Orris

This two pdf is my subject previous year questions give me the repeted questions in every year in 2 mark also give me the each every questions how many time asked and give me all 2 marks answers please both are my university previous year questions papers so dont conused with sub code and year academic

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Running Command

python3 << 'EOF' import pdfplumber pdf1 = "/tmp/workspace/attachments/1dcb5cd8-6873-4d71-be6f-cfbd5237a117/Clinical ortho 2020.26 .pdf" pdf2 = "/tmp/workspace/attachments/1dcb5cd8-6873-4d71-be6f-cfbd5237a117/Clinicalortho 2011.24 .pdf" print("=== PDF 1: Clinical ortho 2020.26 ===") with pdfplumber.open(pdf1) as pdf: print(f"Total pages: {len(pdf.pages)}") for i, page in enumerate(pdf.pages): text = page.extract_text() print(f"\n--- Page {i+1} ---") print(text) EOF

Running Command

python3 << 'EOF' import pdfplumber pdf2 = "/tmp/workspace/attachments/1dcb5cd8-6873-4d71-be6f-cfbd5237a117/Clinicalortho 2011.24 .pdf" print("=== PDF 2: Clinicalortho 2011.24 ===") with pdfplumber.open(pdf2) as pdf: print(f"Total pages: {len(pdf.pages)}") for i, page in enumerate(pdf.pages): text = page.extract_text() print(f"\n--- Page {i+1} ---") print(text) EOF

Now I have all the data. Let me analyze and compile everything.
Running Command

python3 << 'EOF' from collections import defaultdict # PDF1 (Sub Code 6284, 3rd Year, 2020-2026) - 10 papers pdf1_questions = { "Dec2020 (6284)": [ "Define Periarthritis Shoulder. List the clinical features.", "List the splints used for Upper extremity Peripheral nerve injuries.", "Difference between open fracture and closed fracture.", "List the levels of Lower limb Amputation.", "Difference between dislocation and subluxation.", "List the causes for shoulder impingement syndrome.", "Difference between Tide and Untided injuries of hand.", "Cobb's Angle.", "List the types of Leprosy.", "Difference between Pescavus and Pesplanus.", ], "Sep2021 (6284)": [ "Z plasty.", "Thompson test.", "Boxer's fracture.", "Neuropraxia.", "Knock Knee.", "Ischemic Contracture.", "Painful arc syndrome.", "Slump test.", "Jumper's Knee.", "Hangman's fracture.", ], "Jan2022 (6284)": [ "Aeroplane splint.", "Apley scratch test.", "Piriformis syndrome.", "Delayed Union.", "Vertical Talus.", "Waddling Gait.", "Three point principles.", "Anterior cruciate ligament.", "Madelung's Deformity.", "McMurrey test.", ], "Jun2022 (6284)": [ "Lumbosacral belt.", "Mallet's finger.", "Deep vein thrombosis.", "Erb's palsy.", "Apley's compression test.", "Cozen's test.", "Gibbus deformity.", "Cock up splint.", "Galeazzi fracture.", "Hill's sach lesion.", ], "Oct2022 (6284)": [ "Difference between coxa vara and coxa valga.", "Central dislocation of hip.", "Define burns and the degrees of burns.", "Define swan-neck deformity.", "Define genu recurvatum.", "Define dislocation and subluxation.", "Define metatarsalgia.", "Chest wall deformities.", "Causes of foot drop.", "Wry neck.", ], "Apr2023 (6284)": [ "Types of CTEV.", "Q angle.", "SLR test.", "Cold abscess.", "De quervain's disease.", "Erb's point.", "Phantom limb pain.", "Z thumb deformity.", "Ely's test.", "Hoffa's fracture.", ], "Nov2023 (6284)": [ "P.A Shoulder.", "Bamboo spine.", "Gun Stoke Deformity.", "Trigger finger.", "Malunion.", "Hangman's fracture.", "Brodies abscesses.", "Coxa vara.", "Torticollis.", "Phantom limb.", ], "Aug2024 (6284)": [ "Hallux valgus.", "Non union.", "Kyphosis.", "Bamboo spine.", "Ape thumb.", "Ulnar claw.", "Osteochondroma.", "Onion peel appearance.", "Cubitus varus.", "Erb's point.", ], "Feb2025 (6284)": [ "Alkaline phosphatase.", "Dennis Brown Splint.", "Scoliosis.", "Ankylosis.", "Compression fractures of Vertebrae.", "Chronic Synovitis.", "Osteoid Osteoma.", "Taylor Knight Brace.", "Kyphosis.", "Bisphosphonates.", ], "Feb2026 (6284)": [ "Pointing index.", "Coin test.", "Dinner fork deformity.", "Antalgic gait.", "Osteotomy.", "Skin traction.", "Cervical rib.", "Dorsiflexion test.", "Bumper Injury.", "Cock up splint.", ], } # PDF2 (Sub Code 6266, 4th Year, 2011-2026) - 29 papers pdf2_questions = { "Aug2011 (6266)": [ "Green stick fracture.", "Hallux Valgus.", "Subluxation.", "Carpal bones.", "Delayed union.", "Volkman's sign.", "McMurray's test.", "Scapulo-humeral rhythm.", "Antalgic gait.", "Hypothenar muscles of hand.", ], "Feb2012 (6266)": [ "Z-Thumb deformity.", "Hallux valgus.", "Guillotine amputation.", "Mallet finger.", "Ely's test.", "Complications of Scaphoid fracture.", "Attachments and nerve supply of hamstring muscle.", "List the complications of Supracondylar fracture of humerus.", "Clarke's test.", "Q-angle.", ], "Aug2012 (6266)": [ "Swan neck deformity.", "Thenar muscles of hand.", "Name four entrapment neuropathies.", "Genu valgum.", "Anterior drawer test.", "Dugas sign.", "Bunion.", "External rotators of the hip.", "Tinel's sign.", "Name the fracture and dislocation in Monteggia fracture dislocation.", ], "Feb2013 (6266)": [ "Management of fracture neck of femur.", "Erbs point.", "Involucrum.", "Osteotomy.", "Hugh Oven Thomas.", "Cold abscess.", "Genu valgum.", "Barton's fracture.", "Dequervain's disease.", "Triple dislocation.", ], "Aug2013 (6266)": [ "Define Periarthritis Shoulder. List the clinical features.", "List the splints used for Upper extremity Peripheral nerve injuries.", "Straight leg raising test.", "List the levels of Lower limb Amputation.", "Difference between dislocation and subluxation.", "List the causes for shoulder impingement syndrome.", "Difference between Tide and Untided injuries of hand.", "Define Q Angle.", "List the types of Leprosy.", "Types of CTEV.", ], "Feb2014 (6266)": [ "Deformities of Rheumatoid Arthritis.", "Bamboo Spine.", "Cervical Rib.", "Wry neck.", "Mal union.", "Carpal Tunnel Syndrome.", "Kernick's Sign.", "Cobb's angle.", "Hallux Valgus.", "Genu Varum.", ], "Aug2014 (6266)": [ "Stages of bone healing.", "Metatarsalgia.", "Excisional arthroplasty.", "Bennett's fracture.", "Osteomyelitis.", "Chest wall deformities.", "Painful arc syndrome.", "Myositis ossificans.", "Volkman's ischaemic contracture.", "Boxer's fracture.", ], "Feb2015 (6266)": [ "Define Congenital Dislocation of Hip. List the clinical features.", "Define Foot Drop. List the clinical features.", "List the complications of Patellectomy.", "List the levels of Upper limb Amputation.", "Define Dislocation and Subluxation.", "List the causes for Shoulder Hand Syndrome.", "Define Claw Hand and list the clinical features.", "Define Genu Recurvatum.", "List the types of Fractures.", "Define Prepatellar Bursitis and list the causes.", ], "Aug2015 (6266)": [ "Extensor Zones of Hand.", "Define Deltoid Fibrosis and list the causes.", "Define Kyphosis and list the complications.", "Difference between Coxa vara and Coxa valga.", "Define Burns and list the degrees of Burns.", "List the complications of fracture.", "Define Plantar Fasciitis and list the clinical features.", "Central Dislocation of Hip.", "Carpal Tunnel Syndrome.", "List the clinical features seen in TB Spine.", ], "Feb2016 (6266)": [ "Barton fracture.", "Tenosynovitis.", "Reflex grading.", "Cozen's test.", "Swan neck deformity.", "Mallet finger.", "Thomas test.", "Non union.", "Apprehension sign.", "Ober's test.", ], "Aug2016 (6266)": [ "Coxa vera.", "Taylor's brace.", "Bankart lesion.", "Gunstoke deformity.", "Q angle in knee.", "Deformities of rheumatoid hand.", "Pseudo gout.", "Cold abscess.", "Erb's palsy.", "Dupuytren's contracture.", ], "Feb2017 (6266)": [ "Tennis elbow.", "Genu valgum.", "Few complications of Colle's fracture.", "Compound fracture.", "Trigger finger.", "Entrapment neuropathy.", "Barton's fracture.", "De Quervain's disease.", "Types of scoliosis.", "Smith's fracture.", ], "Aug2017 (6266)": [ "Hangman's fracture.", "Trendelenberg gait.", "Madelung's deformity.", "Bone graft.", "Cobb's angle.", "Sprengel's shoulder.", "Bennett's fracture.", "Scapular winging.", "Nursemaid elbow.", "Boutonniere Deformity.", ], "Feb2018 (6266)": [ "Stages of bone healing.", "Prosthesis.", "Arthroplasty.", "Bennett's fracture and dislocation.", "Pescavus.", "Pelvic tilt.", "Slump test.", "Medical management - RA.", "Paget disease.", "Boxer's fracture.", ], "Aug2018 (6266)": [ "Ape thumb deformity.", "Phalen's test.", "Avulsion fracture.", "Mal union.", "Swan neck deformity.", "Tendinitis.", "Flat foot.", "Erb's point.", "Painful arc syndrome.", "Metatarsalgia.", ], "Feb2019 (6266)": [ "Ganslens test.", "Risser's sign.", "Pawlik harness.", "Bone graft.", "Tardy ulnar nerve palsy.", "Round back.", "Jersey finger.", "Fracture classification.", "Volkman's Ischaemic contracture.", "Rotator cuff muscle injury special test.", ], "Aug2019 (6266)": [ "Pott's fracture.", "Fracture disease.", "CTEV Boot.", "Bamboo spine.", "Axonotmesis.", "Klumpke's palsy.", "Compound fracture.", "Painful arc syndrome.", "Osteomalacia.", "Cross union.", ], "Feb2020 (6266)": [ "Types of fracture.", "Radiological features of Colle's fracture.", "Dislocation.", "Pen Test.", "Neuropraxia.", "Arthroplasty.", "Genu recurvatum.", "Costochondritis.", "Erb's palsy.", "Straight Leg Raising (SLR) Test.", ], "Dec2020 (6266)": [ "Repetitive stress injury.", "Boxer's fracture.", "Mallet thumb.", "Green stick fracture.", "Bankart's repair.", "Tinel's sign.", "Prone knee bend test.", "Bursitis.", "Golfer's elbow.", "Costochondritis.", ], "Sep2021 (6266)": [ "Delayed Union.", "Carpal Bones.", "Pescavus.", "Resting position of Hand.", "Compartmental Syndrome.", "Klippel-Feil syndrome.", "Dennis Brown Splint.", "Ely's test.", "Q angle.", "Cubitus varus.", ], "Jan2022 (6266)": [ "Jefferson's Fracture.", "Osteoblastoma.", "Coxa vara.", "C splint.", "Rickets.", "Anterior drawer test.", "Jersey finger.", "Phalen's test.", "Smith fracture.", "Cortical bone.", ], "Jun2022 (6266)": [ "Bamboo spine.", "Egawa test.", "Myositis ossificans.", "Tabes Dorsalis.", "Ankle Foot Orthosis.", "Nerve graft.", "Cubitus valgus.", "Pelvic Harness.", "Paget's disease.", "Scurvy.", ], "Oct2022 (6266)": [ "Green Stick Fracture.", "Morton's Fracture.", "SLR.", "Arthrodesis.", "Subluxation vs Dislocation.", "Erb's Palsy.", "Genu Valgum.", "Cobb's angle.", "McMurray's test.", "Radial club hand.", ], "Apr2023 (6266)": [ "Trendelenburg gait.", "Madelung's deformity.", "Bennett's fracture.", "Tennis elbow.", "Calcaneal spur.", "Sprain vs Strain.", "Triple nerve palsy.", "MRI.", "Bursitis.", "Stump.", ], "Nov2023 (6266)": [ "Segmental fracture.", "Tenosynovitis.", "CT scan.", "Smith's fracture.", "Trigger finger.", "Speed test.", "Vertical talus.", "Rotator Cuff Tear.", "Thomas splint.", "Night stick fracture.", ], "Aug2024 (6266)": [ "Tenosynovitis.", "Cozen's test.", "Swan neck deformity.", "Pott's fracture.", "Painful arc syndrome.", "Bamboo spine.", "Osteomalacia.", "SLR.", "Erb's Palsy.", "Cobb's angle.", ], "Feb2025 (6266)": [ "Define Sprain.", "Swan neck deformity with suitable diagram.", "Coxa magma.", "Dupuytren's contracture.", "Smith's fracture.", "Jones fracture.", "Biceps tendinitis.", "Define Lordosis.", "Adhesive capsulitis.", "Arthrogryposis.", ], "Aug2025 (6266)": [ "Axonotmesis.", "Radiological features of Colles' fracture.", "Dislocation.", "Pen Test.", "Neuropraxia.", "Arthroplasty.", "Genu recurvatum.", "CTEV Boot.", "Fracture disease.", "Straight Leg Raising (SLR) Test.", ], "Feb2026 (6266)": [ "Arches of foot.", "Mallet finger.", "Subluxation.", "Ulnar claw hand.", "Tinel sign.", "Scaphoid fracture.", "Radiological features of Ankylosing spondylosis.", "Flat foot.", "Froment's sign.", "Arthrodesis.", ], } # Combine all questions all_questions_by_paper = {} all_questions_by_paper.update(pdf1_questions) all_questions_by_paper.update(pdf2_questions) # Normalize for comparison def normalize(q): q = q.lower().strip().rstrip('.') # remove "define " prefix q = q.replace("define ", "").replace("list the ", "").replace("difference between ", "") return q # Count each question from collections import defaultdict question_count = defaultdict(list) # normalized_q -> list of paper names for paper, questions in all_questions_by_paper.items(): for q in questions: norm = normalize(q) question_count[norm].append((paper, q)) # Print repeated questions (asked 2+ times) print("=" * 80) print("REPEATED 2-MARK QUESTIONS (asked in multiple years)") print("=" * 80) repeated = {k: v for k, v in question_count.items() if len(v) >= 2} # Sort by frequency descending sorted_repeated = sorted(repeated.items(), key=lambda x: len(x[1]), reverse=True) for norm_q, occurrences in sorted_repeated: print(f"\n[Asked {len(occurrences)} times] {occurrences[0][1]}") for paper, original_q in occurrences: print(f" - {paper}") print("\n\n" + "=" * 80) print(f"Total repeated questions: {len(repeated)}") print(f"Total unique questions: {len(question_count)}") EOF

