Osce practical in Orthopedic and Trauma medicine

Asking for Preferences

Reading File

Finding Sources

Searching the Web

OSCE orthopedic trauma medical student stations checklist examination fractures

Finding Sources

Reading File

Finding Sources

Reading File

Here is your complete Orthopedic & Trauma OSCE preparation guide for MBBS/MD level, covering study notes, practice stations, and examiner mark schemes.

Orthopedic & Trauma Medicine - OSCE Preparation Guide

MBBS/MD Level | Study Notes + Practice Stations + Mark Schemes

PART 1: CORE PRINCIPLES - HIGH-YIELD NOTES

1. THE UNIVERSAL APPROACH TO ANY FRACTURE

Every OSCE examiner expects you to follow this systematic framework regardless of which bone is fractured.

LOOK - FEEL - MOVE (+ Special Tests + Neurovascular)

History Framework (SOCRATES + Mechanism)

Point	What to Ask
Site	Which bone / joint?
Onset	Sudden (trauma) vs. gradual (stress fracture)
Character	Type of pain - sharp, aching, throbbing
Radiation	Down limb? Nerve territory?
Associated	Swelling, deformity, inability to weight-bear
Time	When did it happen? First time?
Exacerbating	Weight bearing, movement
Severity	Pain score, ability to function
Mechanism	Fall on outstretched hand (FOOSH)? Twisting? High vs. low energy? Direct vs. indirect?
Neurovascular	Pins & needles, weakness, colour changes

2. THE 6 Ps OF VASCULAR COMPROMISE (must know cold)

Memorise as: "Pain, Pallor, Pulselessness, Paraesthesia, Paralysis, Poikilothermia (Perishingly cold)"

Pain - especially pain out of proportion to injury, or pain on passive stretch of muscles (key sign of compartment syndrome)
Pallor - white/dusky skin distal to injury
Pulselessness - absent or diminished distal pulses (compare sides)
Paraesthesia - numbness/tingling in dermatome/nerve territory distal to injury
Paralysis - inability to move distal muscles (late sign)
Poikilothermia - cold limb compared with contralateral side

Source: ROSEN's Emergency Medicine, Compartment Syndrome section

3. COMPARTMENT SYNDROME - OSCE RED FLAG

Compartment syndrome is a true orthopaedic emergency. Have a high index of suspicion for:

Crush injuries
Tibial shaft fractures (most common)
Forearm fractures
Any fracture with a tight cast

Classic presentation:

Pain out of proportion to injury
Pain on passive stretch of compartment muscles
Tense, woody feel of the compartment
Paraesthesia in the nerve running through the compartment

Management: Immediate fasciotomy - do not delay. Remove all circumferential dressings first.

Source: ROSEN's Emergency Medicine & Campbell's Operative Orthopaedics 15th Ed 2026

4. X-RAY INTERPRETATION FRAMEWORK

ABCDS system:

A - Alignment (bones in normal alignment? Dislocated?)
B - Bones (cortical breaks, density changes, lucent lines)
C - Cartilage (joint space - narrowed, widened?)
D - Density changes (sclerosis = stress/healing; lytic = pathological?)
S - Soft tissue (swelling, fat-pad signs, foreign bodies)

Always state:

Type of X-ray (AP/lateral/oblique), date, patient name
Adequacy (two views? two joints for long bones?)
"I can see a fracture of the [bone] that is [transverse/spiral/oblique/comminuted], [displaced/undisplaced], [open/closed], at the [proximal/mid/distal] third"

Fracture patterns:

Pattern	Mechanism	Example
Transverse	Direct blow / bending force	Tibial shaft
Spiral	Twisting / torsion	Tib-fib (running injury)
Oblique	Axial loading + angulation	Femoral shaft
Comminuted	High-energy	Tibial plateau
Avulsion	Muscle/ligament pull	Lateral malleolus
Pathological	Minimal trauma on diseased bone	Metastasis, osteoporosis
Stress/Insufficiency	Repetitive loading	2nd metatarsal, tibia
Greenstick	Children (incomplete)	Radius/ulna

Source: Rockwood and Green's Fractures in Adults, 10th ed 2025 - Classification section

PART 2: JOINT-BY-JOINT EXAMINATION CHECKLISTS

SHOULDER EXAMINATION CHECKLIST

LOOK: Muscle wasting (deltoid, supraspinatus, infraspinatus), asymmetry, swelling, scars, skin changes, deformity (step deformity in AC joint injury, anterior fullness in glenohumeral dislocation, squared-off deltoid in shoulder dislocation)

FEEL: Sternoclavicular joint -> clavicle -> AC joint -> coracoid -> greater tuberosity -> bicipital groove -> posterior joint line -> spine of scapula. Note temperature, tenderness.

MOVE (Active then Passive):

Abduction: 0-180° (painful arc = 60-120° suggests subacromial impingement)
Forward flexion: 0-180°
Extension: 0-60°
External rotation (arm at side): 0-90°
Internal rotation (hand behind back to which vertebral level)

Special Tests:

Test	Positive Finding	Significance
Neer's	Pain on passive forward flexion with arm pronated	Subacromial impingement
Hawkins-Kennedy	Pain on passive internal rotation at 90° flexion	Subacromial impingement
Empty Can (Jobe's)	Weakness on resisted abduction at 30° forward flexion	Supraspinatus tear
External rotation lag sign	Cannot maintain externally rotated position	Infraspinatus/teres minor tear
Speed's test	Pain with resisted forward flexion at 90° (elbow straight, forearm supinated)	Long head biceps pathology
Yergason's	Pain in bicipital groove on resisted supination with elbow at 90°	Biceps tendon pathology
Apprehension test	Apprehension with anterior force applied to posterior shoulder	Anterior instability
Load-and-shift	Assess anterior/posterior translation	Instability
Sulcus sign	Inferior subluxation with downward traction on arm	Multi-directional instability
Cross-body adduction	Pain at AC joint	AC joint pathology

ELBOW EXAMINATION CHECKLIST

LOOK: Carrying angle (cubitus valgus > 15° females, > 10° males - abnormal), swelling in olecranon bursa, medial/lateral epicondyle prominence

FEEL: Medial epicondyle -> lateral epicondyle -> radial head (rotate forearm) -> olecranon -> cubital tunnel

MOVE:

Flexion-extension: 0-145°
Pronation-supination: 90°/90°

Special Tests:

Test	Positive Finding	Significance
Cozen's (lateral epicondyle)	Pain at lateral epicondyle on resisted wrist extension	Tennis elbow (lateral epicondylitis)
Mill's	Pain at lateral epicondyle on passive wrist flexion	Tennis elbow
Golfer's elbow test	Pain at medial epicondyle on resisted wrist flexion	Medial epicondylitis
Valgus stress test	Medial pain/laxity at 30° flexion	MCL injury
Varus stress test	Lateral pain/laxity	LCL injury
Tinel's at cubital tunnel	Paraesthesia in ring/little finger	Ulnar nerve entrapment

WRIST & HAND EXAMINATION CHECKLIST

LOOK: Anatomical snuffbox swelling (scaphoid fracture), FOOSH mechanism - think scaphoid!

Special Tests for Wrist:

Test	Positive	Significance
Anatomical snuffbox tenderness	Pain at snuffbox	Scaphoid fracture (treat as such even if X-ray normal - risk of AVN)
Scaphoid tubercle tenderness	Pain at tuberosity	Scaphoid fracture
Watson's (scaphoid shift)	Clunk on radial deviation	Scaphoid instability
Finkelstein's	Pain at radial styloid with ulnar deviation of fist	De Quervain's tenosynovitis
Piano key sign	Springing of ulnar head	DRUJ instability
Tinel's at wrist	Paraesthesia in median nerve distribution	Carpal tunnel syndrome
Phalen's	Paraesthesia in 60 seconds	Carpal tunnel syndrome

Scaphoid Fracture - Key OSCE fact:

X-ray may be normal in up to 20% of cases. If clinical suspicion is high (snuffbox tenderness + mechanism = FOOSH), treat as scaphoid fracture and immobilise. MRI or repeat X-ray at 10-14 days is the gold standard. Risk of avascular necrosis if missed.

