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Give me all 2 marks answers by using this pdfs

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import pdfplumber pdf1 = "/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinical ortho 2020.26 .pdf" pdf2 = "/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinicalortho 2011.24 .pdf" for label, path in [("PDF1 (2020)", pdf1), ("PDF2 (2011)", pdf2)]: print(f"\n{'='*60}") print(f" {label}") print(f"{'='*60}") with pdfplumber.open(path) as pdf: print(f"Total pages: {len(pdf.pages)}") # Print first 3 pages to understand structure for i, page in enumerate(pdf.pages[:3]): print(f"\n--- Page {i+1} ---") txt = page.extract_text() if txt: print(txt[:2000])

Running Command

python3 -c " import pdfplumber pdf1 = '/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinical ortho 2020.26 .pdf' pdf2 = '/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinicalortho 2011.24 .pdf' for label, path in [('PDF1_2020', pdf1), ('PDF2_2011', pdf2)]: print('='*60) print(label) print('='*60) with pdfplumber.open(path) as pdf: print('Total pages:', len(pdf.pages)) for i, page in enumerate(pdf.pages[:4]): print('--- Page', i+1, '---') txt = page.extract_text() if txt: print(txt[:1500]) print() "

Running Command

python3 -c " import pdfplumber pdf1 = '/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinical ortho 2020.26 .pdf' pdf2 = '/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinicalortho 2011.24 .pdf' print('=== PDF1 (2020) ALL PAGES ===') with pdfplumber.open(pdf1) as pdf: for i, page in enumerate(pdf.pages): txt = page.extract_text() if txt: print(f'--- PAGE {i+1} ---') print(txt) print() "

Running Command

python3 -c " import pdfplumber pdf2 = '/tmp/workspace/attachments/f3bd0970-4319-473c-8a78-118110762d60/Clinicalortho 2011.24 .pdf' print('=== PDF2 (2011) ALL PAGES ===') with pdfplumber.open(pdf2) as pdf: for i, page in enumerate(pdf.pages): txt = page.extract_text() if txt: print(f'--- PAGE {i+1} ---') print(txt) print() "

Here are all 2-mark questions with answers from both PDFs, organized paper-by-paper:

ALL 2-MARK QUESTIONS & ANSWERS

Clinical Orthopaedics - BPT Examinations (TNMGRMU)

PDF 1: 2020-2026 (3rd Year, Sub Code 6284)

Dec 2020 / Aug 2020 Session

1. Define Periarthritis Shoulder. List the clinical features. Periarthritis shoulder (adhesive capsulitis/frozen shoulder) is a painful, progressive loss of glenohumeral joint motion due to inflammation and fibrosis of the joint capsule. Clinical features: Pain at rest and on movement, progressive stiffness in all planes (abduction, external rotation most affected), night pain, shoulder muscle wasting, loss of scapulohumeral rhythm, three stages - freezing (painful), frozen (stiff), thawing (recovery).
2. List the splints used for Upper extremity Peripheral nerve injuries.
  • Radial nerve palsy - Cock-up splint / Wrist extension splint
  • Ulnar nerve palsy - Knuckle bender splint / Anti-claw splint / Lively splint
  • Median nerve palsy - Opponens splint
  • Combined (median + ulnar) - Intrinsic plus splint
  • Brachial plexus injury - Aeroplane splint / Overhead sling
3. Difference between open fracture and closed fracture.
Open FractureClosed Fracture
Skin overlying fracture is brokenSkin intact over fracture site
Bone may be exposedBone not exposed
High infection riskLow infection risk
Requires wound debridementNo wound management needed
Graded by Gustilo-Anderson classificationNo such grading
4. List the levels of Lower limb Amputation.
  • Hindquarter (hemipelvectomy)
  • Hip disarticulation
  • Above knee (transfemoral)
  • Through-knee (knee disarticulation)
  • Below knee (transtibial)
  • Syme's amputation (ankle disarticulation)
  • Transmetatarsal
  • Ray amputation
  • Toe amputation
5. Difference between dislocation and subluxation.
DislocationSubluxation
Complete loss of articular contactPartial/incomplete loss of contact
Complete displacement of joint surfacesJoint surfaces still partially in contact
More severeLess severe
Requires reduction under anaesthesiaMay reduce spontaneously
Example: anterior shoulder dislocationExample: subluxation of patella
6. List the causes for shoulder impingement syndrome.
  • Supraspinatus tendon degeneration
  • Subacromial bursitis
  • Acromial spur / hooked acromion (type II/III)
  • Acromioclavicular joint arthritis
  • Thickened coracoacromial ligament
  • Weakness of rotator cuff muscles
  • Poor posture (forward head, rounded shoulders)
  • Repetitive overhead activities
7. Difference between Tidy and Untidy injuries of hand.
Tidy InjuriesUntidy Injuries
Clean, sharp, incised woundsCrush, avulsion, or contaminated wounds
Wound edges cleanWound edges ragged/devitalized
Primary repair possibleSecondary repair preferred
Better prognosisPoorer prognosis
Example: glass cutExample: machinery crush injury
8. Cobb's Angle. Cobb's angle is the standard radiological measurement used to quantify the degree of lateral curvature in scoliosis. Method: On AP X-ray, identify the uppermost and lowermost end vertebrae of the curve. Draw perpendicular lines from the upper endplate of the top vertebra and lower endplate of the bottom vertebra. The angle between these perpendicular lines = Cobb's angle.
  • <10°: Normal
  • 10-20°: Observation
  • 20-40°: Bracing
  • 40°: Surgical correction
9. List the types of Leprosy. Based on Ridley-Jopling classification:
  • Tuberculoid (TT)
  • Borderline tuberculoid (BT)
  • Mid borderline (BB)
  • Borderline lepromatous (BL)
  • Lepromatous (LL)
  • Indeterminate (I) WHO classification: Paucibacillary (1-5 lesions) and Multibacillary (>5 lesions)
10. Difference between Pes Cavus and Pes Planus.
Pes CavusPes Planus
Abnormally high medial longitudinal archFlat/absent medial longitudinal arch
Exaggerated archCollapsed arch
Associated with neurological conditions (CMT, polio)Associated with ligamentous laxity, tibialis posterior dysfunction
Claw toes, callosities on metatarsal headsValgus heel, medial bulge
Navicular drop sign - negativeNavicular drop sign - positive