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I have all the data I need. Now let me compile the comprehensive final answer with all repeated questions, their frequency counts, and answers.Here is the complete analysis of both your Clinical Orthopaedics question papers (Sub Code 6284 - 3rd Year, 2020-2026 and Sub Code 6266 - 4th Year, 2011-2026).

CLINICAL ORTHOPAEDICS - 2 MARK REPEATED QUESTIONS + ANSWERS

Both papers cover the same subject, so questions overlap across years. Don't confuse sub code with year - both are analysed together.

SECTION 1: REPEATED QUESTIONS (by frequency, highest first)

🔴 Asked 6 Times (TOP PRIORITY)

1. Bamboo Spine Papers: Nov2023(6284), Aug2024(6284), Feb2014(6266), Aug2019(6266), Jun2022(6266), Aug2024(6266)
Answer: Bamboo spine is the characteristic radiological finding in Ankylosing Spondylitis. It occurs due to ossification of the annulus fibrosus (syndesmophytes), anterior and posterior longitudinal ligaments, and interspinous ligaments. On X-ray, the entire spine appears like a "bamboo cane" with a continuous bony column. It leads to rigid spine, loss of spinal mobility, and risk of fracture even with minor trauma.

🔴 Asked 5 Times (HIGH PRIORITY)

2. Cobb's Angle Papers: Dec2020(6284), Feb2014(6266), Aug2017(6266), Oct2022(6266), Aug2024(6266)
Answer: Cobb's angle is the standard method of measuring the degree of spinal curvature in scoliosis on an AP X-ray.
  • Method: Draw a line along the superior end-plate of the uppermost tilted vertebra and a line along the inferior end-plate of the lowermost tilted vertebra. The angle between these two lines (or their perpendiculars) is the Cobb's angle.
  • Normal: <10°. Treatment: Bracing if 25-40°, Surgery (spinal fusion) if >40-45°.
3. Painful Arc Syndrome Papers: Sep2021(6284), Aug2014(6266), Aug2018(6266), Aug2019(6266), Aug2024(6266)
Answer: Painful arc syndrome is pain in the shoulder during 60°-120° of shoulder abduction. It occurs due to impingement of the supraspinatus tendon between the greater tuberosity and the undersurface of the acromion during mid-range abduction. Causes: supraspinatus tendinitis, subacromial bursitis, calcification. Pain disappears beyond 120° (tendon passes under acromion). Managed by physiotherapy, NSAIDs, corticosteroid injection.
4. Erb's Palsy Papers: Jun2022(6284), Aug2016(6266), Feb2020(6266), Oct2022(6266), Aug2024(6266)
Answer: Erb's palsy is injury to the upper trunk of brachial plexus (C5, C6 roots). Caused by excessive lateral flexion of head from the shoulder (birth injury or fall on shoulder).
  • Deformity: "Waiter's tip" - arm hangs at side, shoulder adducted and internally rotated, elbow extended, forearm pronated.
  • Muscles affected: Deltoid, supraspinatus, biceps, brachioradialis.
  • Erb's point = Junction of C5, C6 at the upper trunk (6 cm above clavicle, behind posterior border of sternomastoid).

🟠 Asked 4 Times

5. Dislocation vs Subluxation Papers: Dec2020(6284), Oct2022(6284), Aug2013(6266), Feb2015(6266)
Answer:
FeatureDislocationSubluxation
DefinitionComplete loss of contact between joint surfacesPartial/incomplete loss of contact
StabilityCompletely unstablePartially stable
DeformityMore pronouncedLess pronounced
MovementCompletely lostPartially restricted
ExampleAnterior shoulder dislocationSubluxation of hip (DDH)
6. Boxer's Fracture Papers: Sep2021(6284), Aug2014(6266), Feb2018(6266), Dec2020(6266)
Answer: Boxer's fracture is a fracture of the neck of the 5th metacarpal (ring/little finger side), caused by punching with a clenched fist. The head of the metacarpal angulates volarly (palmarly).
  • Clinical features: Swelling, tenderness over 5th knuckle, loss of knuckle prominence, shortening.
  • Management: Buddy strapping, Ulnar gutter splint in safe position (MCP 70° flexion, IP extended). Surgery if angulation >30-40°.
7. Genu Recurvatum Papers: Oct2022(6284), Feb2015(6266), Feb2020(6266), Aug2025(6266)
Answer: Genu recurvatum is hyperextension deformity of the knee joint (back-knee deformity). The tibia angulates posteriorly relative to the femur beyond the normal 0°.
  • Causes: Poliomyelitis (quadriceps paralysis with intact hamstrings), ligamentous laxity, rickets, femoral/tibial malunion, burns contracture.
  • Features: Knee hyperextends during stance phase, patient has abnormal gait.
  • Treatment: Physiotherapy, knee-ankle-foot orthosis (KAFO), surgical correction.
8. Hallux Valgus Papers: Aug2024(6284), Aug2011(6266), Feb2012(6266), Feb2014(6266)
Answer: Hallux valgus is lateral deviation of the great toe at the first metatarsophalangeal (MTP) joint, with medial deviation of the first metatarsal (metatarsus primus varus).
  • Features: Prominence of the medial side of 1st MTP joint (bunion), pain over bunion, overlapping toes.
  • Causes: Ill-fitting footwear, hereditary, flat foot, rheumatoid arthritis.
  • Treatment: Wide-toed footwear, bunion pads, orthotics. Surgery: Mitchell's osteotomy, Keller's arthroplasty.
9. Swan Neck Deformity Papers: Aug2012(6266), Feb2016(6266), Aug2018(6266), Aug2024(6266)
Answer: Swan neck deformity of finger consists of hyperextension of the PIP joint and flexion of the DIP joint.
  • Causes: Rheumatoid arthritis (rupture of FDS), mallet finger neglected, spastic conditions.
  • Mechanism: Subluxation of lateral bands dorsally at PIP joint.
  • Treatment: Ring splint to prevent PIP hyperextension, surgical reconstruction (FDS tenodesis, Swanson implant).
10. Genu Valgum (Knock Knee) Papers: Aug2012(6266), Feb2013(6266), Feb2017(6266), Oct2022(6266)
Answer: Genu valgum is a deformity where the knees angle inward and touch each other when standing, with the ankles apart.
  • Normal: Slight valgus (5-7°) is physiological in children.
  • Causes: Rickets, rheumatoid arthritis, Paget's disease, trauma, poliomyelitis, obesity.
  • Measurement: Intermalleolar distance (normal <10 cm).
  • Treatment: Treat cause, valgus corrective osteotomy for severe cases.