HIP EXAMINATION CHECKLIST

Patient positioning: Supine, then lateral decubitus for Trendelenburg, then standing

LOOK: Gait (antalgic = short stance phase on painful side; Trendelenburg gait = pelvis drops to contralateral side due to abductor weakness), limb length discrepancy (true vs. apparent), rotational deformity

FEEL: Greater trochanter, anterior joint (inguinal region), ASIS

MOVE:

Flexion: 0-120°
Extension (in prone or Thomas test position): 0-30°
Abduction: 0-45°
Adduction: 0-30°
Internal rotation: 0-45°
External rotation: 0-45°

Special Tests:

Test	Positive	Significance
Thomas test	Opposite hip flexes when tested hip is fully flexed (reveals fixed flexion deformity)	FFD of hip
FABER/Patrick's	Hip pain on Flexion-ABduction-External Rotation	Hip pathology, SI joint pathology
FADIR	Hip pain on Flexion-ADduction-Internal Rotation	Femoroacetabular impingement (FAI), labral tear
Trendelenburg test	Pelvis drops on non-weight-bearing side when standing on one leg	Abductor (gluteus medius) weakness / superior gluteal nerve palsy
Log roll	Pain on passive internal/external rotation	Hip joint pathology

Neck of Femur (NOF) Fracture - Classic OSCE presentation:

Elderly female, osteoporosis, fall
Leg: shortened, externally rotated, unable to straight-leg raise
Garden classification: I = incomplete/valgus impacted; II = complete undisplaced; III = complete partial displacement; IV = complete full displacement
Management: surgical (hemiarthroplasty for displaced intracapsular; DHS for extracapsular)

KNEE EXAMINATION CHECKLIST

LOOK: Varus/valgus alignment, quadriceps wasting (measure at 10-15 cm above knee), effusion (patellar tap, bulge sign), scars, swelling

Effusion tests:

Bulge sign (sweep test): Stroke fluid from medial to lateral gutter, then medial stroke gives bulge - detects small effusions
Ballottement/Patellar tap: Press patella down - tap suggests moderate-large effusion

FEEL: Joint line (medial then lateral), tibial tubercle, patellar edges, MCL, LCL, popliteal fossa for Baker's cyst

MOVE:

Flexion: 0-140°
Extension: 0° (hyperextension to -10° is normal in some)

Special Tests:

Test	Positive	Significance
Lachman's (most sensitive)	Soft/absent endpoint with anterior tibial translation at 20-30° flexion	ACL tear
Anterior Drawer	Anterior tibial translation at 90°	ACL tear
Posterior Drawer	Posterior tibial translation at 90°	PCL tear
Valgus stress test (at 30° and 0°)	Medial pain/laxity	MCL injury
Varus stress test (at 30° and 0°)	Lateral pain/laxity	LCL injury
McMurray's	Pain + click with flexion/rotation	Meniscal tear
Apley grind test	Pain on compression + rotation in prone position	Meniscal tear
Thessaly test	Pain/click at 20° single-leg squat with rotation	Meniscal tear
Clarke's test	Pain on patellar compression against femur	Patellofemoral syndrome

ANKLE & FOOT EXAMINATION CHECKLIST

Ottawa Rules (must state in any ankle OSCE): X-ray indicated if:

Tenderness at posterior tip or lower 6 cm of lateral malleolus
Tenderness at posterior tip or lower 6 cm of medial malleolus
Inability to weight bear (4 steps) immediately and in ED
Tenderness at navicular base or base of 5th metatarsal (foot rules)

Special Tests:

Test	Positive	Significance
Thompson test	No plantar flexion on calf squeeze (prone position)	Achilles tendon rupture
Anterior Drawer (ankle)	Anterior translation of talus	ATFL tear (lateral ankle sprain)
Talar tilt	Inversion tilt vs. contralateral side	CFL injury (severe lateral sprain)
Mulder's click	Painful click on web-space compression	Morton's neuroma

SPINE EXAMINATION (Cervical & Lumbar)

Cervical:

MOVE: flexion (70°), extension (70°), lateral flexion (45°), rotation (80°)
Spurling's test: Compress head in lateral flexion - reproduces radicular pain = nerve root compression
Lhermitte's sign: Electric shock down spine on neck flexion = spinal cord involvement (myelopathy/MS)
ASIA grading if cord injury suspected

Lumbar:

Schober's test: 10 cm mark above and 5 cm below L5-S1; should increase to >15 cm on full flexion (tests lumbar mobility, reduced in ankylosing spondylitis)
Straight Leg Raise (SLR / Lasegue's): Pain radiating below knee at 30-70° = positive; tests L4/L5/S1 nerve roots; sciatic nerve tension
Crossed SLR: Raising opposite leg reproduces symptoms = large central/lateral disc prolapse
Femoral Stretch Test (prone, knee flexion): Anterior thigh pain = L2/L3/L4 nerve root compression

Dermatomes and myotomes (must know):

Level	Sensation	Motor	Reflex
L1/L2	Groin/upper thigh	Hip flexion	Cremasteric
L3/L4	Medial knee/shin	Knee extension	Knee jerk
L4	Medial foot, big toe (medial)	Ankle dorsiflexion	Knee jerk
L5	Dorsum of foot, 1st web space	Big toe extension	None
S1	Lateral foot, sole	Ankle plantar flexion	Ankle jerk
S3/S4	Perineum	Bladder/bowel	Anal wink

Saddle anaesthesia (S3-S5) + bilateral neurology + bladder/bowel dysfunction = Cauda Equina Syndrome = surgical emergency

PART 3: PRACTICE OSCE STATIONS WITH FULL MARK SCHEMES

STATION 1: Tibial Fracture (Emergency Trauma)

Candidate instructions: You are the junior doctor in A&E. A 29-year-old woman fell while running, twisting her left lower leg. She has immediate-onset severe left lower leg pain and cannot weight-bear. Perform an orthopaedic examination, request investigations, interpret the X-ray and give a management plan.

MARK SCHEME:

Domain	Action	Marks
Introduction	Wash hands, introduce, consent, expose	2
History	Mechanism (twisting = spiral), timing, weight-bearing, neurovascular Sx	3
LOOK	Swelling, deformity, shortening, rotation, skin integrity (open fracture?)	3
FEEL	Tenderness (bony point), assess compartment tension (tense = emergency), temperature, CRT	3
Neurovascular	Distal pulses (DP + PT), capillary refill, sensation (peroneal/tibial distribution), motor (EHL, ankle DF/PF)	4
Compartment syndrome	Names 4 compartments of leg, signs of CS, states it is an emergency	3
Investigations	Requests AP + lateral tib/fib X-ray (including knee and ankle joints)	2
X-ray Interpretation	States: spiral fracture, which third, displaced/undisplaced, closed	3
Management	Analgesia (IV morphine titrated) -> ABCDE if polytrauma -> splint -> admit -> orthopaedic referral -> IMN likely treatment	4
Safety-netting	States will recheck NV status after splint, monitor for compartment syndrome	2
Total		29

Examiner's model answer for management:

ABCDE if trauma - rule out polytrauma
IV access + analgesia (morphine + anti-emetic)
Long leg posterior splint to immobilise
Admit under orthopaedics
Tetanus prophylaxis if open
Definitive: intramedullary nail (IMN) for displaced/unstable tibial shaft fractures
Non-operative (cast) reserved for: closed, stable, minimally displaced, low-energy fractures

Source: Campbell's Operative Orthopaedics 15th Ed 2026, Tibial Fractures chapter

STATION 2: Acutely Swollen Knee

Candidate instructions: A 22-year-old male footballer twists his right knee during a game. He felt a "pop" and the knee swelled up within 2 hours. Examine the knee and give a differential diagnosis and management plan.

MARK SCHEME:

Domain	Action	Marks
Introduction	Wash hands, introduce, expose (shorts), observe gait	2
LOOK	Effusion (haemarthrosis = ACL, PCL, tibial plateau #), quadriceps wasting, alignment	3
FEEL	Patellar tap / bulge test for effusion, joint line tenderness (medial = MCL/medial meniscus), lateral, temperature	3
MOVE	Flexion-extension range, quality of endpoint	2
Lachman's test	Correct technique (20-30° flexion, thigh fixed, tibia drawn anteriorly) - MOST IMPORTANT ACL test	4
Anterior drawer	Correct technique	2
MCL/LCL stress tests	Correct technique at 30° and 0°	2
Meniscal tests	McMurray's and/or Apley grind test	2
Differential	ACL tear (most likely), PCL, MCL, meniscal tear, tibial plateau fracture	3
Investigations	Plain X-ray (exclude fracture), MRI knee (gold standard for ligament/meniscus)	2
Management	RICE, analgesia, physiotherapy, orthopaedic referral; ACL reconstruction if functionally unstable	3
Total		28

Key teaching point: Haemarthrosis (blood in joint) within 2 hours = ACL tear until proven otherwise. Rapid effusion = haemarthrosis. Slow effusion (overnight) = more likely synovial fluid from meniscal/chondral injury.

STATION 3: Hip Fracture in an Elderly Patient

Candidate instructions: An 80-year-old woman was found on the floor at home after a fall. She is unable to mobilise. Examine her hips and formulate a management plan.

MARK SCHEME:

Domain	Action	Marks
Introduction	Wash hands, introduce, check pain level, expose	2
LOOK	Shortened and externally rotated right leg, inability to lift leg off bed	3
Limb length	True length (ASIS to medial malleolus) vs. apparent length (umbilicus to medial malleolus)	2
FEEL	Greater trochanter tenderness, palpate inguinal region	2
MOVE	Unable to perform active SLR; passive movement attempted gently (painful)	2
Neurovascular	Distal pulses, sensation, motor function of foot	2
Investigations	AP pelvis + lateral hip X-ray; bloods (FBC, U&E, clotting, group & save, ECG, CXR)	3
Classification	States Garden classification (I-IV); importance for treatment decision	3
Management	Analgesia (FNB = femoral nerve block excellent choice), catheterise, NBM, orthopaedic referral, ORIF vs. hemiarthroplasty	4
Systemic context	Recognises likely osteoporosis, asks about medications (warfarin, bisphosphonates), bone protection	2
Total		25

Classification pearl:

Intracapsular (subcapital, transcervical): blood supply to femoral head at risk
- Undisplaced (Garden I/II): internal fixation (cannulated screws / DHS)
- Displaced (Garden III/IV) elderly: hemiarthroplasty; young patient: attempt ORIF to preserve head
Extracapsular (intertrochanteric, subtrochanteric): blood supply intact
- Treatment: sliding hip screw (DHS) or proximal femoral nail (PFN)

STATION 4: Wrist Injury (FOOSH)

Candidate instructions: A 25-year-old fell on his outstretched hand playing rugby. He has right wrist pain and swelling. Examine his wrist and hand.

