthExam Education Viva Topics
TRAUMA
1) Type 3 periprosthetic fracture
2) THR presents with a first time dislocation
3) Posterior dislocation with a fractured acetabulum
4) Osteochondral fracture of the knee
5) 15 year 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 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 hip dislocation & pneumothorax
11) 18 year old with subtalar dislocation
12) 32 year 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 year 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 type II injury 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 proximal humerus fracture
35) Distal femoral fracture in elderly
36) Secondary prevention of 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) Salter Harris type 4 fracture proximal phalanx great toe
45) Grade 3 (Ruedi's) 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 injury
54) Shaft femur with neck of femur
55) Periprosthetic fracture around knee
56) Ankle instability
57) Unstable inter-trochanteric fracture
58) Galeazzi #
59) Pathological # Humerus
ADULT PATHOLOGY
1) 50 year 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 year old
15) Degenerative spine. What are worrying reg flag signs.
16) MRI of PCL deficient knee
17) 56 year 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 neurological signs in a 70 year old male (Myeloma)
20) Chronic osteomyelitis in adult tibia
21) Fibrous dysplasia with Shepherd's crook deformity
22)
23) Unicortical # in a patient with Paget's disease. 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 X-ray 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 months after weber B fracture treated in POP with RSD/CRPS
31) Glass eye due to retinoblastoma as a child. X-ray of knee showed osteosarcoma
32) Elbow x-ray with multiple loose bodies
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 hip
42) Rheumatoid foot
43) Hallux valgus
44) Dislocated MTPJ’s in Rheumatoid foot, management surgical options
45) Spondylolysis
46) Gangrenous foot post-op
47) Syme’s, Chopart’s and B/K amputation, design of B/K 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) Multiple Myeloma
56) Looser’ s zones
57) Synovial chondromatosis
58) Paget’s with THR and protrusion
59) Spinal stenosis
60) Fowler’s operation
1) Draw a hip free body diagram
2) Posterior approach of the hip
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 inpatient.
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 recent National Joint registry report 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 (Standard deviation, 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 a 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 year old pregnant female, steps you take to reduce the dose
28) How do you do an arthrogram. What are the contra-indications 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 & 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 ulnar bursa of 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) Osteogenesis Imperfecta
58) Dwarfism
59) Torticollis
60) Osteoid Osteoma
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
72) Brachial plexus injury with Horner
73) Henry approach to radius
74) Course of nerves & muscles innervated in upper and lower limbs
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-sectional 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, effect of laceration, loading and unloading
87) Articular cartilage defects and repair methods
88) Draw an 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 of polyethylene
102) Traction
103) MRI principle
104) Stress-strain curve
105) Phyeal injuries
106) Palacos cement
107) Highly Cross-Linked polyethylene
108) Ex-fix construct
HANDS & 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 disease
11) STT OA
12) Clinical slide of a hypothenar eminence haemangioma
13) Clinical slide of recurrent Dupuytren's contracture
14) Boutonniere deformity
15) Tibial spine avulsion
16) Arthrogram in an 18 month old DDH
17) Clinical picture of anterolateral bowing tibia in a toddler with café au lait spot
18) Clinical photograph of an adolescent pes planus
19) Calcaneonavicular tarsal coalition
20) Extra-articular distal radius fracture management options
21) Ulnar Collateral Ligament injury of the thumb and management options
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 disease
49) Perilunate dislocation
50) Osteochondral defect of the knee
51)
52) Dorsal PIPJ fracture dislocation
53) Undisplaced scaphoid fracture
54) Pes cavus with claw toes
55) Grease gun injury
56) Old Monteggia's fracture
57) Bipartite patella
58) Galeazzi's fracture
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 of the proximal phalanx 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's type VIII distal radial #, options for DRUJ reconstruction (osteotomies), Darrach's, Suave-Kapandji & ulnar head replacement
74) Clinical photo of a traumatic amputation through MCPJ's of all fingers
75) Asked about the different types of hand 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 harness
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 Child's 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 a 2 year old child
94) Picture of Gallow's traction
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