🟡 Asked 3 Times

11. Neuropraxia Papers: Sep2021(6284), Feb2020(6266), Aug2025(6266)
Answer: Neuropraxia is the mildest grade of nerve injury (Seddon's classification Grade I / Sunderland Grade 1). There is temporary loss of nerve conduction due to local demyelination or ischemia, without axonal damage. The endoneurium, perineurium, and epineurium are intact. Recovery is complete in days to weeks (usually 6-8 weeks). No Wallerian degeneration. Example: Saturday night palsy (radial nerve compression).
12. Hangman's Fracture Papers: Sep2021(6284), Nov2023(6284), Aug2017(6266)
Answer: Hangman's fracture is a traumatic spondylolisthesis of C2 vertebra - bilateral fracture through the pedicles/pars interarticularis of C2.
  • Mechanism: Hyperextension + distraction (hanging, diving, MVA).
  • Features: Neck pain, neurological deficit (may be minimal due to wide spinal canal at C2), unstable fracture.
  • Classification: Levine-Edwards (Types I-III).
  • Treatment: Cervical collar for Type I; halo vest for Type II; surgery for Type IIA/III.
13. Delayed Union Papers: Jan2022(6284), Aug2011(6266), Sep2021(6266)
Answer: Delayed union is a condition where a fracture fails to unite within the expected normal time for that particular fracture but still has the potential to heal.
  • Causes: Infection, poor blood supply, inadequate immobilization, malnutrition, corticosteroids, distraction.
  • Radiologically: No callus formation at expected time.
  • Treatment: Correct the cause - optimize nutrition, bone grafting, electrical stimulation, ensure adequate immobilization.
  • Differs from non-union: Delayed union can still heal; non-union has lost healing potential.
14. Madelung's Deformity Papers: Jan2022(6284), Aug2017(6266), Apr2023(6266)
Answer: Madelung's deformity is a congenital deformity of the wrist characterized by:
  • Dorsal subluxation of the distal ulna (bayonet appearance)
  • Increased radial inclination
  • Volar tilt of the distal radial articular surface
  • Shortening of radius
  • Cause: Premature fusion of the antero-medial part of distal radial physis (Vickers' ligament pulls on the growth plate).
  • Features: Dinner fork deformity in reverse, restricted dorsiflexion.
  • Treatment: Vickers' ligament release in children, corrective osteotomy in adults.
15. Cozen's Test Papers: Jun2022(6284), Feb2016(6266), Aug2024(6266)
Answer: Cozen's test is a special test for Lateral Epicondylitis (Tennis Elbow).
  • Method: Patient makes a fist and extends the wrist with forearm pronated against resistance while the examiner palpates the lateral epicondyle.
  • Positive: Pain over the lateral epicondyle.
  • Also called: "Resisted wrist extension test."
16. Metatarsalgia Papers: Oct2022(6284), Aug2014(6266), Aug2018(6266)
Answer: Metatarsalgia is pain in the forefoot region at the metatarsal heads during weight-bearing.
  • Causes: Pes cavus, rheumatoid arthritis, prominent metatarsal heads, ill-fitting footwear, Morton's neuroma, stress fracture.
  • Features: Pain and tenderness under metatarsal heads, callosity formation, burning sensation.
  • Treatment: Metatarsal pad/bar, corrective footwear, surgical osteotomy (Freiberg's operation).
17. Q Angle Papers: Apr2023(6284), Aug2013(6266), Sep2021(6266)
Answer: Q angle (Quadriceps angle) is the angle formed between:
  • Line from ASIS (Anterior Superior Iliac Spine) to center of patella
  • Line from center of patella to tibial tubercle
  • Normal: Males < 14°, Females < 17°.
  • Clinical significance: Increased Q angle causes lateral patellar malalignment, chondromalacia patellae, patellofemoral pain syndrome. Measured in supine with knee extended and quadriceps relaxed.
18. Cold Abscess Papers: Apr2023(6284), Feb2013(6266), Aug2016(6266)
Answer: Cold abscess is a pus-filled cavity associated with Tuberculosis (TB) that lacks the classic signs of acute inflammation (no heat, no redness, no fever - hence "cold").
  • Pathology: Caseous material liquefies to form pus which collects and can track along tissue planes.
  • Sites: Psoas abscess (TB spine tracking down to groin), retropharyngeal abscess (TB cervical spine).
  • Treatment: Anti-tubercular drugs, aspiration or surgical drainage, treating the primary TB focus.
19. Erb's Point Papers: Apr2023(6284), Aug2024(6284), Aug2018(6266)
Answer: Erb's point is the anatomical point on the neck where the C5 and C6 nerve roots meet to form the upper trunk of the brachial plexus. Located 2-3 cm above the clavicle, behind the posterior border of the sternocleidomastoid muscle. It is the most vulnerable point of the brachial plexus to traction injury. Pressure here produces Erb's palsy (waiter's tip deformity). Named after Wilhelm Heinrich Erb.
20. Ely's Test Papers: Apr2023(6284), Feb2012(6266), Sep2021(6266)
Answer: Ely's test is a clinical test for rectus femoris contracture / tightness (also tests for lumbar nerve root irritation at L3/L4 level).
  • Method: Patient lies prone. Examiner passively flexes the knee rapidly.
  • Positive test: The ipsilateral hip spontaneously flexes up from the table (buttock rises), indicating rectus femoris tightness.
  • Also positive in: L3/L4 femoral nerve irritation (pain radiates to front of thigh).
21. Trigger Finger (Stenosing Tenosynovitis) Papers: Nov2023(6284), Feb2017(6266), Nov2023(6266)
Answer: Trigger finger (stenosing flexor tenosynovitis) is catching, snapping, or locking of the finger during flexion/extension due to a discrepancy between the size of the flexor tendon and its fibro-osseous sheath (A1 pulley).
  • Features: Pain at base of finger, palpable nodule, locking in flexion, "triggering" on extension.
  • Common in: Ring finger, thumb (trigger thumb), middle finger.
  • Treatment: Rest, steroid injection, surgical A1 pulley release.
22. Green Stick Fracture Papers: Aug2011(6266), Dec2020(6266), Oct2022(6266)
Answer: Greenstick fracture is an incomplete fracture of children's bones where only one cortex breaks and the other cortex bends (like breaking a green twig). Occurs because children's bones are more flexible and porous.
  • X-ray: One cortex broken; other intact but bent.
  • Common sites: Distal radius, clavicle.
  • Treatment: Manipulation to complete the fracture if angulated, then cast immobilization.
23. Mallet Finger Papers: Feb2012(6266), Feb2016(6266), Feb2026(6266)
Answer: Mallet finger (baseball finger) is flexion deformity of the DIP joint due to rupture or avulsion of the extensor tendon at its insertion onto the distal phalanx.
  • Mechanism: Forced flexion of an extended DIP (ball hitting fingertip).
  • Types: Tendinous (no bony fragment), bony (avulsion fracture of dorsal base of distal phalanx).
  • Treatment: Stack splint keeping DIP in full extension for 6-8 weeks. Surgery if >30% of articular surface involved.
24. Bennett's Fracture Papers: Aug2014(6266), Aug2017(6266), Apr2023(6266)
Answer: Bennett's fracture is an intra-articular fracture-dislocation of the base of the 1st metacarpal at the carpometacarpal (CMC) joint.
  • Mechanism: Axial force along the thumb metacarpal (punching, fall on thumb).
  • Pathology: A small triangular fragment of the volar lip remains attached to the trapezium; the rest of the metacarpal shaft dislocates proximally and radially due to APL pull.
  • Treatment: Reduction + thumb spica cast, or surgical fixation (K-wire/screw).
  • Rolando fracture = comminuted version of Bennett's.
25. Tenosynovitis Papers: Feb2016(6266), Nov2023(6266), Aug2024(6266)
Answer: Tenosynovitis is inflammation of the tendon sheath (synovial membrane surrounding the tendon).
  • Causes: Overuse/repetitive strain, rheumatoid arthritis, infection (suppurative), gout.
  • Features: Pain, swelling, crepitus along the tendon, restricted movement.
  • Common sites: Flexor tendons of hand (trigger finger), de Quervain's (first dorsal compartment), bicipital tendon sheath.
  • Treatment: Rest, NSAIDs, steroid injection, physiotherapy; surgery for persistent cases.
26. Smith's Fracture Papers: Feb2017(6266), Nov2023(6266), Feb2025(6266)
Answer: Smith's fracture (reverse Colles' fracture) is a fracture of the distal radius with volar/anterior angulation of the distal fragment.
  • Mechanism: Fall on the back of the hand (dorsum) with wrist in flexion, or direct blow.
  • X-ray: Distal radial fragment displaced volarly ("Garden spade" deformity / "fork in reverse").
  • Contrast: Colles' fracture = dorsal displacement (dinner fork); Smith's = volar displacement.
  • Treatment: Closed reduction and below-elbow cast (in supination and extension) or surgical fixation.
27. Arthroplasty Papers: Feb2018(6266), Feb2020(6266), Aug2025(6266)
Answer: Arthroplasty is a surgical procedure to restore joint function either by resurfacing, realigning, or replacing the joint.
  • Types:
    • Excision arthroplasty (Keller's, Girdlestone's) - removal of part of joint
    • Interposition arthroplasty - insertion of biological/synthetic material
    • Replacement arthroplasty (Total Hip Replacement, Total Knee Replacement) - most common
    • Hemi-arthroplasty - only one side replaced
  • Indications: OA, RA, AVN, failed internal fixation.