MARK SCHEME:

Domain	Action	Marks
Introduction	Wash hands, expose bilaterally, observe from front and side	2
LOOK	Dinner fork deformity (Colles), anatomical snuffbox swelling, bruising	2
FEEL	Anatomical snuffbox (critical - scaphoid fracture!), scaphoid tubercle, distal radius, ulnar styloid	4
MOVE	Wrist flexion/extension, radial/ulnar deviation, forearm pronation/supination	2
Scaphoid tests	Compression along thumb axis reproduces pain, snuffbox tenderness	3
Median nerve	Sensation to palm (thenar eminence), index, middle finger (carpal tunnel injury with distal radius fracture)	2
Investigations	PA + lateral wrist X-ray; if normal but clinical suspicion high - MRI or repeat X-ray 10-14 days	3
X-ray interpretation	Colles fracture = distal radius fracture with dorsal displacement, dorsal angulation, radial shortening, impaction. Dinner fork deformity	3
Management	Undisplaced: forearm cast; Displaced: manipulation under anaesthesia; if unstable: K-wires / volar plate	3
Scaphoid management	If suspected, thumb spica cast even if X-ray normal; if confirmed, scaphoid cast 6-12 weeks; waist fracture may need ORIF	3
Total		27

Scaphoid rule: Tenderness in the anatomical snuffbox = treat as scaphoid fracture until proven otherwise. Risk of avascular necrosis of proximal pole if missed or treated inadequately.

STATION 5: Shoulder Dislocation / Rotator Cuff

Candidate instructions: A 35-year-old rugby player presents with right shoulder pain after being tackled. Examine his shoulder and give a diagnosis.

MARK SCHEME:

Domain	Action	Marks
Introduce & look from front/back/side	Squared-off deltoid (anterior dislocation), muscle wasting, step deformity (AC joint), scars	3
FEEL	Bicipital groove, AC joint, GHJ line, coracoid, acromioclavicular, SCJ	2
MOVE	Active then passive abduction, forward flexion, IR/ER	2
Painful arc	60-120°	2
Impingement tests	Neer's, Hawkins-Kennedy	2
Rotator cuff tests	Empty can (SS), external rotation lag (IS), lift-off or belly press (subscapularis)	3
Instability tests	Apprehension, relocation, sulcus sign	2
Axillary nerve	Critical: sensation over regimental badge area (lateral deltoid); motor: deltoid contraction - check BEFORE and AFTER reduction	3
Investigations	AP + axial/lateral view + Y-view X-ray; Hill-Sachs lesion (posterolateral humeral head compression fracture - sign of prior anterior dislocation); Bankart lesion (anteroinferior glenoid rim avulsion)	3
Reduction + management	Hennepin/Cunningham technique; Kocher's; post-reduction X-ray; sling; immobilisation; physiotherapy; recurrence risk high in young	3
Total		25

STATION 6: Back Pain / Lumbar Disc Prolapse

Candidate instructions: A 45-year-old lorry driver has low back pain radiating down his left leg to the foot. Examine his spine and neurology.

MARK SCHEME:

Domain	Action	Marks
Inspect gait, observe spine from front/back/side	Scoliosis, list to side, loss of lumbar lordosis	2
MOVE lumbar spine	Flexion (touch toes), extension, lateral flexion, Schober's test (normal >5 cm increase from 10 cm + 5 cm mark)	3
SLR	Correctly performed (<70° with sciatic radiation below knee = positive)	3
Neurological lower limb	Power: hip flex, knee ext, ankle DF, big toe ext, ankle PF	3
Sensation	L3 medial knee, L4 medial malleolus, L5 1st web space, S1 lateral foot	3
Reflexes	Knee jerk (L3/4), ankle jerk (S1), plantar response	3
Red flags (must mention)	Saddle anaesthesia, bladder/bowel dysfunction, bilateral leg weakness = Cauda Equina - emergency MRI + surgery	3
Investigations	X-ray to exclude bony pathology; MRI lumbar spine gold standard	2
Management	Conservative: analgesia, NSAIDs, physiotherapy, bed rest short term only; if cauda equina = emergency decompression	2
Total		24

PART 4: HIGH-YIELD CLASSIFICATIONS YOU MUST KNOW

Fracture/Condition	Classification	Key Points
NOF fracture	Garden I-IV	I undisplaced (impacted); IV fully displaced
Tibial plateau	Schatzker I-VI	I-IV low energy; V-VI high energy, bicondylar
Open fractures	Gustilo-Anderson I-III	III = contaminated/vascular injury
Ankle fractures	Weber A/B/C (fibula) + Lauge-Hansen	C = above syndesmosis = unstable
Distal radius	Colles/Smith/Barton; Frykman	Colles = dorsal displacement; Smith = volar
Spinal cord	ASIA A-E	A = complete; E = normal
Cervical spine	SLIC (Subaxial Cervical Injury Classification)	Score >4 = surgery
Periprosthetic hip #	Vancouver A/B/C	B2 = loose stem = revision; B1 = well-fixed = ORIF
Shoulder dislocation	Anterior (95%), Posterior, Inferior (luxatio erecta)	Posterior = after seizure/electrocution, fixed IR

Sources: Rockwood and Green's Fractures in Adults 10th Ed 2025; Campbell's Operative Orthopaedics 15th Ed 2026

PART 5: EMERGENCY ORTHOPAEDIC MANAGEMENT MNEMONICS

ATLS Primary Survey (Trauma OSCE)

ABCDE:

A - Airway (+ C-spine immobilisation)
B - Breathing
C - Circulation (haemorrhage control - splint pelvis if suspect pelvic fracture)
D - Disability (GCS, pupils)
E - Exposure / Environment (undress, logroll, keep warm)

Open Fracture Management

ABCs / trauma resuscitation first
Wound photograph, sterile saline soaked dressing - do NOT repeatedly unwrap
IV antibiotics within 1 hour (co-amoxiclav OR cefuroxime)
Tetanus prophylaxis
Splint
Urgent washout and debridement in theatre (ideally <6 hours for Gustilo IIIB/C)

Pelvic Fracture Haemorrhage Control

"Close the book" - pelvic binder or sheet around the greater trochanters for unstable pelvic fractures; can lose 4+ litres into retroperitoneum

PART 6: IMAGING INTERPRETATION - COMMON X-RAY CASES

Case	X-Ray Findings	Your Diagnosis
Elderly woman, fall	NOF # - disrupted medial cortex, Garden type	Neck of femur fracture
Young adult, FOOSH	Loss of carpal arcs, density lucency at scaphoid waist	Scaphoid fracture
Footballer, knee twist	Lateral capsular avulsion (Segond fracture = highly specific for ACL tear)	ACL tear with Segond fracture
Wrist pain, dinner fork	Dorsal displacement/angulation of distal radius	Colles' fracture
Young runner, lower leg	Spiral fracture tib/fib	Tibial shaft fracture
Elbow, child	CRITOE ossification; posterior fat-pad sign	Supracondylar fracture / radial head fracture
Acute hip pain	Loss of Shenton's line	Hip dislocation (posterior most common)

CRITOE (elbow ossification centres - children): Capitellum (1y) - Radial head (3y) - Internal epicondyle (5y) - Trochlea (7y) - Olecranon (9y) - External epicondyle (11y)

If you see an ossification centre out of sequence or an avulsed medial epicondyle - suspect injury.

QUICK REVISION SUMMARY

Topic	Key Point
Compartment syndrome	Pain on passive stretch + tense compartment + out-of-proportion pain = fasciotomy
Scaphoid	Snuffbox tenderness = treat even if X-ray normal; risk AVN
NOF fracture	Shortened + ER leg; Garden I-IV; intracapsular vs. extracapsular determines treatment
Cauda equina	Saddle anaesthesia + bladder dysfunction = emergency MRI + decompression
ACL	Haemarthrosis + pop + Lachman's positive; MRI to confirm
Achilles	Thompson test positive = no plantar flexion = rupture
Ottawa rules	Know these: lateral/medial malleolus + navicular + 5th MT base
ATLS	ABCDE; pelvic binder for unstable pelvis; permissive hypotension if haemorrhage
Open fracture	IV abx within 1 hour; photo; sterile dressing; theatre washout
Shoulder dislocation	Check axillary nerve BEFORE and AFTER reduction; Hill-Sachs + Bankart complications

Sources consulted:

Campbell's Operative Orthopaedics, 15th Ed (2026) - fracture evaluation, tibial fractures, neurovascular assessment
Rockwood and Green's Fractures in Adults, 10th Ed (2025) - fracture classification, tibial plateau, proximal humerus, ankle
ROSEN's Emergency Medicine, Concepts & Clinical Practice - compartment syndrome, ankle fractures, soft tissue injuries
Miller's Review of Orthopaedics, 9th Ed - cervical spine SLIC classification, spinal injury

Generate a presentation on imaging interpretation for orthopedic X-rays

Reading File

Running Command

ls -la /tmp/workspace/ 2>/dev/null || echo "workspace not yet created"