🟢 Asked 2 Times

28. Define Periarthritis Shoulder / List clinical features Papers: Dec2020(6284), Aug2013(6266)
Answer: Periarthritis shoulder (Frozen Shoulder / Adhesive Capsulitis) is a condition characterized by global restriction of shoulder joint movement with pain.
  • Clinical features: Gradual onset of shoulder pain, progressive restriction of all movements (especially external rotation and abduction), night pain, inability to perform daily activities (combing hair, fastening bra).
  • Stages: Painful phase (3-9 months) → Freezing phase → Thawing phase.
29. Splints for Upper Extremity Peripheral Nerve Injuries Papers: Dec2020(6284), Aug2013(6266)
Answer:
Nerve InjuredDeformitySplint Used
Radial nerveWrist dropCock-up splint (wrist extension splint)
Ulnar nerveClaw hand (ring + little)Knuckle-bender / Anti-claw splint
Median nerveApe thumb / loss of oppositionOpponens splint
Combined ulnar + medianTotal claw handDynamic lumbrical splint
C5-C6 (Erb's palsy)Adducted, IR shoulderAeroplane splint
30. Levels of Lower Limb Amputation Papers: Dec2020(6284), Aug2013(6266)
Answer: Levels (proximal to distal):
  1. Hindquarter amputation (hemipelvectomy)
  2. Hip disarticulation
  3. Above-knee amputation (transfemoral) - ideal at lower 1/3 femur
  4. Knee disarticulation (through-knee)
  5. Below-knee amputation (transtibial) - ideal at junction of upper and middle 1/3 of leg
  6. Syme's amputation (through ankle)
  7. Transmetatarsal amputation
  8. Ray amputation
  9. Toe amputation
31. Shoulder Impingement Syndrome - Causes Papers: Dec2020(6284), Aug2013(6266)
Answer: Causes of shoulder impingement (subacromial impingement):
  1. Supraspinatus tendinitis/tear
  2. Subacromial bursitis
  3. Calcific tendinitis
  4. Acromioclavicular joint osteoarthritis
  5. Type III (hooked) acromion
  6. Thickened coracoacromial ligament
  7. Acromial osteophytes
  8. Shoulder instability (secondary impingement)
32. Tidy vs Untidy (Tide/Untide) Injuries of Hand Papers: Dec2020(6284), Aug2013(6266)
Answer:
FeatureTidy InjuryUntidy Injury
WoundClean incised woundLacerated, crushed, contaminated
MechanismSharp cutCrush, machinery, blast
TissuesCleanly cutDevitalized, contaminated
Primary repairPossibleNot recommended
ManagementPrimary tendon/nerve repairDebridement, delayed repair
33. Types of Leprosy Papers: Dec2020(6284), Aug2013(6266)
Answer: Ridley-Jopling classification:
  1. Tuberculoid (TT) - high immunity, few lesions, positive lepromin test
  2. Borderline Tuberculoid (BT)
  3. Mid-Borderline (BB)
  4. Borderline Lepromatous (BL)
  5. Lepromatous (LL) - low immunity, many lesions, negative lepromin test WHO classification: Paucibacillary (TT, BT) and Multibacillary (BB, BL, LL).
34. Slump Test Papers: Sep2021(6284), Feb2018(6266)
Answer: The Slump test is used to detect neural tension / dural irritation in the lumbar and lower limb neural system (similar to SLR but more sensitive).
  • Method: Patient sits on edge of table → Slouch (thoracic + lumbar flexion) → Chin to chest → Extend knee → Dorsiflex ankle.
  • Positive: Reproduction of patient's familiar pain in the lower limb.
  • Used for: Disc prolapse, neural tension syndromes, meralgia paraesthetica.
35. Vertical Talus Papers: Jan2022(6284), Nov2023(6266)
Answer: Vertical talus (congenital convex pes valgus / rocker-bottom foot) is a rigid flatfoot deformity where the talus is vertically oriented.
  • Features: Rocker-bottom appearance of the foot, dorsolateral dislocation of navicular on talus, rigid deformity, plantarflexion of talus.
  • Causes: Idiopathic, spina bifida, arthrogryposis, chromosomal anomalies.
  • Treatment: Serial casting (Dobbs method), surgical reduction and stabilization.
36. Cock-up Splint Papers: Jun2022(6284), Feb2026(6284)
Answer: Cock-up splint (wrist extension splint) is an orthosis that maintains the wrist in 20-30° of extension.
  • Indications: Radial nerve palsy (wrist drop), rehabilitation after wrist injuries, carpal tunnel syndrome (night splint), de Quervain's tenosynovitis.
  • Design: Extends from mid-forearm to MCP joints (leaving fingers free), holds wrist in functional position.
  • Prevents: Wrist drop deformity, enables hand function while nerve heals.
37. Coxa Vara vs Coxa Valga Papers: Oct2022(6284), Aug2015(6266)
Answer:
FeatureCoxa VaraCoxa Valga
Neck-shaft angleDecreased (<120°)Increased (>135°)
Normal angle120-135°120-135°
Limb lengthShortLong
GaitTrendelenburg gaitScissor gait
CauseRickets, Paget's, fracture neck femurCoxa valga - cerebral palsy
38. Central Dislocation of Hip Papers: Oct2022(6284), Aug2015(6266)
Answer: Central dislocation of hip (protrusio acetabuli traumatica) occurs when the femoral head is driven medially through the acetabular floor into the pelvis.
  • Mechanism: Axial force along the femoral shaft (dashboard injury, fall from height).
  • Features: Limb shortened and externally rotated (less so than posterior dislocation), pain, inability to bear weight.
  • Complications: Sciatic nerve injury, bladder/bowel injury, AVN, OA.
  • Treatment: Skeletal traction, open reduction with internal fixation (ORIF).
39. Chest Wall Deformities Papers: Oct2022(6284), Aug2014(6266)
Answer: Common chest wall deformities:
  1. Pectus excavatum (funnel chest) - depression of sternum
  2. Pectus carinatum (pigeon chest) - protrusion of sternum
  3. Harrison's sulcus - horizontal groove at lower ribs due to rickets
  4. Barrel chest - increased AP diameter (emphysema)
  5. Kyphoscoliotic chest - secondary to spinal deformity Treatment: Conservative (physiotherapy, bracing for mild cases), surgical correction for severe cases.
40. Wry Neck (Torticollis) Papers: Oct2022(6284), Feb2014(6266)
Answer: Wry neck (torticollis) is a condition where the head is tilted to one side with the chin rotated to the opposite side.
  • Types: Congenital muscular torticollis (fibrous SCM), Acute (spasm), Bony (Klippel-Feil syndrome), Ocular, Neurogenic.
  • Congenital: Fibrosis of sternocleidomastoid (SCM) due to birth trauma or intrauterine malposition.
  • Features: Head tilt, restricted rotation, facial asymmetry (plagiocephaly).
  • Treatment: Stretching exercises, SCM release surgery (after 1 year if no improvement).
41. Types of CTEV Papers: Apr2023(6284), Aug2013(6266)
Answer: CTEV (Congenital Talipes Equino Varus / Club Foot) types:
  1. Postural/Positional CTEV - flexible, due to intrauterine malposition, easily correctable
  2. Structural/Rigid CTEV - true club foot, due to bony/soft tissue abnormality
  3. Syndromic CTEV - associated with spina bifida, arthrogryposis Dimeglio's classification: Grades I-IV based on severity and reducibility.
42. De Quervain's Disease Papers: Apr2023(6284), Feb2017(6266)
Answer: De Quervain's tenosynovitis is stenosing tenosynovitis of the first dorsal compartment of the wrist containing abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons.
  • Cause: Repetitive thumb and wrist movements, overuse.
  • Features: Pain and tenderness over radial styloid, swelling, Finkelstein's test positive (passive ulnar deviation of wrist with thumb in palm causes pain).
  • Treatment: Rest, thumb spica splint, steroid injection, surgical decompression.
43. Coxa Vara Papers: Nov2023(6284), Jan2022(6266)
Answer: Coxa vara is a deformity of the hip where the neck-shaft angle is reduced below 120° (normal 120-135°).
  • Causes: Rickets, Paget's disease, fracture neck of femur (malunion), Perthes disease, osteomalacia, congenital.
  • Features: Short limb, Trendelenburg gait, limited abduction, positive Trendelenburg test.
  • Treatment: Valgus intertrochanteric osteotomy.
44. Non-Union Papers: Aug2024(6284), Feb2016(6266)
Answer: Non-union is failure of a fracture to heal even after twice the expected healing time (usually >6 months) with no signs of progression towards union.
  • Types: Hypertrophic (elephants foot) - good blood supply but mechanically unstable; Atrophic - poor blood supply.
  • Causes: Infection, excessive movement, bone loss, poor blood supply, systemic disease.
  • Investigations: X-ray, bone scan.
  • Treatment: Hypertrophic - rigid fixation (IM nail, plating). Atrophic - debridement + bone grafting + fixation.
45. Kyphosis Papers: Aug2024(6284), Feb2025(6284)
Answer: Kyphosis is an abnormal increase in the posterior curvature of the thoracic spine (normal thoracic kyphosis = 20-45°).
  • Types: Postural (flexible, common in adolescents), Scheuermann's disease (rigid, wedging of vertebrae), Congenital, Pathological (TB, fracture, tumor).
  • Features: Rounded upper back, forward stoop, back pain, restrictive lung disease in severe cases.
  • Treatment: Postural exercises, bracing (Milwaukee brace for Scheuermann's). Surgery for severe kyphosis (>75°) or neurological deficit.
46. Cubitus Varus Papers: Aug2024(6284), Sep2021(6266)
Answer: Cubitus varus (gunstock deformity) is reduction of the carrying angle of the elbow below normal (normal carrying angle = 10-15° in females, 5-10° in males). The forearm is deviated medially (varus).
  • Cause: Most common - malunited supracondylar fracture of humerus in children.
  • Features: Ugly cosmetic deformity, normal function usually, occasional lateral condyle prominence.
  • Treatment: Corrective lateral closing wedge osteotomy above the elbow.
47. Dennis Brown Splint Papers: Feb2025(6284), Sep2021(6266)
Answer: Dennis Brown splint (Denis Brown boots/bar) is a dynamic orthosis used for treatment of CTEV (Club foot) and metatarsus adductus in infants.
  • Design: Two shoes connected by an adjustable metal bar (70 cm long). Shoes are set in outward rotation.
  • Use: After serial casting (Ponseti method) correction is achieved, Dennis Brown splint maintains correction.
  • Protocol: Full-time use for 3 months, then night-time use until age 4.
48. Antalgic Gait Papers: Feb2026(6284), Aug2011(6266)
Answer: Antalgic gait is an abnormal gait pattern where the stance phase on the affected limb is shortened to minimize pain.
  • Mechanism: Patient reduces time spent bearing weight on the painful extremity.
  • Causes: Hip OA, knee OA, ankle pathology, foot pain, piriformis syndrome, fractures.
  • Appearance: Limp on the affected side, quick transfer to unaffected side during walking.
  • Differs from Trendelenburg: Antalgic = short stance to avoid pain; Trendelenburg = trunk lurch over affected side due to abductor weakness.
49. Osteotomy Papers: Feb2026(6284), Feb2013(6266)
Answer: Osteotomy is a surgical procedure where bone is cut to reshape or realign it.
  • Types: Varus, Valgus, Rotational, Lengthening, Shortening osteotomy.
  • Indications: Correction of deformity (coxa vara, cubitus varus), offloading in OA (high tibial osteotomy), malunited fractures.
  • High Tibial Osteotomy (HTO): Used for medial compartment OA of knee - shifts weight to less affected lateral compartment.
  • Complications: Delayed union, non-union, neurovascular injury.
50. Cervical Rib Papers: Feb2026(6284), Feb2014(6266)
Answer: Cervical rib is a supernumerary rib arising from C7 vertebra (occurs in ~0.5% of population). It may be complete (attached to first rib) or incomplete (fibrous band).
  • Causes symptoms via compression of: Brachial plexus (lower trunk - C8, T1 = neurogenic TOS), Subclavian artery/vein (vascular TOS).
  • Features: Pain and numbness in ulnar distribution, wasting of intrinsic muscles of hand, Raynaud's phenomenon.
  • Diagnosis: X-ray (cervical rib visible), Adson's test, Doppler.
  • Treatment: Conservative (physiotherapy, posture correction). Surgery: Cervical rib excision, first rib resection.
51. Subluxation Papers: Aug2011(6266), Feb2026(6266)
Answer: Subluxation is partial displacement of joint surfaces where some contact remains between articulating surfaces (unlike dislocation where there is complete loss of contact).
  • Example: Subluxation of hip in DDH, atlantoaxial subluxation in RA/Down syndrome, subluxation of patella.
  • Features: Pain, restricted movement, deformity (less severe than dislocation).
  • Treatment: Depends on cause - reduction, bracing, or surgery.
52. Carpal Bones Papers: Aug2011(6266), Sep2021(6266)
Answer: The carpus has 8 bones in 2 rows:
  • Proximal row (lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform
  • Distal row (lateral to medial): Trapezium, Trapezoid, Capitate, Hamate Mnemonic: "She Looks Too Pretty, Try To Catch Her" The scaphoid is the most commonly fractured carpal bone.
53. McMurray's Test Papers: Aug2011(6266), Oct2022(6266)
Answer: McMurray's test is used to detect meniscal tears of the knee.
  • Method: Patient supine, knee fully flexed.
    • For medial meniscus: Externally rotate tibia, apply valgus stress, then extend knee.
    • For lateral meniscus: Internally rotate tibia, apply varus stress, then extend knee.
  • Positive: Palpable/audible "click" or "clunk" with pain at the joint line.
  • Sensitivity ~53%, Specificity ~59%.
54. Anterior Drawer Test Papers: Aug2012(6266), Jan2022(6266)
Answer: Anterior drawer test assesses the integrity of the Anterior Cruciate Ligament (ACL) of the knee.
  • Method: Patient supine, hip 45°, knee 90° flexed. Examiner sits on patient's foot and pulls the tibia anteriorly.
  • Positive: Excessive anterior translation (>6mm) of the tibia on the femur.
  • Compare with Lachman test (more sensitive, knee at 20-30° flexion).
  • Also: Anterior drawer test of ankle - tests anterior talofibular ligament integrity.
55. Tinel's Sign Papers: Aug2012(6266), Dec2020(6266)
Answer: Tinel's sign is a clinical sign of nerve regeneration or nerve compression.
  • Method: Gentle tapping over a nerve trunk along its course.
  • Positive: Tingling/paraesthesia in the distribution of the nerve.
  • Applications:
    • Carpal tunnel syndrome (tap at wrist over median nerve)
    • Cubital tunnel syndrome (tap at medial epicondyle)
    • Nerve regeneration after injury (Tinel's sign advances distally as nerve regenerates)
56. Barton's Fracture Papers: Feb2013(6266), Feb2017(6266)
Answer: Barton's fracture is an intra-articular fracture of the distal radius with subluxation/dislocation of the radiocarpal joint.
  • Volar Barton's: Volar marginal fracture with volar subluxation of carpus (more common, unstable).
  • Dorsal Barton's: Dorsal marginal fracture with dorsal subluxation.
  • Mechanism: Fall on outstretched hand, forceful wrist extension with pronation.
  • Treatment: Surgical - volar plate fixation (Barton's is unstable and requires surgery).
57. Malunion Papers: Feb2014(6266), Aug2018(6266)
Answer: Malunion is healing of a fracture in incorrect position/alignment - with angulation, rotation, shortening, or translation.
  • Causes: Inadequate reduction, loss of reduction, muscular pull, inadequate immobilization.
  • Consequences: Deformity, functional impairment, joint pain, OA, limb length discrepancy.
  • Treatment: Corrective osteotomy to realign the bone.
  • Examples: Cubitus varus after supracondylar fracture, dinner fork deformity after Colles' fracture.
58. Carpal Tunnel Syndrome Papers: Feb2014(6266), Aug2015(6266)
Answer: CTS is compression of the median nerve in the carpal tunnel at the wrist.
  • Contents: 9 tendons (FDP, FDS, FPL) + median nerve (carpal tunnel = 10 structures).
  • Features: Pain and paraesthesia in thumb, index, middle finger and radial half of ring finger (median nerve distribution), especially at night; Tinel's sign, Phalen's test positive, weakness/wasting of thenar muscles.
  • Causes: Pregnancy, RA, hypothyroidism, DM, ganglion, idiopathic.
  • Treatment: Wrist splint, steroid injection, surgical carpal tunnel release.
59. Stages of Bone Healing Papers: Aug2014(6266), Feb2018(6266)
Answer:
  1. Hematoma formation (0-24 hrs): Bleeding, clot formation, fibrin network.
  2. Inflammatory stage (1-3 days): Phagocytosis of debris, growth factor release.
  3. Soft callus stage (1-3 weeks): Periosteal callus formation, cartilage bridging the fracture.
  4. Hard callus stage (3-12 weeks): Cartilage replaced by woven bone (primary callus).
  5. Remodelling stage (months-years): Woven bone → lamellar bone, Wolff's law, medullary cavity restored.
60. Myositis Ossificans Papers: Aug2014(6266), Jun2022(6266)
Answer: Myositis ossificans is heterotopic ossification (ectopic bone formation) within muscle.
  • Types: Myositis ossificans traumatica (after single trauma or repeated minor trauma), Myositis ossificans progressiva (Fibrodysplasia ossificans progressiva - rare genetic condition).
  • Cause: Trauma, haematoma, periosteal stripping.
  • Common sites: Brachialis (after elbow dislocation), quadriceps (after thigh injury).
  • X-ray: Zonal pattern - peripheral ossification with lucent centre.
  • Treatment: Rest, NSAIDs, avoid massage in acute phase. Surgical excision after maturation (>6 months).
61. Volkmann's Ischemic Contracture Papers: Aug2014(6266), Feb2019(6266)
Answer: Volkmann's ischemic contracture is a fibrosis and contracture of the forearm muscles following compartment syndrome, usually after supracondylar fracture.
  • Pathology: Ischemia → Necrosis → Fibrosis of forearm flexors (FDP, FDS, FPL).
  • Deformity: Elbow flexed, wrist flexed, fingers flexed (can be extended passively if wrist flexed).
  • Degrees: Mild (Zancolli: 2-3 fingers), Moderate (3-4 fingers + wrist), Severe (all fingers + wrist).
  • Treatment: Mild - physiotherapy, splinting. Moderate/Severe - muscle slide operation, excision of infarcted muscle, free muscle transfer.
62. Dupuytren's Contracture Papers: Aug2016(6266), Feb2025(6266)
Answer: Dupuytren's contracture is progressive fibrosis and contracture of the palmar fascia leading to finger flexion deformity.
  • Features: Pitting and puckering of palm, nodules in palmar fascia, progressive flexion of MCP and PIP joints (ring and little finger most common).
  • Associations: Diabetes, epilepsy, alcoholic cirrhosis, Peyronie's disease, plantar fibromatosis.
  • Treatment: Conservative (collagenase injection). Surgery: Fasciotomy (division), Fasciectomy (excision) - when MCP flexion >30° or PIP any flexion.
63. Tennis Elbow Papers: Feb2017(6266), Apr2023(6266)
Answer: Tennis elbow (Lateral Epicondylitis) is tendinopathy/enthesopathy of the extensor origin at the lateral epicondyle of the humerus (mainly ECRB - Extensor Carpi Radialis Brevis).
  • Cause: Repetitive gripping and wrist extension (tennis, carpenters, plumbers).
  • Features: Pain at lateral epicondyle, tender on palpation, Cozen's test positive, Mill's test positive.
  • Treatment: Rest, NSAIDs, physiotherapy (eccentric exercises), steroid injection, lateral epicondyle release surgery.
64. Compound Fracture (Open Fracture) Papers: Feb2017(6266), Aug2019(6266)
Answer: Open (compound) fracture is one where the fracture communicates with the external environment through a wound in the skin.
  • Gustilo-Anderson Classification:
    • Type I: Wound <1cm, clean
    • Type II: Wound 1-10cm, no extensive soft tissue damage
    • Type IIIA: Wound >10cm, adequate soft tissue coverage
    • Type IIIB: Inadequate soft tissue coverage, needs flap
    • Type IIIC: Vascular injury requiring repair
  • Treatment: Emergency - wound debridement, IV antibiotics (within 6 hrs), tetanus prophylaxis, fracture stabilization (external fixator preferred initially).
65. Bone Graft Papers: Aug2017(6266), Feb2019(6266)
Answer: Bone graft is a transplant of bone tissue to augment healing, fill bone defects, or stimulate new bone formation.
  • Types by source: Autograft (same individual, gold standard), Allograft (same species), Xenograft (different species), Synthetic (hydroxyapatite, calcium phosphate).
  • Properties: Osteogenesis (contains living osteoblasts), Osteoinduction (stimulates osteoblast differentiation), Osteoconduction (scaffold).
  • Common donor site: Iliac crest (autograft).
  • Uses: Non-union, bone defects after tumor excision, arthrodesis, spinal fusion.
66. Pescavus (Pes Cavus) Papers: Feb2018(6266), Sep2021(6266)
Answer: Pes cavus is a high arch foot deformity with excessive plantar flexion of the forefoot on the hindfoot (excessive longitudinal arch).
  • Causes: Neurological (Charcot-Marie-Tooth, Friedreich's ataxia, poliomyelitis, spina bifida) - most common cause is neurological.
  • Features: High arch, clawing of toes, callosity under metatarsal heads, restricted ankle dorsiflexion, foot pain.
  • Treatment: Footwear modification, physiotherapy, surgery (soft tissue releases, osteotomy for rigid cases).
67. Phalen's Test Papers: Aug2018(6266), Jan2022(6266)
Answer: Phalen's test (wrist flexion test) is a provocative test for Carpal Tunnel Syndrome.
  • Method: Patient holds wrists in full flexion (back of hands together) for 60 seconds.
  • Positive: Reproduction of paraesthesia in the median nerve distribution (thumb, index, middle, radial half of ring finger) within 60 seconds.
  • Sensitivity ~68%, Specificity ~73%.
  • Mechanism: Wrist flexion increases carpal tunnel pressure, compressing median nerve.
68. Flat Foot (Pes Planus) Papers: Aug2018(6266), Feb2026(6266)
Answer: Flat foot is absence or reduction of the medial longitudinal arch of the foot.
  • Types: Flexible (arch appears when non-weight bearing, disappears on standing) and Rigid (arch absent even non-weight bearing).
  • Causes: Ligamentous laxity, obesity, tibialis posterior tendon dysfunction, tarsal coalition, cerebral palsy.
  • Features: Medial arch flattening, heel valgus, forefoot abduction ("too many toes" sign), foot pain.
  • Treatment: Arch supports/orthotics (flexible), surgery (rigid/symptomatic - fusion, osteotomy).
69. Jersey Finger Papers: Feb2019(6266), Jan2022(6266)
Answer: Jersey finger is avulsion of the flexor digitorum profundus (FDP) tendon from its insertion on the distal phalanx.
  • Mechanism: Forced extension of the DIP joint while actively flexing (grabbing jersey during tackling).
  • Features: Inability to flex the DIP joint, pain, swelling at DIP.
  • Ring finger most commonly affected.
  • Classification: Leddy and Packer (Types I-III based on how far tendon retracts).
  • Treatment: Surgical repair (urgent - tendon retracts, blood supply compromised). FDP reattachment to distal phalanx.
70. Pott's Fracture Papers: Aug2019(6266), Aug2024(6266)
Answer: Pott's fracture is a bimalleolar fracture of the ankle (fracture of lateral malleolus + fracture/rupture of medial ligament, or fracture of both malleoli with/without posterior malleolus).
  • Mechanism: Forceful eversion of the foot (ankle twisting injury).
  • Features: Swelling, bruising around ankle, inability to bear weight, bony tenderness.
  • Classification: Denis Weber (A, B, C based on level of fibular fracture relative to syndesmosis).
  • Treatment: Conservative (below-knee cast) for stable fractures; ORIF for unstable/displaced.
71. Fracture Disease Papers: Aug2019(6266), Aug2025(6266)
Answer: Fracture disease is a complex of complications arising from prolonged immobilization of a fracture.
  • Components: Muscle wasting, osteoporosis, joint stiffness, skin atrophy, soft tissue tightness.
  • Pathology: Disuse atrophy of muscles, Sudeck's atrophy (complex regional pain syndrome), contractures.
  • Prevention: Early mobilization, physiotherapy, isometric exercises even in cast.
  • Treatment: Active exercises, hydrotherapy, physiotherapy, mobilization.
72. CTEV Boot Papers: Aug2019(6266), Aug2025(6266)
Answer: CTEV boot (Denis Brown boots) is specially designed footwear for managing clubfoot (CTEV).
  • Design: High-top boots with curved soles, attached to Dennis Brown bar in external rotation.
  • Use: Maintenance of correction after casting (Ponseti method).
  • Settings: Initially 60-70° external rotation, 10-15° dorsiflexion.
  • Protocol: Worn full-time for 3 months, then 12 hrs/day (night) until age 4 years.
73. Axonotmesis Papers: Aug2019(6266), Aug2025(6266)
Answer: Axonotmesis is a grade II-IV nerve injury (Seddon's classification) where the axons are disrupted but the endoneurium/perineurium remain intact (Sunderland Grade II: axon disrupted, endoneurium intact).
  • Causes: Compression, traction, contusion.
  • Features: Complete loss of motor, sensory, and autonomic functions. Wallerian degeneration occurs distal to injury.
  • Recovery: Spontaneous regeneration at rate of ~1mm/day (or 1 inch/month). Complete recovery expected.
  • Differs from neurotmesis (complete nerve division - requires surgical repair).
74. Dislocation Papers: Feb2020(6266), Aug2025(6266)
Answer: Dislocation is complete displacement of articular surfaces of a joint so that they are no longer in contact.
  • Causes: Trauma (most common), congenital (DDH), pathological (septic arthritis, TB).
  • Types: Anterior, Posterior, Central, Inferior (depending on direction).
  • Features: Pain, deformity, swelling, loss of function, abnormal limb position.
  • Treatment: Prompt reduction (ASAP), followed by immobilization, physiotherapy.
75. Straight Leg Raise (SLR) Test Papers: Feb2020(6266), Aug2025(6266)
Answer: SLR test is used to detect lumbar nerve root irritation (primarily L4, L5, S1).
  • Method: Patient supine, examiner passively raises the leg with knee extended.
  • Positive: Reproduction of patient's familiar radiating leg pain (sciatica) below the knee at <60-70° of hip flexion.
  • A positive SLR between 30-60° is more specific for disc prolapse.
  • Bowstring test (Cram test): Flex the knee slightly to relieve pain, then press on the popliteal fossa (median nerve) - reproduction of pain = positive.
76. Osteomalacia Papers: Aug2019(6266), Aug2024(6266)
Answer: Osteomalacia is defective mineralization of the osteoid matrix in adults (equivalent of rickets in adults).
  • Cause: Vitamin D deficiency, malabsorption, renal failure, anticonvulsant therapy.
  • Features: Bone pain and tenderness (especially pelvis, spine), proximal muscle weakness, waddling gait, pathological fractures, deformity.
  • X-ray: Looser's zones (pseudofractures), reduced bone density, biconcave vertebrae.
  • Lab: Low serum calcium, low phosphate, elevated ALP, low 25-OHD3.
  • Treatment: Vitamin D and calcium supplementation, treat underlying cause.
77. Bursitis Papers: Dec2020(6266), Apr2023(6266)
Answer: Bursitis is inflammation of a bursa (fluid-filled sac that reduces friction between structures).
  • Common sites: Subacromial, prepatellar (housemaid's knee), olecranon (student's elbow), trochanteric, retrocalcaneal, infrapatellar.
  • Causes: Repeated trauma/friction, rheumatoid arthritis, gout, infection (septic bursitis).
  • Features: Localized swelling, warmth, tenderness, restricted movement.
  • Treatment: Rest, ice, NSAIDs, aspiration, steroid injection, surgical bursectomy for chronic cases.
78. SLR (in 2-mark context) Papers: Oct2022(6266), Aug2024(6266) - see answer in #75 above.
79. Arthrodesis Papers: Oct2022(6266), Feb2026(6266)
Answer: Arthrodesis is a surgical procedure to achieve permanent fusion of a joint by removing the articular cartilage and allowing the bones to fuse together.
  • Indications: Painful destroyed joint (infection, TB, OA), unstable joint (polio, neuropathic joint), failed arthroplasty.
  • Common sites: Ankle, wrist, subtalar joint, small joints of foot.
  • Technique: Joint surface removed, bone graft applied, held with internal fixation (screws, plate) until fusion.
  • Advantages: Pain relief, stability. Disadvantages: Loss of motion, adjacent joint OA.
80. Costochondritis Papers: Feb2020(6266), Dec2020(6266)
Answer: Costochondritis (Tietze's syndrome) is inflammation of the costal cartilages at the costochondral junctions.
  • Features: Localized chest wall tenderness at the costochondral/costosternal junction (usually 2nd-5th ribs), reproducible on palpation, no swelling (unlike Tietze's which has swelling).
  • Causes: Trauma, respiratory infections, repetitive minor strain.
  • Treatment: NSAIDs, local heat, rest, physiotherapy, local anaesthetic/steroid injection.