Running Command

mkdir -p /tmp/workspace/ortho-xray-pptx

Writing File

~/ortho-xray-pptx/build_pptx.py

from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.enum.shapes import MSO_SHAPE_TYPE
from io import BytesIO
import copy

# ── Colour palette ─────────────────────────────────────────────────────────────
DARK_BLUE   = RGBColor(0x0D, 0x2B, 0x55)   # slide background / header
MID_BLUE    = RGBColor(0x1A, 0x5A, 0x96)   # accent bars
LIGHT_BLUE  = RGBColor(0xD6, 0xE8, 0xF7)   # content card background
RED_ALERT   = RGBColor(0xC0, 0x39, 0x2B)   # emergency / red flags
GOLD        = RGBColor(0xF3, 0x9C, 0x12)   # highlight / key points
WHITE       = RGBColor(0xFF, 0xFF, 0xFF)
DARK_GREY   = RGBColor(0x2C, 0x3E, 0x50)
LIGHT_GREY  = RGBColor(0xEC, 0xF0, 0xF1)
GREEN       = RGBColor(0x27, 0xAE, 0x60)
ORANGE      = RGBColor(0xE6, 0x7E, 0x22)

W = Inches(13.333)
H = Inches(7.5)

prs = Presentation()
prs.slide_width  = W
prs.slide_height = H
blank = prs.slide_layouts[6]


# ── Helper functions ────────────────────────────────────────────────────────────

def add_rect(slide, x, y, w, h, fill_color, line_color=None, line_width=None):
    from pptx.enum.shapes import MSO_SHAPE
    shp = slide.shapes.add_shape(MSO_SHAPE.RECTANGLE, x, y, w, h)
    shp.fill.solid()
    shp.fill.fore_color.rgb = fill_color
    if line_color:
        shp.line.color.rgb = line_color
        shp.line.width = Pt(line_width or 1)
    else:
        shp.line.fill.background()
    shp.shadow.inherit = False
    return shp

def add_tb(slide, x, y, w, h, text, font_size, bold=False, color=WHITE,
           align=PP_ALIGN.LEFT, italic=False, word_wrap=True, v_anchor=MSO_ANCHOR.TOP):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = word_wrap
    tf.vertical_anchor = v_anchor
    tf.margin_left = 0; tf.margin_right = 0; tf.margin_top = 0; tf.margin_bottom = 0
    p  = tf.paragraphs[0]
    p.alignment = align
    run = p.add_run()
    run.text = text
    run.font.name  = "Calibri"
    run.font.size  = Pt(font_size)
    run.font.bold  = bold
    run.font.italic = italic
    run.font.color.rgb = color
    return tb

def add_multiline_tb(slide, x, y, w, h, lines, font_size, bold=False, color=WHITE,
                     align=PP_ALIGN.LEFT, line_spacing_pt=None, indent_first=False):
    """lines = list of (text, bold_override, color_override, font_size_override)"""
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    tf.margin_left  = Pt(2)
    tf.margin_right = Pt(2)
    tf.margin_top   = Pt(4)
    tf.margin_bottom= Pt(4)
    first = True
    for item in lines:
        if isinstance(item, str):
            text, b, c, fs = item, bold, color, font_size
        else:
            text = item[0]
            b    = item[1] if len(item) > 1 else bold
            c    = item[2] if len(item) > 2 else color
            fs   = item[3] if len(item) > 3 else font_size
        if first:
            p = tf.paragraphs[0]
            first = False
        else:
            p = tf.add_paragraph()
        p.alignment = align
        run = p.add_run()
        run.text = text
        run.font.name  = "Calibri"
        run.font.size  = Pt(fs)
        run.font.bold  = b
        run.font.color.rgb = c
    return tb

def slide_bg(slide, color=DARK_BLUE):
    add_rect(slide, 0, 0, W, H, color)

def header_bar(slide, title, subtitle=None, bar_color=MID_BLUE):
    add_rect(slide, 0, 0, W, Inches(1.25), bar_color)
    add_tb(slide, Inches(0.4), Inches(0.1), Inches(12.5), Inches(0.7),
           title, 28, bold=True, color=WHITE, align=PP_ALIGN.LEFT)
    if subtitle:
        add_tb(slide, Inches(0.4), Inches(0.75), Inches(12.5), Inches(0.4),
               subtitle, 14, bold=False, color=LIGHT_BLUE, align=PP_ALIGN.LEFT)

def section_label(slide, text, x, y, w=Inches(2.5), h=Inches(0.35)):
    add_rect(slide, x, y, w, h, GOLD)
    add_tb(slide, x+Inches(0.1), y, w-Inches(0.1), h, text, 11, bold=True,
           color=DARK_BLUE, align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)

def card(slide, x, y, w, h, bg=LIGHT_BLUE):
    return add_rect(slide, x, y, w, h, bg, line_color=MID_BLUE, line_width=0.5)

def divider_line(slide, x, y, w, color=GOLD, thickness=2):
    from pptx.enum.shapes import MSO_CONNECTOR
    ln = slide.shapes.add_connector(MSO_CONNECTOR.STRAIGHT, x, y, x+w, y)
    ln.line.color.rgb = color
    ln.line.width = Pt(thickness)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 1 – TITLE SLIDE
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_BLUE)

# Decorative left bar
add_rect(slide, 0, 0, Inches(0.45), H, GOLD)

# Central panel
add_rect(slide, Inches(0.85), Inches(1.8), Inches(11.6), Inches(4.0), MID_BLUE,
         line_color=GOLD, line_width=2)

add_tb(slide, Inches(1.2), Inches(2.1), Inches(11.0), Inches(1.2),
       "Imaging Interpretation for", 32, bold=False, color=LIGHT_BLUE, align=PP_ALIGN.CENTER)
add_tb(slide, Inches(1.2), Inches(2.9), Inches(11.0), Inches(1.4),
       "Orthopedic X-Rays", 54, bold=True, color=WHITE, align=PP_ALIGN.CENTER)

divider_line(slide, Inches(2.5), Inches(4.45), Inches(8.3), GOLD, 2)

add_tb(slide, Inches(1.2), Inches(4.6), Inches(11.0), Inches(0.5),
       "OSCE Preparation Guide  |  MBBS / MD Level", 18, bold=False,
       color=LIGHT_BLUE, align=PP_ALIGN.CENTER)
add_tb(slide, Inches(1.2), Inches(5.1), Inches(11.0), Inches(0.4),
       "Sources: Rockwood & Green 10th Ed 2025  •  Campbell's Operative Orthopaedics 15th Ed 2026  •  ROSEN's Emergency Medicine",
       11, bold=False, color=LIGHT_BLUE, align=PP_ALIGN.CENTER)

# Bottom strip
add_rect(slide, 0, Inches(6.8), W, Inches(0.7), GOLD)
add_tb(slide, Inches(0.3), Inches(6.82), Inches(12.7), Inches(0.4),
       "Fractures  •  Dislocations  •  Soft Tissue  •  Spine  •  Paediatric  •  Pathological",
       13, bold=False, color=DARK_BLUE, align=PP_ALIGN.CENTER)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 2 – X-RAY INTERPRETATION FRAMEWORK (ABCDS)
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_GREY)
header_bar(slide, "The ABCDS Framework", "Systematic Approach to Every Orthopaedic X-Ray")

letters = [
    ("A", "Alignment",     "Are bones in normal anatomical alignment? Is there a dislocation or subluxation?",            RGBColor(0x1A,0xBC,0x9C)),
    ("B", "Bones",         "Look for cortical breaks, lucent fracture lines, impaction, comminution, sclerosis.",          RGBColor(0x27,0xAE,0x60)),
    ("C", "Cartilage",     "Assess joint spaces — narrowed (arthritis/infection), widened (effusion/ligament injury).",    RGBColor(0x29,0x80,0xB9)),
    ("D", "Density",       "Increased density = sclerosis (stress/healing). Decreased = lytic lesion, osteoporosis, AVN.", RGBColor(0x85,0x44,0xBF)),
    ("S", "Soft Tissue",   "Swelling, fat-pad displacement, foreign bodies, gas (infection), calcification.",              GOLD),
]

x_start = Inches(0.35)
box_w   = Inches(2.5)
box_h   = Inches(4.8)
gap     = Inches(0.15)

for i, (letter, label, desc, col) in enumerate(letters):
    bx = x_start + i*(box_w + gap)
    add_rect(slide, bx, Inches(1.45), box_w, box_h, col)
    # Big letter
    add_tb(slide, bx+Inches(0.1), Inches(1.5), box_w-Inches(0.2), Inches(1.4),
           letter, 72, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
    # Divider
    divider_line(slide, bx+Inches(0.2), Inches(2.95), box_w-Inches(0.4), WHITE, 1)
    # Label
    add_tb(slide, bx+Inches(0.1), Inches(3.0), box_w-Inches(0.2), Inches(0.5),
           label, 15, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
    # Description
    add_multiline_tb(slide, bx+Inches(0.15), Inches(3.55), box_w-Inches(0.3), Inches(2.5),
                     [desc], 12, color=WHITE, align=PP_ALIGN.LEFT)