SECTION 2: QUESTIONS ASKED ONLY ONCE (unique questions, all answers)

Below are unique questions with brief answers:
Aeroplane Splint - A static orthosis used for Erb's palsy that holds the shoulder in 90° abduction and external rotation (aeroplane position), preventing adduction contracture while nerve heals.
Apley Scratch Test - Test for shoulder ROM assessment. Patient reaches over head to touch opposite shoulder (tests abduction + ER) and reaches behind back to touch opposite shoulder blade (tests IR + adduction).
Piriformis Syndrome - Entrapment of the sciatic nerve by the piriformis muscle causing buttock pain and sciatica. Diagnosed by FAIR test (Flexion, Adduction, Internal Rotation).
Waddling Gait - Bilateral Trendelenburg gait; alternating trunk sway from side to side during walking due to bilateral hip abductor weakness. Seen in bilateral CDH, bilateral coxa vara, muscular dystrophy.
Three-Point Principles (of casting) - In applying a plaster cast for fractures, three-point pressure is used: one point at the fracture site and two counter-pressure points above and below to maintain reduction.
Apley's Compression Test - Test for meniscal injury. Patient prone, knee 90° flexed. Apply axial compression and rotate tibia. Pain = positive (meniscal tear). Then distract (Apley's distraction) - pain = ligamentous injury.
Hill-Sachs Lesion - Compression fracture (osteochondral defect) of the posterolateral head of the humerus, caused by impaction against the anterior glenoid rim during anterior shoulder dislocation.
Lumbosacral Belt - Rigid or semi-rigid orthosis for lower back support. Provides lumbar lordosis correction, reduces intradiscal pressure, limits flexion/extension. Used in LBP, lumbar disc prolapse, spondylolisthesis.
Mallet's Finger - See answer above (asked 3 times) - DIP flexion deformity due to extensor tendon avulsion.
Deep Vein Thrombosis (DVT) - Formation of blood clot in deep veins, usually in the leg. Features: calf pain, swelling, Homan's sign. Risk after orthopaedic surgery. Diagnosed by Doppler ultrasound. Treated with anticoagulants (heparin → warfarin).
Galeazzi Fracture - Fracture of the distal 1/3 of the radius with dislocation of the distal radioulnar joint (DRUJ). "Fracture of necessity" - always requires surgery (ORIF of radius + DRUJ repair).
Burns and Degrees - Burns classification: 1st degree (epidermal only - erythema), 2nd degree superficial (papillary dermis - blisters, painful), 2nd degree deep (reticular dermis), 3rd degree (full thickness - leathery, insensate), 4th degree (to bone/muscle).
Z-Thumb Deformity - Deformity in Rheumatoid Arthritis: flexion of IP joint of thumb and hyperextension of MCP joint, resembling letter "Z". Due to extensor pollicis brevis laxity and FPL overpull.
Hoffa's Fracture - Coronal fracture of the lateral femoral condyle. Rare intra-articular fracture. Difficult to see on AP X-ray, better on lateral view. Requires ORIF.
PA (Periarthritis) Shoulder - See Periarthritis Shoulder answer above.
Gun Stock Deformity - Same as Cubitus Varus. See answer #46 above.
Brodie's Abscess - A localized chronic bone abscess, sequela of subacute haematogenous osteomyelitis. Seen in metaphysis of tibia. X-ray: round/oval lucency with surrounding sclerosis. Treated with curettage and bone grafting.
Torticollis - See Wry Neck answer (#40 above).
Phantom Limb Pain - Sensation of pain perceived in an amputated limb. Occurs in 60-80% of amputees. Mechanism: cortical reorganization of somatosensory cortex. Treatment: mirror therapy, TENS, medications (amitriptyline, gabapentin), graded motor imagery.
Alkaline Phosphatase - Enzyme present in bone, liver, intestine. In bone: produced by osteoblasts during bone formation. Elevated in: Paget's disease, bone tumors, osteoblastic metastases, healing fractures, rickets, osteomalacia.
Dennis Brown Splint - See answer #47 above.
Scoliosis - Lateral curvature of the spine >10° (Cobb's angle). Types: Idiopathic (most common - 80%), Congenital, Neuromuscular, Degenerative. Treated with observation, bracing (25-40°), surgery (>40-45°).
Ankylosis - Complete fusion/immobility of a joint. Fibrous ankylosis (fibrous tissue, some limited movement) vs bony ankylosis (bone bridges joint, complete immobility). Causes: septic arthritis, TB, RA. Treatment: surgical arthrodesis (if painless) or total joint replacement.
Compression Fracture of Vertebrae - Axial loading causing anterior wedge compression of vertebral body. Common in osteoporosis (T12, L1 most common). Features: sudden back pain, kyphosis. Treatment: analgesia, bracing; vertebroplasty/kyphoplasty for severe cases.
Chronic Synovitis - Persistent inflammation of the synovial membrane of a joint. Causes: RA, gout, pseudogout, tuberculosis, pigmented villonodular synovitis (PVNS). Features: joint swelling, warmth, effusion, morning stiffness. Treatment: depends on cause.
Osteoid Osteoma - Benign bone tumor (<1.5 cm) consisting of nidus of osteoid tissue surrounded by reactive sclerosis. Features: severe night pain relieved by aspirin/NSAIDs. X-ray: small radiolucent nidus with surrounding dense sclerosis. Treatment: radiofrequency ablation or surgical excision.
Taylor Knight Brace (TK Brace) - Thoracolumbar spinal orthosis (TLSO) providing support for the thoracic and lumbar spine. Indications: compression fractures (T11-L4), post-spinal surgery, spondylolisthesis. Limits flexion and lateral bending.
Bisphosphonates - Drugs that inhibit osteoclast activity and bone resorption. Examples: alendronate, risedronate, zoledronic acid. Uses: osteoporosis, Paget's disease, bone metastases, osteogenesis imperfecta. Side effects: osteonecrosis of jaw, atypical femoral fractures.
Pointing Index - Loss of ability to point with the index finger. Occurs in anterior interosseous nerve (AIN) palsy (branch of median nerve). AIN supplies FDP to index, FPL, pronator quadratus. Patient cannot form "O" sign.
Coin Test - A test for spinal (thoracic) cord lesion. Patient holds a coin between extended fingers; inability to hold indicates loss of proprioception/grip. Also used to detect sensory level in spinal cord injury.
Dinner Fork Deformity - The lateral profile of wrist in Colles' fracture resembles a fork placed face down at a dinner table. Dorsal displacement and angulation of distal radius fragments creates this characteristic appearance.
Skin Traction - Traction applied to skin (via adhesive tapes, foam) to indirectly pull on bone. Maximum 5-7 lbs to avoid skin complications. Examples: Buck's traction (lower extremity), Russell's traction, Gallows traction (children). Used for temporary immobilization, reduction of deformity.
Dorsiflexion Test - Test for Achilles tendon integrity / Simmonds-Thompson test (calf squeeze test). Patient prone, knee bent - squeeze calf, foot should dorsiflex. Absence of dorsiflexion = complete Achilles tendon rupture.
Bumper Injury - Pedestrian injury caused by impact of vehicle bumper, typically striking the knee area. Causes: tibial plateau fracture (lateral most common), collateral ligament injury, peroneal nerve injury. Also called "fender fracture."
Thompson Test - Simmonds-Thompson test for Achilles tendon rupture. Patient prone with feet hanging over edge of table. Squeeze calf muscle - normal: plantar flexion of foot. Positive (no movement): complete Achilles tendon rupture.
Neuropraxia - See answer #11 above.
Knock Knee - See Genu Valgum answer #10 above.
Ischemic Contracture - Volkmann's Ischemic Contracture (see answer #61).
Jumper's Knee (Patellar Tendinitis) - Inflammation/degeneration of the patellar tendon at its proximal attachment to inferior pole of patella. Caused by repetitive jumping. Features: anterior knee pain below patella, tender inferior pole. Treatment: eccentric exercises, physiotherapy, PRP, surgery.
Z-Plasty - Surgical technique to lengthen a scar or release a contracture. Two triangular flaps are created at the ends of a central limb of the "Z", then transposed. Net effect: lengthening of the contracted direction by 75% (for standard 60° Z-plasty). Used for linear scars, web contractures.
Boxer's Fracture - See answer #6 above.
Vertical Talus - See answer #35 above.
MCMurrey Test - See answer #53 above.
Piriformis Syndrome - See above.
Waddling Gait - See above.
Scapulohumeral Rhythm - The coordinated movement between the scapula and humerus during shoulder abduction. For every 2° of glenohumeral movement, there is 1° of scapular rotation. Total 180° abduction = 120° glenohumeral + 60° scapulothoracic (2:1 ratio).
Hypothenar Muscles of Hand - 4 muscles: Abductor digiti minimi, Flexor digiti minimi brevis, Opponens digiti minimi, Palmaris brevis. All supplied by deep branch of ulnar nerve (C8, T1). Perform abduction, flexion, and opposition of little finger.
Guillotine Amputation - Emergency amputation where the limb is cut straight across without creating skin flaps. Done in contaminated wounds, gas gangrene. Wound left open, formal amputation with stump closure done later (second stage).
Z-Thumb Deformity - See above.
Ely's Test - See answer #20 above.
Q-Angle - See answer #17 above.
Genu Valgum - See answer #10 above.
Bunion - Bony prominence at medial aspect of 1st MTP joint in hallux valgus, covered by bursa. Caused by chronic pressure of ill-fitting footwear. Treatment: protective padding, wider shoes, surgical correction.
External Rotators of Hip - 6 short rotators: Piriformis, Obturator internus, Obturator externus, Gemellus superior, Gemellus inferior, Quadratus femoris. Supplied by sacral plexus branches. Also: Gluteus maximus contributes to external rotation.
Monteggia Fracture - Fracture of proximal 1/3 of ulna with dislocation of radial head. Bado classification (Types I-IV based on direction of radial head dislocation). Treatment: ORIF of ulna + closed reduction of radial head.
Triple Dislocation - Simultaneous dislocation of the midtarsal, subtalar, and ankle joints. Very rare, caused by severe violent trauma.
Hugh Owen Thomas - Pioneer of orthopaedic surgery in UK. Invented Thomas splint for immobilization of femur fractures. "Rest is the cardinal remedy." Thomas collar, Thomas test (for hip flexion contracture - flatten lumbar lordosis, any hip flexion = contracture).
Thomas Test - Detects hip flexion contracture. Patient supine, flex opposite hip to flatten lumbar lordosis. Affected hip rises = hip flexion contracture present. Degree of rise = degree of contracture.
Reflex Grading - Medical Research Council scale: 0 = absent, 1+ = diminished, 2+ = normal, 3+ = increased, 4+ = clonus. Hyperreflexia = UMN lesion. Hyporeflexia = LMN lesion or peripheral neuropathy.
Apprehension Sign - Test for recurrent anterior shoulder dislocation. Externally rotate and abduct shoulder (90°) with elbow flexed. Patient becomes apprehensive/tenses up fearing dislocation = positive. Relocation test (posterior pressure relieves apprehension) confirms.
Ober's Test - Tests for IT band (iliotibial band) tightness. Patient side-lying, affected side up. Hip extended, abducted, then adducted. If leg does not drop to table = IT band tightness.
Coxa Vera - Another term for Coxa Vara (see #43 above).
Taylor's Brace - A dorsolumbar corset providing support to T6-L3 vertebrae. Rigid metal uprights with horizontal bands. Used for thoracolumbar fractures, scoliosis, kyphosis.
Bankart Lesion - Avulsion of the anteroinferior labrum and capsule from the glenoid rim following anterior shoulder dislocation. The essential lesion of recurrent anterior shoulder instability. Bankart's repair = surgical reattachment of the labrum.
Pseudogout (Calcium Pyrophosphate Deposition - CPPD) - Crystal arthropathy caused by calcium pyrophosphate dihydrate (CPPD) crystals. Features: acute joint inflammation similar to gout, usually knees. X-ray: chondrocalcinosis. Synovial fluid: weakly positive birefringent rhomboid crystals.
Dupuytren's Contracture - See answer #62 above.
Entrapment Neuropathy - Nerve compression at specific anatomical sites. Examples: CTS (median at wrist), cubital tunnel (ulnar at elbow), radial tunnel (radial at lateral elbow), tarsal tunnel (posterior tibial), Morton's metatarsalgia (digital nerve). Features: pain, paraesthesia, weakness in nerve distribution.
Smith's Fracture - See answer #26 above.
Trendelenburg Gait - Abnormal gait due to hip abductor weakness (gluteus medius/minimus). During single-leg stance on affected side, pelvis drops to opposite side. Body compensates by lurching trunk over affected hip. Positive Trendelenburg test.
Sprengel's Shoulder - Congenital elevation of the scapula due to failure of scapular descent during fetal development (normally descends from C4 to T7-T8 level). Features: small elevated scapula, restricted shoulder abduction. May have omovertebral bone. Treatment: surgical (Woodward procedure).
Scapular Winging - Prominence of the medial border of the scapula away from the chest wall. Long thoracic nerve (serratus anterior) injury causes classic medial scapular winging. Trapezius palsy causes lateral winging.
Nursemaid Elbow (Pulled Elbow) - Subluxation of the radial head in children (1-4 years) due to sudden pull on the arm. The annular ligament becomes partially entrapped. Child holds elbow slightly flexed and refuses to use arm. Treated by supination and flexion of elbow (reduces spontaneously with audible/palpable click).
Boutonniere Deformity - Finger deformity: PIP joint flexion + DIP joint hyperextension. Caused by central slip disruption of extensor tendon at PIP joint (RA most common). Lateral bands slip volar to PIP axis. Treatment: PIP extension splint, surgical reconstruction.
Prosthesis - Artificial device replacing a missing body part. In orthopaedics: artificial limb. Types: endo-prosthesis (internal - hip/knee replacement), exo-prosthesis (external - artificial leg). Requirements: lightweight, durable, cosmetic, functional.
Pelvic Tilt - Anterior pelvic tilt (pelvis tips forward, lumbar hyperlordosis), Posterior pelvic tilt (pelvis tips backward), Lateral pelvic tilt (one iliac crest higher). Used as compensatory mechanism or pathological finding.
Paget's Disease - Chronic metabolic bone disorder with abnormal bone turnover (excessive osteoclastic resorption followed by disorganized osteoblastic formation). Features: bone pain, deformity (bowing of tibia), pathological fractures, skull enlargement, elevated ALP. Treated with bisphosphonates.
Avulsion Fracture - Fracture caused by sudden forceful muscle/tendon/ligament pull that tears off a fragment of bone at the insertion. Examples: medial epicondyle avulsion, tibial tubercle avulsion, 5th metatarsal (peroneus brevis avulsion - "Jones-type").
Tendinitis - Inflammation of a tendon. Features: localized pain, tenderness, swelling along tendon, pain on resisted movement and stretching. Common: supraspinatus tendinitis, patellar tendinitis, Achilles tendinitis. Treatment: rest, ice, NSAIDs, physiotherapy, PRP.
Risser Sign - Radiological sign used to assess skeletal maturity in scoliosis management. Graded 0-5 based on the amount of iliac apophyseal ossification (0 = no ossification; 5 = fusion of apophysis to iliac crest = skeletal maturity). Used to predict scoliosis progression risk.
Pawlik Harness - Dynamic abduction orthosis used for treatment of DDH (Developmental Dysplasia of Hip) in infants <6 months. Holds hips in flexion and abduction (human position). Promotes acetabular development.
Round Back - Increased thoracic kyphosis. Postural round back = flexible, corrects on extension. Structural = rigid (Scheuermann's disease).
Rotator Cuff Special Tests - Supraspinatus: Empty can test (Jobe's), Full can test; Infraspinatus/Teres minor: External rotation lag test; Subscapularis: Lift-off test (Gerber), Napoleon test, Bear-hug test; Impingement: Neer's, Hawkins-Kennedy.
Types of Fractures - Complete (transverse, oblique, spiral, comminuted, segmental) vs Incomplete (greenstick, torus/buckle, stress). By communication: open/compound vs closed. By mechanism: compression, avulsion, pathological.
Radiological Features of Colles' Fracture - X-ray: dorsal displacement and angulation of distal radial fragment, loss of normal volar tilt (normal 11-12° → reversed to dorsal tilt), loss of radial inclination (normal 23° → reduced), radial shortening, impaction. Dinner fork deformity.
Pen Test (for nerve injury) - Patient unable to uncap a pen using the affected hand. Specifically tests for anterior interosseous nerve (AIN) palsy - inability to flex DIP of index finger and IP of thumb (cannot form "O" sign). Also called "O-sign."
Genu Recurvatum - See answer #7 above.
Repetitive Stress Injury (RSI) - Cumulative trauma disorder from repeated microtrauma to musculoskeletal structures. Examples: carpal tunnel syndrome, tennis elbow, de Quervain's tenosynovitis. Features: pain, tenderness, reduced function. Prevention: ergonomic modifications.
Mallet Thumb - Flexion deformity of the IP joint of the thumb due to disruption of extensor pollicis longus (EPL) at its insertion on the distal phalanx. Treatment: splinting in extension.
Green Stick Fracture - See answer #22 above.
Bankart's Repair - Surgical procedure for recurrent anterior shoulder dislocation. Reattachment of the detached anteroinferior labrum (Bankart lesion) to the anterior glenoid rim using suture anchors. Restores labral bumper and capsular tension.
Prone Knee Bend Test - Femoral nerve stretch test for L2, L3, L4 nerve root irritation. Patient prone, examiner flexes knee passively. Positive: pain radiating to front of thigh/buttock.
Golfer's Elbow (Medial Epicondylitis) - Tendinopathy at the origin of flexor-pronator mass at medial epicondyle. Features: medial elbow pain, tenderness over medial epicondyle, pain on resisted wrist flexion/forearm pronation. Treatment: rest, physiotherapy, steroid injection, surgery.
Jefferson's Fracture - Burst fracture of the C1 (atlas) ring. Caused by axial loading (diving into shallow water). The ring breaks in 3-4 places, typically benign neurologically (canal widens). Diagnosed on open mouth view X-ray (lateral mass displacement), CT scan. Treatment: cervical orthosis or halo vest.
Osteoblastoma - Benign bone tumor >2 cm (larger version of osteoid osteoma). Features: aching pain (not relieved by aspirin unlike osteoid osteoma), common in spine posterior elements, large enough to be seen on plain X-ray. Treatment: surgical excision/curettage.
C Splint - "C" shaped orthosis for the thumb, maintaining the first web space and opposition post. Used after median nerve injury, thumb ray injuries, de Quervain's.
Rickets - Defective mineralization of growing bone in children due to Vitamin D deficiency (or calcium/phosphate deficiency). Features: craniotabes, rachitic rosary (costochondral beading), Harrison's sulcus, bow legs (genu varum), widened metaphyses, Looser's zones. Treatment: Vitamin D and calcium.
Extensor Zones of Hand - Verdan's classification (8 zones): Zone I (DIP), II (middle phalanx), III (PIP), IV (proximal phalanx), V (MCP), VI (metacarpal), VII (wrist - extensor retinaculum), VIII (distal forearm). Thumb has its own zones (TI-TV).
Deltoid Fibrosis - Fibrosis of deltoid muscle causing restriction of shoulder abduction and/or adduction. Causes: repeated injections into deltoid in childhood (common in India), trauma. Treatment: surgical release.
Complications of Patellectomy - Quadriceps weakness, loss of knee extension power, OA of knee joint, extensor lag, instability, pain.
Levels of Upper Limb Amputation - Forequarter → Shoulder disarticulation → Above elbow (transhumeral) → Elbow disarticulation → Below elbow (transradial) → Wrist disarticulation → Transcarpal → Transmetacarpal → Digital.
Claw Hand - Hyperextension of MCP joints + flexion of IP joints. Ulnar claw = ring + little fingers (ulnar nerve palsy - intrinsic minus). Median nerve = index + middle. Complete (all 4 fingers) = combined median + ulnar palsy.
Prepatellar Bursitis - Inflammation of the bursa between skin and patella ("housemaid's knee"). Caused by repeated kneeling. Features: fluctuant swelling over patella, pain, restricted flexion. Treatment: aspiration, steroid injection, surgical bursectomy.
TB Spine (Pott's spine) Features - Fever, night sweats, weight loss; back pain; kyphosis/gibbus deformity; cold (psoas) abscess; paraplegia (Pott's paraplegia); vertebral body destruction on X-ray (disc space loss, vertebral wedging).
Barton Fracture - See answer #56 above.
Cozen's Test - See answer #15 above.
Non-Union - See answer #44 above.
Ganslén's Test - Test for sacroiliac joint pathology. With patient supine, apply lateral compression to both iliac crests simultaneously. Pain in SI joint = positive.
Fracture Classification - Numerous systems: AO/OTA (comprehensive), Salter-Harris (epiphyseal), Gustilo (open), Garden (neck of femur), Neer (proximal humerus), Lauge-Hansen (ankle). General: complete/incomplete, open/closed, stable/unstable, simple/comminuted.
Pott's Fracture - See answer #70 above.
Cross Union - Abnormal bony union between the radius and ulna after fractures of both bones (synostosis). Prevents forearm rotation. Risk factors: high-energy injury, single incision approach, inadequate initial reduction, delay in fixation.
Arthroplasty - See answer #27 above.
Costochondritis - See answer #80 above.
Neuropraxia - See answer #11 above.
Delayed Union - See answer #13 above.
Carpal Bones - See answer #52 above.
Compartmental Syndrome - Increased pressure within a closed fascial compartment compromising blood flow to muscles and nerves. Features: the "6 P's" - Pain (worst; disproportionate), Pressure (on palpation), Paresthesia, Paralysis, Pallor, Pulselessness (late). Emergency treatment: fasciotomy.
Klippel-Feil Syndrome - Congenital fusion of 2 or more cervical vertebrae. Features: Short neck, low posterior hairline, restricted cervical ROM (classic triad). Associated with scoliosis, Sprengel's shoulder, renal anomalies.
Resting Position of Hand - Position of hand when all wrist and finger muscles are relaxed: wrist 10-15° extension, MCP 40-45° flexion, IP joints slightly flexed, thumb in partial opposition. This is the intrinsic plus position for splinting to prevent deformity.
Egawa Test - Test for intrinsic muscle function of the hand (interossei). Patient abducts and adducts the middle finger. Inability indicates intrinsic muscle weakness (ulnar nerve palsy).
Tabes Dorsalis - Degeneration of the dorsal columns and dorsal nerve roots due to tertiary syphilis. Features: lightning pains, loss of proprioception, ataxia, Charcot's joints, Romberg's sign positive, Argyll Robertson pupils.
Ankle Foot Orthosis (AFO) - Orthosis covering the foot and ankle, extending to below the knee. Indications: foot drop (peroneal nerve palsy), post-stroke, post-polio, cerebral palsy. Types: solid AFO, hinged AFO, posterior leaf spring.
Nerve Graft - Surgical bridging of a nerve gap using a donor nerve segment. Used when direct repair is not possible (gap >2.5 cm) or excessive tension. Donor: sural nerve, medial cutaneous nerve of forearm. Results better with shorter gaps and younger patients.
Pelvic Harness (Lorenz Splint) - See Pawlik Harness (similar concept) - holds hips in abduction for DDH treatment.
Scurvy - Vitamin C deficiency causing collagen synthesis failure. Bone changes: subperiosteal hemorrhage, metaphyseal spurs (Pelkan spurs), corner sign/Trümmerfeld zone, ground glass osteoporosis. Ring scurvy appearance on X-ray.
Radial Club Hand - Congenital longitudinal deficiency of the radius. Features: short/absent radius, radial deviation of hand, thumb hypoplasia/absence. Treatment: centralization of wrist on ulna, pollicization.
Segmental Fracture - Fracture with two complete fracture lines creating an isolated "floating" fragment of bone in the middle. The middle segment has no soft tissue attachment. High energy injury, difficult to treat, high risk of non-union/delayed union.
Speed Test - Bicipital tendon test (bicipital groove). Patient flexes shoulder 60-90° with elbow extended and forearm supinated against resistance. Pain in bicipital groove = positive (long head of biceps pathology).
Night Stick Fracture - Isolated fracture of the ulnar shaft (diaphysis) caused by a direct blow to the ulna (e.g., raising the arm to ward off a blow - as if blocking with a nightstick). Usually treated with long arm cast if minimally displaced; ORIF if >10° angulation or >50% displacement.
Thomas Splint - Ring splint for the thigh/femur. The ring sits over the ischial tuberosity, and the leg is attached with canvas slings. Used for immobilization of femoral shaft fractures (especially for transportation), traction of hip.
Rotator Cuff Tear - Tear of one or more tendons of the rotator cuff (supraspinatus most common). Features: shoulder pain, weakness of abduction/rotation, drop arm sign. Diagnosed by MRI. Treatment: physiotherapy (partial tears), surgical repair (complete tears).
CT Scan - Computerized Tomography provides cross-sectional bone images. Superior for: bony detail, comminuted fractures, acetabular fractures, spinal fractures, tumour extent. Not as good as MRI for soft tissue. Radiation dose higher than X-ray.
Tenosynovitis - See answer #25 above.
Calcaneal Spur - Bony outgrowth from the calcaneus, usually at the plantar fascial attachment (inferior spur) or Achilles tendon attachment (posterior spur). Inferior spur associated with plantar fasciitis. X-ray shows spike of bone. Treated with heel pads, physiotherapy, steroid injection, surgical excision.
Sprain vs Strain - Sprain = injury to a ligament (stretching/tearing of ligament). Strain = injury to a muscle or tendon (stretching/tearing). Graded I-III based on severity.
Triple Nerve Palsy - Palsy of median, ulnar, and radial nerves together. Results in complete hand paralysis (both intrinsic and extrinsic muscles). Very disabling - "useless hand." Rare, occurs with high brachial plexus injuries or combined nerve injuries.
MRI - Magnetic Resonance Imaging. Best for soft tissue: meniscal tears, ligament injuries, rotator cuff tears, spinal cord pathology, AVN, stress fractures, tumors. No radiation. Contraindicated with metallic implants (relative), pacemakers.
Stump - Residual limb after amputation. Ideal stump: adequate length (lower third thigh/upper third leg), cone shaped, non-adherent healed scar, good padding, no bone spurs, mobile joints proximally.
Jefferson's Fracture - See above.
Phalen's Test - See answer #67 above.
Smith Fracture - See answer #26 above.
Cortical Bone - Dense compact bone forming the outer shell of long bones. 80% of skeletal mass. Features: Haversian system (osteons), slow metabolic turnover. Provides strength for bending and torsional forces. Compared to cancellous bone (trabecular, inner, metabolically active).
Bamboo Spine - See answer #1 above.
Myositis Ossificans - See answer #60 above.
Paget's Disease - See above.
Cubitus Valgus - Increased carrying angle of elbow (>15° in females, >10° in males). Causes: lateral condyle fracture malunion, rickets. Features: tardy ulnar nerve palsy (late cubital tunnel compression), cosmetic deformity.
Glenohumeral Rhythm - See Scapulohumeral Rhythm above.
Subluxation vs Dislocation - See answer #5 above.
Cobb's Angle - See answer #2 above.
Trendelenburg Gait - See above.
Madelung's Deformity - See answer #14 above.
Arches of Foot - 3 arches: Medial longitudinal arch (most important; talus, calcaneus, navicular, cuneiforms, 1st-3rd metatarsals - supported by plantar fascia, tibialis posterior, FHL, spring ligament), Lateral longitudinal arch (calcaneus, cuboid, 4th-5th metatarsals), Transverse arch (bases of metatarsals + cuneiforms + cuboid).
Mallet Finger - See answer #23 above.
Ulnar Claw Hand - Clawing of ring and little fingers due to ulnar nerve palsy (intrinsic minus). MCP hyperextension + IP flexion in ring and little fingers. Ring finger more clawed than little (due to FDP; little has weaker FDP by median nerve).
Tinel Sign - See answer #55 above.
Froment's Sign - Test for ulnar nerve palsy (specifically adductor pollicis weakness). Patient holds a paper between thumb and index finger. Examiner pulls paper away. Positive: patient flexes the IP joint of the thumb (using FPL via median nerve) to compensate for weak adductor pollicis (ulnar nerve).
Arthrodesis - See answer #79 above.
Coxa Magma - Enlargement of the femoral head (mushrooming of femoral head). Occurs as a sequela of Perthes disease, slipped upper femoral epiphysis (SUFE), avascular necrosis. The oversized head no longer fits the acetabulum properly.
Sprain - Injury to a ligament from sudden overstretching. Grade I: stretched (no tears), Grade II: partial tear, Grade III: complete tear. Features: pain, swelling, ecchymosis, instability (Grade III). Treatment: RICE (Rest, Ice, Compression, Elevation), physiotherapy.
Jones Fracture - Transverse fracture of the base of the 5th metatarsal at the metaphyseal-diaphyseal junction (Zone 2-3). Prone to non-union due to poor blood supply. Treated with non-weight bearing cast (conservative) or intramedullary screw (athletes).
Biceps Tendinitis - Inflammation of the long head of biceps tendon in the bicipital groove. Features: anterior shoulder pain (worse with supination and flexion), Speed test/Yergason's test positive, tender in bicipital groove. Treatment: physiotherapy, steroid injection, tenotomy/tenodesis.
Lordosis - Anterior (concave posterior) curvature of the spine. Normal in cervical and lumbar regions. Abnormal hyperlordosis: lumbar hyperlordosis due to obesity, pregnancy, hip flexor contracture, weak core. Features: exaggerated lumbar curve, anterior pelvic tilt, "sway back."
Adhesive Capsulitis - See Periarthritis Shoulder above.
Arthrogryposis (Arthrogryposis Multiplex Congenita) - Multiple congenital joint contractures in ≥2 different body areas at birth. Cause: fetal akinesia (reduced fetal movement in utero). Involves rigid joints with muscle fibrosis. Treatment: serial casting, physiotherapy, surgical releases.
Axonotmesis - See answer #73 above.
Fracture Disease - See answer #71 above.
CTEV Boot - See answer #72 above.
Dislocation - See answer #74 above.
Pen Test - See above.
Sprain - See above.
Coxa Magma - See above.
Dupuytren's Contracture - See answer #62 above.
Smith's Fracture - See answer #26 above.
Define Lordosis - See above.
Night Stick Fracture - See above.
Radiological Features of Ankylosing Spondylitis - Bamboo spine, syndesmophytes, squaring of vertebral bodies, fusion of sacroiliac joints (earliest finding), romanus lesion (anterior corner erosions), "shining corner" sign, atlantoaxial subluxation.
Froment's Sign - See above.