# Bottom note
add_rect(slide, 0, Inches(6.6), W, Inches(0.9), DARK_BLUE)
add_tb(slide, Inches(0.4), Inches(6.65), Inches(12.5), Inches(0.5),
       "Always state:  1) Type of view (AP/Lateral/Oblique)   2) Date & adequacy (two views? two joints for long bones?)   3) Your systematic findings before giving a diagnosis",
       12, color=LIGHT_BLUE, align=PP_ALIGN.LEFT)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 3 – FRACTURE DESCRIPTION TEMPLATE
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_BLUE)
header_bar(slide, "Describing a Fracture on X-Ray", "Use this template for every fracture OSCE station")

# Left column: step-by-step
card(slide, Inches(0.3), Inches(1.4), Inches(6.0), Inches(5.8))
section_label(slide, "STEP-BY-STEP DESCRIPTION", Inches(0.35), Inches(1.45), Inches(5.9))

steps = [
    ("1", "Which bone?",        "Name the specific bone and side (e.g. left distal radius)"),
    ("2", "Fracture site",      "Proximal / middle / distal third; epiphysis / metaphysis / diaphysis"),
    ("3", "Pattern",            "Transverse, spiral, oblique, comminuted, impacted, avulsion, greenstick"),
    ("4", "Displacement",       "None / partial / complete; direction (dorsal, volar, lateral)"),
    ("5", "Angulation",         "Degrees and direction (varus, valgus, dorsal, volar)"),
    ("6", "Shortening",         "Estimated mm; overlapping fragments"),
    ("7", "Open vs Closed",     "Look for soft tissue gas; skin integrity (clinical)"),
    ("8", "Intra/extra-articular", "Does the fracture line cross the joint?"),
    ("9", "Associated findings","Dislocation, other fractures, foreign bodies, AVN"),
]
y = Inches(1.9)
for num, title, desc in steps:
    add_rect(slide, Inches(0.4), y, Inches(0.45), Inches(0.42), GOLD)
    add_tb(slide, Inches(0.4), y, Inches(0.45), Inches(0.42), num, 12, bold=True,
           color=DARK_BLUE, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE)
    add_tb(slide, Inches(0.95), y+Inches(0.01), Inches(1.45), Inches(0.4),
           title, 11, bold=True, color=GOLD, align=PP_ALIGN.LEFT)
    add_tb(slide, Inches(2.45), y+Inches(0.01), Inches(3.65), Inches(0.4),
           desc, 11, color=WHITE, align=PP_ALIGN.LEFT)
    y += Inches(0.5)

# Right column: fracture pattern table
card(slide, Inches(6.65), Inches(1.4), Inches(6.35), Inches(5.8), DARK_BLUE)
add_rect(slide, Inches(6.65), Inches(1.4), Inches(6.35), Inches(0.35), MID_BLUE)
add_tb(slide, Inches(6.75), Inches(1.4), Inches(6.15), Inches(0.35),
       "FRACTURE PATTERN REFERENCE", 12, bold=True, color=WHITE, align=PP_ALIGN.LEFT,
       v_anchor=MSO_ANCHOR.MIDDLE)

patterns = [
    ("PATTERN",        "MECHANISM",            "COMMON SITE",         True),
    ("Transverse",     "Direct blow / bending", "Tibia, phalanges",   False),
    ("Spiral",         "Twisting / torsion",    "Tib/Fib, humerus",   False),
    ("Oblique",        "Axial + angulation",    "Femur, tibia",       False),
    ("Comminuted",     "High energy",           "Tibial plateau",     False),
    ("Avulsion",       "Ligament/tendon pull",  "Lat. malleolus",     False),
    ("Impacted",       "Axial load",            "Distal radius, NOF", False),
    ("Stress",         "Repetitive loading",    "2nd MT, tibia",      False),
    ("Pathological",   "Minimal trauma",        "Metastasis, MM",     False),
    ("Greenstick",     "Children",              "Radius / ulna",      False),
    ("Buckle/Torus",   "Children – axial load", "Distal radius",      False),
]

col_widths = [Inches(1.55), Inches(2.0), Inches(2.4)]
col_x      = [Inches(6.75), Inches(8.35), Inches(10.35)]
row_h      = Inches(0.44)
y = Inches(1.8)

for row in patterns:
    bg = MID_BLUE if row[3] else (DARK_GREY if patterns.index(row) % 2 == 0 else DARK_BLUE)
    txt_col = WHITE
    add_rect(slide, Inches(6.65), y, Inches(6.35), row_h, bg)
    for ci, text in enumerate(row[:3]):
        add_tb(slide, col_x[ci], y+Inches(0.04), col_widths[ci], row_h-Inches(0.08),
               text, 11 if not row[3] else 11, bold=row[3], color=txt_col,
               align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)
    y += row_h


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 4 – COMMON FRACTURES: UPPER LIMB
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_GREY)
header_bar(slide, "Upper Limb Fractures", "Key X-Ray Findings & Clinical Pearls")

cases = [
    {
        "title": "Colles' Fracture",
        "subtitle": "Distal Radius",
        "icon": "FOOSH",
        "findings": [
            "Transverse # at distal radius metaphysis",
            "Dorsal displacement & angulation",
            "Radial shortening + impaction",
            "\"Dinner fork\" deformity",
            "Associated ulnar styloid #",
        ],
        "pearl": "Check median nerve! CTS complication. Smith's = volar displacement (reversed Colles).",
        "color": RGBColor(0x1A,0x5A,0x96),
    },
    {
        "title": "Scaphoid Fracture",
        "subtitle": "Wrist (FOOSH)",
        "icon": "AVN",
        "findings": [
            "Lucent line at scaphoid waist (70-80%)",
            "May be X-ray NEGATIVE initially",
            "Loss of scaphoid cortex",
            "3 views: PA, lateral, oblique",
            "MRI if X-ray normal but clinically +ve",
        ],
        "pearl": "Anatomical snuffbox tenderness = treat as scaphoid # even if X-ray normal! Risk of AVN of proximal pole.",
        "color": RGBColor(0xC0,0x39,0x2B),
    },
    {
        "title": "Proximal Humerus #",
        "subtitle": "Shoulder",
        "icon": "Neer",
        "findings": [
            "AP + axial + Y-view required",
            "Neer 2-4 part classification",
            "Greater tuberosity avulsion",
            "Look for Hill-Sachs (post-lat head)",
            "Bankart (ant-inf glenoid rim)",
        ],
        "pearl": "Hill-Sachs = humeral head compression after anterior dislocation. Axillary nerve injury common.",
        "color": RGBColor(0x27,0xAE,0x60),
    },
    {
        "title": "Paediatric Elbow",
        "subtitle": "Supracondylar / Radial Head",
        "icon": "CRITOE",
        "findings": [
            "Posterior fat-pad sign = effusion",
            "Anterior fat-pad (sail sign) = effusion",
            "Anterior humeral line alignment",
            "Radiocapitellar line (radial head)",
            "CRITOE ossification sequence",
        ],
        "pearl": "CRITOE: 1-3-5-7-9-11 years. Posterior fat pad ALWAYS abnormal — treat as radial head # or supracondylar.",
        "color": RGBColor(0x85,0x44,0xBF),
    },
]

cx = Inches(0.3)
cw = Inches(3.1)
ch = Inches(5.65)

for case in cases:
    c = case["color"]
    # Card bg
    add_rect(slide, cx, Inches(1.35), cw, ch, DARK_BLUE, line_color=c, line_width=1.5)
    # Colour header
    add_rect(slide, cx, Inches(1.35), cw, Inches(0.75), c)
    add_tb(slide, cx+Inches(0.1), Inches(1.37), cw-Inches(0.2), Inches(0.45),
           case["title"], 16, bold=True, color=WHITE, align=PP_ALIGN.LEFT)
    add_tb(slide, cx+Inches(0.1), Inches(1.78), cw-Inches(0.2), Inches(0.28),
           case["subtitle"], 11, color=LIGHT_BLUE, align=PP_ALIGN.LEFT)
    # Badge
    add_rect(slide, cx+cw-Inches(0.9), Inches(1.38), Inches(0.8), Inches(0.3), GOLD)
    add_tb(slide, cx+cw-Inches(0.9), Inches(1.38), Inches(0.8), Inches(0.3),
           case["icon"], 9, bold=True, color=DARK_BLUE, align=PP_ALIGN.CENTER,
           v_anchor=MSO_ANCHOR.MIDDLE)
    # Findings header
    add_tb(slide, cx+Inches(0.1), Inches(2.15), cw-Inches(0.2), Inches(0.3),
           "X-RAY FINDINGS", 9, bold=True, color=GOLD)
    # Findings list
    y = Inches(2.42)
    for f in case["findings"]:
        add_tb(slide, cx+Inches(0.25), y, cw-Inches(0.35), Inches(0.36),
               f"• {f}", 10.5, color=WHITE)
        y += Inches(0.38)
    # Pearl box
    add_rect(slide, cx+Inches(0.1), Inches(4.55), cw-Inches(0.2), Inches(0.05), GOLD)
    add_rect(slide, cx+Inches(0.1), Inches(4.62), cw-Inches(0.2), Inches(1.2), RGBColor(0x1C,0x2F,0x4A))
    add_tb(slide, cx+Inches(0.15), Inches(4.65), cw-Inches(0.3), Inches(0.28),
           "CLINICAL PEARL", 9, bold=True, color=GOLD)
    add_multiline_tb(slide, cx+Inches(0.15), Inches(4.93), cw-Inches(0.3), Inches(0.85),
                     [case["pearl"]], 10, color=LIGHT_BLUE, align=PP_ALIGN.LEFT)
    cx += cw + Inches(0.17)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 5 – LOWER LIMB FRACTURES
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_BLUE)
header_bar(slide, "Lower Limb Fractures", "Key X-Ray Findings, Classifications & Management")