SUMMARY TABLE: Most Repeated Questions

#QuestionTimes Asked
1Bamboo Spine6
2Cobb's Angle5
3Painful Arc Syndrome5
4Erb's Palsy5
5Dislocation vs Subluxation4
6Boxer's Fracture4
7Genu Recurvatum4
8Hallux Valgus4
9Swan Neck Deformity4
10Genu Valgum4
11Neuropraxia3
12Hangman's Fracture3
13Delayed Union3
14Madelung's Deformity3
15Cozen's Test3
16Metatarsalgia3
17Q Angle3
18Cold Abscess3
19Erb's Point3
20Ely's Test3
21Trigger Finger3
22Green Stick Fracture3
23Mallet Finger3
24Bennett's Fracture3
25Tenosynovitis3
26Smith's Fracture3
27Arthroplasty3
All questions asked 2 times are included in the answer section above.
Important notes for your exam:
  • Sub code 6284 = 3rd Year paper (2017-2018 batch onwards), papers from 2020 to 2026
  • Sub code 6266 = 4th Year paper (admitted up to 2016-2017), papers from 2011 to 2026
  • Both are the same subject (Clinical Orthopaedics) under different regulations - that's why questions repeat across them
  • Bamboo spine, Cobb's angle, Painful arc syndrome, and Erb's palsy are your highest priority 2-mark answers - study these firstHere is a complete summary of everything I found from both your question papers:

What I Analyzed

  • PDF 1 (Sub Code 6284) - 3rd Year Clinical Orthopaedics: 10 papers (Dec 2020 to Feb 2026) = 100 questions
  • PDF 2 (Sub Code 6266) - 4th Year Clinical Orthopaedics: 29 papers (Aug 2011 to Feb 2026) = 290 questions
  • Total 2-mark questions across both papers: ~390
  • Repeated questions found: 81 (asked in 2 or more years)

Top Priority Questions (Most Repeated)

RankQuestionTimes Asked
🔴 1Bamboo Spine6 times
🔴 2Cobb's Angle5 times
🔴 3Painful Arc Syndrome5 times
🔴 4Erb's Palsy5 times
🟠 5Dislocation vs Subluxation4 times
🟠 6Boxer's Fracture4 times
🟠 7Genu Recurvatum4 times
🟠 8Hallux Valgus4 times
🟠 9Swan Neck Deformity4 times
🟠 10Genu Valgum4 times
All answers are written in full detail above - including all 2-mark questions asked only once. The answers are written at the appropriate 2-mark level (concise but complete). Good luck with your exams!
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