cases = [
    {
        "title": "Neck of Femur",
        "findings": [
            "AP pelvis + lateral hip views",
            "Disruption of Shenton's line",
            "Garden classification I–IV",
            "Loss of medial cortex continuity",
            "Check trabecular pattern",
        ],
        "classification": "Garden I: Incomplete/valgus impacted\nGarden II: Complete undisplaced\nGarden III: Partial displacement\nGarden IV: Full displacement",
        "mgmt": "I/II: Cannulated screws / DHS\nIII/IV (elderly): Hemiarthroplasty\nIII/IV (young): ORIF (preserve head)",
        "color": MID_BLUE,
    },
    {
        "title": "Tibial Plateau",
        "findings": [
            "AP + lateral + 45° oblique views",
            "CT essential for surgical planning",
            "Depression of lateral plateau",
            "Schatzker I–VI classification",
            "Check fibular head for LCL injury",
        ],
        "classification": "Schatzker I-III: Lateral plateau\nSchatzker IV: Medial plateau\nSchatzker V: Bicondylar\nSchatzker VI: Metaphyseal dissoc.",
        "mgmt": "Low energy (I-III): ORIF if depressed >5mm\nHigh energy (IV-VI): Complex ORIF\nRule out compartment syndrome!",
        "color": GREEN,
    },
    {
        "title": "Tibial Shaft",
        "findings": [
            "AP + lateral including knee & ankle",
            "Oblique view for spiral fracture",
            "Note: open wound / soft tissue gas",
            "Assess shortening and rotation",
            "Look for ipsilateral femur / fibula #",
        ],
        "classification": "Open # Gustilo-Anderson:\nI: <1cm, clean\nII: 1-10cm\nIIIA/B/C: >10cm ± vascular",
        "mgmt": "Stable/undisplaced: Cast\nDisplaced/unstable: IMN (gold std)\nOpen: Abx + debridement + IMN/ex-fix",
        "color": ORANGE,
    },
    {
        "title": "Ankle Fracture",
        "findings": [
            "AP + lateral + mortise (15° IR) views",
            "Weber A/B/C (fibula level)",
            "Check medial clear space (<4mm)",
            "Talar tilt / shift = instability",
            "Look for posterior malleolus #",
        ],
        "classification": "Weber A: Below syndesmosis (stable)\nWeber B: At syndesmosis\nWeber C: Above syndesmosis (UNSTABLE)\nLauge-Hansen: SA/PA/SE/PE",
        "mgmt": "Weber A: Walking boot / cast\nWeber B: Depends on medial injury\nWeber C: Usually ORIF (unstable)",
        "color": RED_ALERT,
    },
]

cx = Inches(0.3)
cw = Inches(3.1)
ch = Inches(5.65)

for case in cases:
    c = case["color"]
    add_rect(slide, cx, Inches(1.35), cw, ch, DARK_GREY, line_color=c, line_width=1.5)
    add_rect(slide, cx, Inches(1.35), cw, Inches(0.6), c)
    add_tb(slide, cx+Inches(0.1), Inches(1.37), cw-Inches(0.2), Inches(0.56),
           case["title"], 16, bold=True, color=WHITE, align=PP_ALIGN.LEFT,
           v_anchor=MSO_ANCHOR.MIDDLE)

    add_tb(slide, cx+Inches(0.1), Inches(2.0), cw-Inches(0.2), Inches(0.28),
           "X-RAY FINDINGS", 9, bold=True, color=GOLD)
    y = Inches(2.28)
    for f in case["findings"]:
        add_tb(slide, cx+Inches(0.2), y, cw-Inches(0.3), Inches(0.35),
               f"• {f}", 10, color=WHITE)
        y += Inches(0.35)

    # Classification
    add_rect(slide, cx+Inches(0.1), Inches(4.08), cw-Inches(0.2), Inches(0.28), c)
    add_tb(slide, cx+Inches(0.15), Inches(4.08), cw-Inches(0.3), Inches(0.28),
           "CLASSIFICATION", 9, bold=True, color=DARK_BLUE, v_anchor=MSO_ANCHOR.MIDDLE)
    add_multiline_tb(slide, cx+Inches(0.15), Inches(4.38), cw-Inches(0.3), Inches(1.0),
                     [case["classification"]], 9.5, color=LIGHT_BLUE)

    # Management
    add_rect(slide, cx+Inches(0.1), Inches(5.42), cw-Inches(0.2), Inches(0.28), GOLD)
    add_tb(slide, cx+Inches(0.15), Inches(5.42), cw-Inches(0.3), Inches(0.28),
           "MANAGEMENT", 9, bold=True, color=DARK_BLUE, v_anchor=MSO_ANCHOR.MIDDLE)
    add_multiline_tb(slide, cx+Inches(0.15), Inches(5.72), cw-Inches(0.3), Inches(0.9),
                     [case["mgmt"]], 9.5, color=WHITE)

    cx += cw + Inches(0.17)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 6 – DISLOCATIONS
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_GREY)
header_bar(slide, "Joint Dislocations on X-Ray", "Always check neurovascular status before and after reduction")

dislocations = [
    {
        "joint": "Shoulder (GHJ)",
        "type": "95% Anterior",
        "xray": [
            "AP: humeral head below/medial to glenoid",
            "Axial/Y-view: humeral head anterior to glenoid",
            "Hill-Sachs: post-lateral humeral head defect",
            "Bankart: ant-inferior glenoid rim fracture",
            "Always take post-reduction X-ray",
        ],
        "nerve": "Axillary nerve (deltoid, lateral deltoid sensation)",
        "color": MID_BLUE,
        "treat": "Reduction (Hennepin / Cunningham / Kocher); Sling 3-6 wks; Physio",
    },
    {
        "joint": "Hip",
        "type": "90% Posterior",
        "xray": [
            "AP pelvis: femoral head superior & lateral",
            "Loss of Shenton's line",
            "Limb: shortened, adducted, internally rotated",
            "CT after reduction to check joint congruence",
            "Look for posterior acetabular wall #",
        ],
        "nerve": "Sciatic nerve (esp. peroneal division: foot drop)",
        "color": RED_ALERT,
        "treat": "EMERGENCY reduction within 6h (AVN risk). Allis / Stimson technique. ORIF if wall # present.",
    },
    {
        "joint": "Knee (Patella)",
        "type": "Lateral > Medial",
        "xray": [
            "AP knee: patella lateral to trochlea",
            "Axial (skyline) view most helpful",
            "Look for osteochondral fragment",
            "Medial patellofemoral ligament avulsion",
            "Trochlear dysplasia predisposes",
        ],
        "nerve": "Usually no neurovascular injury",
        "color": GREEN,
        "treat": "Extension of knee usually reduces it. Medial press to reduce. Immobilise 4-6 wks. MRI to assess MPFL.",
    },
    {
        "joint": "Elbow",
        "type": "Posterior (most common)",
        "xray": [
            "Lateral: olecranon posterior to humerus",
            "AP: widened joint space",
            "Look for coronoid # (terrible triad)",
            "Radial head #: 'Terrible Triad'",
            "Monteggia: proximal ulna # + radial head disloc.",
        ],
        "nerve": "Brachial artery, ulnar/radial nerve injury",
        "color": GOLD,
        "treat": "Conscious sedation + reduction. Check radio-capitellar line post-reduction. Terrible triad = ORIF.",
    },
    {
        "joint": "Ankle (Talar)",
        "type": "Fracture-dislocation",
        "xray": [
            "AP + lateral + mortise views",
            "Widened medial clear space (>4mm)",
            "Talar tilt on mortise view",
            "Look for trimalleolar fracture",
            "Weber C with diastasis = unstable",
        ],
        "nerve": "Posterior tibial artery / nerve",
        "color": ORANGE,
        "treat": "Urgent reduction (skin necrosis risk). Splint. ORIF for fracture-dislocation.",
    },
]

cx = Inches(0.25)
cw = Inches(2.52)
ch = Inches(5.6)

for d in dislocations:
    c = d["color"]
    add_rect(slide, cx, Inches(1.38), cw, ch, DARK_BLUE, line_color=c, line_width=1.2)
    add_rect(slide, cx, Inches(1.38), cw, Inches(0.68), c)
    add_tb(slide, cx+Inches(0.08), Inches(1.38), cw-Inches(0.16), Inches(0.45),
           d["joint"], 15, bold=True, color=WHITE)
    add_tb(slide, cx+Inches(0.08), Inches(1.78), cw-Inches(0.16), Inches(0.25),
           d["type"], 10, color=LIGHT_BLUE)

    add_tb(slide, cx+Inches(0.08), Inches(2.1), cw, Inches(0.25),
           "X-RAY SIGNS", 8.5, bold=True, color=GOLD)
    y = Inches(2.35)
    for f in d["xray"]:
        add_tb(slide, cx+Inches(0.12), y, cw-Inches(0.2), Inches(0.33),
               f"• {f}", 9.5, color=WHITE)
        y += Inches(0.34)

    # Nerve warning
    add_rect(slide, cx+Inches(0.08), Inches(4.07), cw-Inches(0.16), Inches(0.22), RED_ALERT)
    add_tb(slide, cx+Inches(0.1), Inches(4.07), cw-Inches(0.2), Inches(0.22),
           f"NERVE: {d['nerve']}", 8.5, bold=True, color=WHITE, v_anchor=MSO_ANCHOR.MIDDLE)

    # Treatment
    add_multiline_tb(slide, cx+Inches(0.1), Inches(4.35), cw-Inches(0.2), Inches(1.3),
                     [d["treat"]], 9.5, color=LIGHT_BLUE)

    cx += cw + Inches(0.14)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 7 – SPINE X-RAYS
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_BLUE)
header_bar(slide, "Spine X-Ray Interpretation", "Cervical, Thoracic & Lumbar — Systematic Approach")

# Left half: Cervical
add_rect(slide, Inches(0.3), Inches(1.35), Inches(6.0), Inches(5.85), DARK_GREY)
add_rect(slide, Inches(0.3), Inches(1.35), Inches(6.0), Inches(0.45), MID_BLUE)
add_tb(slide, Inches(0.4), Inches(1.38), Inches(5.8), Inches(0.4),
       "CERVICAL SPINE", 14, bold=True, color=WHITE)

cerv_items = [
    ("ALIGNMENT (4 lines)", [
        "Anterior vertebral line — smooth lordosis",
        "Posterior vertebral line — smooth",
        "Spinolaminar line",
        "Posterior spinous line",
        "BROKEN LINE = dislocation / subluxation",
    ], GOLD),
    ("BONES", [
        "Vertebral body height (anterior = posterior)",
        "Disc space: uniform height",
        "Odontoid peg: central, no gap >3mm (ADI)",
        "Facet joints: overlapping 'shingles'",
    ], MID_BLUE),
    ("SOFT TISSUE", [
        "Pre-vertebral soft tissue: <7mm at C2, <22mm at C6",
        "Widened = haematoma (high injury suspicion)",
    ], GREEN),
    ("PAEDIATRIC PEARL", [
        "Pseudo-subluxation C2/3 or C3/4 in children — normal variant",
        "Swischuk's line: spinolaminar line C1-C3",
    ], ORANGE),
]

y = Inches(1.9)
for title, items, col in cerv_items:
    add_rect(slide, Inches(0.4), y, Inches(5.8), Inches(0.28), col)
    add_tb(slide, Inches(0.5), y, Inches(5.6), Inches(0.28),
           title, 10, bold=True, color=DARK_BLUE, v_anchor=MSO_ANCHOR.MIDDLE)
    y += Inches(0.3)
    for item in items:
        add_tb(slide, Inches(0.55), y, Inches(5.55), Inches(0.32),
               f"• {item}", 10, color=WHITE)
        y += Inches(0.32)
    y += Inches(0.05)

# Right half: Lumbar + emergencies
add_rect(slide, Inches(6.65), Inches(1.35), Inches(6.35), Inches(5.85), DARK_GREY)
add_rect(slide, Inches(6.65), Inches(1.35), Inches(6.35), Inches(0.45), GOLD)
add_tb(slide, Inches(6.75), Inches(1.38), Inches(6.15), Inches(0.4),
       "LUMBAR SPINE  &  RED FLAG FINDINGS", 14, bold=True, color=DARK_BLUE)

lumbar = [
    ("LUMBAR X-RAY CHECKLIST", [
        "Alignment: lordosis preserved?",
        "Vertebral height: anterior vs posterior (wedge # = compression)",
        "Disc spaces: uniform (narrowed = DDD/infection)",
        "Pedicles: oval shadows — 'winking owl sign' if pedicle eroded = malignancy",
        "SI joints: symmetric (asymmetry = AS / fracture)",
        "Spinous processes: interspinous widening = ligament disruption",
    ], MID_BLUE),
    ("SPINE INJURY CLASSIFICATIONS", [
        "AO Spine: Type A (compression), B (distraction), C (rotation/translation)",
        "SLIC cervical: morphology + DLC + neuro; score >4 = surgical",
        "TLICS: thoracolumbar; score >4 = surgical",
    ], GREEN),
    ("EMERGENCY RED FLAGS", [
        "Cauda equina: saddle anaesthesia + bladder/bowel = MRI NOW",
        "Cord compression: bilateral neurology, Lhermitte's sign",
        "Instability: >3.5mm translation or >11° angulation vs. adjacent",
        "Pathological fracture: lytic + minimal trauma = urgent CT/MRI",
    ], RED_ALERT),
]

y = Inches(1.9)
for title, items, col in lumbar:
    add_rect(slide, Inches(6.75), y, Inches(6.15), Inches(0.28), col)
    add_tb(slide, Inches(6.85), y, Inches(6.0), Inches(0.28),
           title, 10, bold=True, color=DARK_BLUE, v_anchor=MSO_ANCHOR.MIDDLE)
    y += Inches(0.3)
    for item in items:
        add_tb(slide, Inches(6.9), y, Inches(5.95), Inches(0.32),
               f"• {item}", 10, color=WHITE)
        y += Inches(0.32)
    y += Inches(0.08)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 8 – CLASSIFICATIONS TABLE
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_GREY)
header_bar(slide, "Must-Know Classifications", "Examiners expect these classification systems by name")

rows = [
    ("Fracture / Condition",    "Classification System",    "Grades / Types",                        "Key Clinical Point",                   True),
    ("NOF Fracture",            "Garden I – IV",            "I=impacted; II=undisplaced;\nIII=partial disp; IV=full disp",   "IV elderly → hemiarthroplasty",        False),
    ("Tibial Plateau",          "Schatzker I – VI",         "I-IV lateral/medial;\nV bicondylar; VI metaphyseal",           "VI = high energy, surgical",           False),
    ("Open Fractures",          "Gustilo-Anderson I – III", "I<1cm; II 1-10cm;\nIIIA/B/C >10cm ± vascular",                "IIIC = vascular = emergency",          False),
    ("Ankle Fracture",          "Weber A / B / C",          "A below syndesm; B at;\nC above (unstable)",                   "Weber C almost always ORIF",           False),
    ("Distal Radius",           "Frykman / AO",             "Colles=dorsal; Smith=volar;\nBarton=shear",                    "Check median nerve (CTS)",             False),
    ("Shoulder Dislocation",    "Direction + lesion",       "Anterior 95%; Posterior (seizure);\nInferior (luxatio erecta)","Post: axillary nerve; Hill-Sachs",     False),
    ("Spinal Cord Injury",      "ASIA A – E",               "A=complete; B=sensory;\nC/D=motor incomplete; E=normal",       "Immediate decompression if incomplete", False),
    ("Cervical Spine Injury",   "SLIC Score",               "Morphology + DLC + Neuro\nScore 0-11; >4 = surgery",           "Check pre-vertebral soft tissue",      False),
    ("Periprosthetic Hip #",    "Vancouver A / B / C",      "B1=well-fixed (ORIF);\nB2=loose stem (revision); B3",          "B2 most important: revision surgery",  False),
    ("Femoral Head AVN",        "Ficat-Arlet I – IV",       "I: normal X-ray;\nII: cysts; III: crescent; IV: collapse",     "MRI detects pre-collapse (Ficat I/II)", False),
    ("Paediatric # Physeal",    "Salter-Harris I – V",      "I: through physis; II: metaphysis;\nIV: epiphysis; V: crush",  "V = worst prognosis (growth arrest)",  False),
]

col_w  = [Inches(2.0), Inches(2.3), Inches(3.5), Inches(3.5), Inches(1.8)]
col_x  = [Inches(0.25), Inches(2.35), Inches(4.75), Inches(8.35), Inches(11.95)]
row_h  = Inches(0.48)
y      = Inches(1.38)

for ri, row in enumerate(rows):
    if row[4]:
        bg = MID_BLUE
        fc = WHITE
        fs = 11
        bold = True
    else:
        bg = DARK_BLUE if ri % 2 == 0 else DARK_GREY
        fc = WHITE
        fs = 10.5
        bold = False

    add_rect(slide, Inches(0.25), y, Inches(13.0), row_h, bg)
    for ci, text in enumerate(row[:4]):
        add_multiline_tb(slide, col_x[ci]+Inches(0.05), y+Inches(0.03),
                         col_w[ci+1 if ci < 3 else 3]-Inches(0.1) if ci < 3 else Inches(1.3),
                         row_h-Inches(0.06),
                         [text], fs, bold=bold, color=fc)
    y += row_h


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 9 – PATHOLOGICAL & SPECIAL X-RAYS
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_BLUE)
header_bar(slide, "Pathological, Paediatric & Special Findings",
           "Patterns to recognise beyond standard trauma fractures")

# Three columns
sections = [
    {
        "title": "PATHOLOGICAL FRACTURES",
        "color": RED_ALERT,
        "items": [
            ("What it is", "Fracture through abnormal / weakened bone from minimal trauma"),
            ("Common causes", "Metastases (breast, lung, prostate, renal, thyroid)\nMultiple myeloma\nOsteoporosis (vertebral wedge)\nPaget's disease\nPrimary bone tumours (rare)"),
            ("X-ray clues", "Lytic lesion at fracture site\nMixed lytic/sclerotic (Paget's)\nVertebral body collapse without proportional trauma\nMultiple fractures at low energy"),
            ("Management", "Biopsy if unknown primary\nOrthopedic fixation (prophylactic if >50% cortex involved)\nOncology referral"),
        ],
    },
    {
        "title": "PAEDIATRIC FRACTURES",
        "color": GREEN,
        "items": [
            ("Unique patterns", "Greenstick (buckled cortex one side)\nTorus/buckle (axial compression)\nPlastic deformation (bowing)\nSalter-Harris physeal injuries I–V"),
            ("Salter-Harris", "I: Physis only (X-ray may be normal)\nII: Physis + metaphysis (most common)\nIII: Physis + epiphysis\nIV: All three\nV: Crush — worst prognosis"),
            ("Non-accidental injury", "Multiple # at different healing stages\nPosterior rib # (highly specific)\nMetaphyseal corner # (classic)\nSubdural haematoma + spiral #"),
            ("Elbow CRITOE", "Capitellum 1yr → Radial head 3yr\nInt epicondyle 5yr → Trochlea 7yr\nOlecranon 9yr → Ext epicondyle 11yr"),
        ],
    },
    {
        "title": "SOFT TISSUE & SPECIAL SIGNS",
        "color": GOLD,
        "items": [
            ("Fat pad signs (elbow)", "Anterior fat pad (sail sign): effusion\nPosterior fat pad: ALWAYS ABNORMAL — treat as occult # / radial head #"),
            ("Segond fracture", "Small avulsion lateral tibial plateau\nHIGHLY SPECIFIC for ACL tear\nLook carefully on AP knee X-ray"),
            ("Pellegrini-Stieda", "Calcification at medial femoral condyle\nIndicates old MCL injury / ossification"),
            ("Bankart & Hill-Sachs", "Bankart: ant-inferior glenoid rim avulsion\nHill-Sachs: posterolateral humeral head impaction\nBoth = anterior shoulder instability"),
            ("Winking Owl Sign", "Spine X-ray: one pedicle shadow absent\n= Pedicle erosion by metastasis"),
        ],
    },
]

cx = Inches(0.3)
cw = Inches(4.2)

for sec in sections:
    c = sec["color"]
    add_rect(slide, cx, Inches(1.38), cw, Inches(5.85), DARK_GREY, line_color=c, line_width=1.5)
    add_rect(slide, cx, Inches(1.38), cw, Inches(0.45), c)
    add_tb(slide, cx+Inches(0.1), Inches(1.4), cw-Inches(0.2), Inches(0.4),
           sec["title"], 13, bold=True, color=DARK_BLUE)
    y = Inches(1.9)
    for label, content in sec["items"]:
        add_rect(slide, cx+Inches(0.1), y, cw-Inches(0.2), Inches(0.26), MID_BLUE)
        add_tb(slide, cx+Inches(0.15), y, cw-Inches(0.3), Inches(0.26),
               label.upper(), 9, bold=True, color=WHITE, v_anchor=MSO_ANCHOR.MIDDLE)
        y += Inches(0.28)
        add_multiline_tb(slide, cx+Inches(0.15), y, cw-Inches(0.3), Inches(1.0),
                         [content], 10.5, color=WHITE)
        lines = content.count("\n") + 1
        y += Inches(0.35 + 0.3*(lines-1))
        y += Inches(0.06)
    cx += cw + Inches(0.17)


# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 10 – OSCE QUICK REFERENCE / SUMMARY
# ══════════════════════════════════════════════════════════════════════════════
slide = prs.slides.add_slide(blank)
slide_bg(slide, DARK_GREY)
header_bar(slide, "OSCE Quick Reference Card", "High-yield summary — last review before your exam")

# 6-item grid
items = [
    ("ABCDS", "Alignment • Bones • Cartilage\nDensity • Soft Tissue\nUse for EVERY X-ray", MID_BLUE),
    ("6 Ps Vascular", "Pain (passive stretch) • Pallor\nPulselessness • Paraesthesia\nParalysis • Perishingly Cold", RED_ALERT),
    ("Ottawa Rules", "X-ray ankle if:\n• Malleous tenderness\n• Navicular tenderness\n• 5th MT base tenderness\n• Cannot weight-bear 4 steps", GOLD),
    ("Scaphoid Rule", "Snuffbox tenderness = treat\nas scaphoid # even if X-ray normal\nRisk: AVN proximal pole\nMRI or repeat X-ray at 14 days", GREEN),
    ("NOF Fracture", "Shortened + externally rotated\nGarden I–IV\nIntracapsular: hemiarthroplasty\nExtracapsular: DHS / PFN", MID_BLUE),
    ("Compartment Sx", "EMERGENCY: pain on\npassive stretch + tense compartment\n→ Fasciotomy IMMEDIATELY\nCommon: tibial #, forearm #", RED_ALERT),
    ("ACL Injury", "Haemarthrosis + pop\nLachman's most sensitive\nSegond # on X-ray = ACL\nMRI to confirm", ORANGE),
    ("Open Fracture", "Gustilo-Anderson I–III\nAbx within 1 hour\nPhoto → sterile dressing\nTheatre washout <6h (IIIB/C)", GREEN),
    ("Cauda Equina", "EMERGENCY: saddle anaesthesia\n+ bladder/bowel dysfunction\n+ bilateral leg weakness\n→ MRI + surgical decompression", RED_ALERT),
    ("Elbow Paediatric", "Posterior fat pad = ABNORMAL\nCRITOE (1-3-5-7-9-11 years)\nAnterior humeral line\nRadiocapitellar line", GOLD),
    ("Shoulder Disloc.", "95% anterior\nAxillary nerve: test BEFORE + AFTER\nHill-Sachs + Bankart\nPosterior = seizure/electrocution", MID_BLUE),
    ("Spinal Trauma", "ASIA A–E\nCauda equina = emergency\nSLIC >4 = surgery\nPre-vertebral STW on C-spine X-ray", ORANGE),
]

col_w = Inches(3.15)
col_h = Inches(1.55)
gx = Inches(0.3)
gy = Inches(1.38)
cols = 4

for i, (title, content, col) in enumerate(items):
    row = i // cols
    c_  = i  % cols
    bx  = gx + c_*(col_w + Inches(0.12))
    by  = gy + row*(col_h + Inches(0.1))

    add_rect(slide, bx, by, col_w, col_h, DARK_BLUE, line_color=col, line_width=1.5)
    add_rect(slide, bx, by, col_w, Inches(0.3), col)
    add_tb(slide, bx+Inches(0.1), by, col_w-Inches(0.2), Inches(0.3),
           title, 11, bold=True, color=DARK_BLUE, v_anchor=MSO_ANCHOR.MIDDLE)
    add_multiline_tb(slide, bx+Inches(0.1), by+Inches(0.32), col_w-Inches(0.2),
                     col_h-Inches(0.38), [content], 10, color=WHITE)


# ══════════════════════════════════════════════════════════════════════════════
# SAVE
# ══════════════════════════════════════════════════════════════════════════════
out_path = "/tmp/workspace/ortho-xray-pptx/Ortho_Xray_Interpretation_OSCE.pptx"
buf = BytesIO()
prs.save(buf)
with open(out_path, "wb") as f:
    f.write(buf.getvalue())
print(f"Saved → {out_path}")

Running Command

cd /tmp/workspace/ortho-xray-pptx && python build_pptx.py 2>&1

Running Command

ls -lh /tmp/workspace/ortho-xray-pptx/Ortho_Xray_Interpretation_OSCE.pptx

Your presentation is ready. Here is the download link:

Ortho Xray Interpretation OSCE

Presentation · PPTX

What's Inside (10 Slides)

Slide	Content
1	Title slide with professional dark blue/gold design
2	ABCDS Framework - the 5-column systematic approach (Alignment, Bones, Cartilage, Density, Soft Tissue)
3	Fracture Description Template - 9-step protocol + fracture pattern reference table (transverse, spiral, oblique, comminuted, greenstick, etc.)
4	Upper Limb Fractures - Colles', Scaphoid, Proximal Humerus, Paediatric Elbow with X-ray findings and clinical pearls per card
5	Lower Limb Fractures - NOF (Garden), Tibial Plateau (Schatzker), Tibial Shaft (Gustilo), Ankle (Weber) with management
6	Dislocations - Shoulder, Hip, Patella, Elbow, Ankle with nerve injury alerts and reduction techniques
7	Spine X-Rays - Cervical 4-line alignment, lumbar checklist, AO Spine / SLIC / TLICS classification, cauda equina red flags
8	Must-Know Classifications Table - Garden, Schatzker, Gustilo, Weber, Frykman, ASIA, Salter-Harris, Vancouver in one reference table
9	Pathological, Paediatric & Special Findings - Segond fracture (ACL), fat-pad signs, Bankart/Hill-Sachs, winking owl sign, non-accidental injury
10	OSCE Quick Reference Card - 12-box grid covering every high-yield topic in a revision-at-a-glance format

Design: 16:9 widescreen, dark navy/blue colour scheme with gold accents, colour-coded by topic - optimised for on-screen study and projector display.

Generate a Word document with case-based OSCE scenarios (diagnosis + classification + management)

Reading File

Running Command

mkdir -p /tmp/workspace/ortho-osce-docx

This is a shared conversation. Sign in to Orris to start your own chat.