Sept 2021 / Feb 2021 Session

1. Z Plasty. Z-plasty is a plastic surgical technique used to lengthen a contracted scar, change the direction of a scar, or release a scar contracture. Two triangular flaps are cut in a Z-shape, and the flaps are transposed. The central limb of the Z is placed along the line of contracture. A standard 60° Z-plasty gives approximately 75% lengthening of the central limb. Uses: Release of scar contractures, correction of web spaces, treatment of Dupuytren's contracture.
2. Thompson Test. Thompson's test (Simmonds test) is used to diagnose rupture of the Achilles tendon. The patient lies prone with feet hanging off the table. The calf muscle is squeezed. Positive test: Absence of plantar flexion of the foot indicates complete Achilles tendon rupture.
3. Boxer's Fracture. A fracture of the neck of the 5th metacarpal (little finger), typically caused by striking with a closed fist. Features: volar angulation of the metacarpal head, deformity (knuckle depression), pain and swelling over the little finger knuckle. Named because it commonly occurs during a punch. Treatment: Neighbour strapping, ulnar gutter splint; reduction if >40° angulation.
4. Neuropraxia. The mildest form of peripheral nerve injury (Seddon's classification). There is a local conduction block without axonal disruption. Myelin sheath may be damaged but the axon and endoneurium remain intact. Features: Motor weakness, no muscle wasting, sensory loss minimal or absent. Prognosis: Complete recovery within days to 3 months without treatment.
5. Knock Knee (Genu Valgum). A deformity where the knees touch together (angled inward) while the ankles remain apart. Measured by: Intermalleolar distance (IMD). Normal up to age 7 years (physiological). Causes: Rickets, obesity, epiphyseal injury, rheumatoid arthritis. Treatment: Physiological - observe; pathological - corrective osteotomy or guided growth.
6. Ischemic Contracture (Volkmann's Ischemic Contracture). A serious complication of compartment syndrome, typically following supracondylar fracture of humerus in children. Ischemia of forearm flexor muscles leads to fibrosis and contracture. Features: Wrist flexion, finger flexion, forearm pronation deformity; intrinsic minus hand. Treatment: Established - muscle slide operation, tendon lengthening; severe - free muscle transfer.
7. Painful Arc Syndrome. Pain during a specific arc of shoulder abduction (60-120°) suggesting impingement of the supraspinatus tendon or subacromial bursa between the greater tuberosity and the acromion. Pain disappears at full elevation (>120°). Cause: Supraspinatus tendinitis, subacromial bursitis, AC joint pathology (pain at top of arc, 160-180°).
8. Slump Test. A neural tension test for lumbar disc herniation or meninges irritation. Method: Patient sits with hips at 90°, slumps the back, flexes neck, extends knee, dorsiflexes foot. Positive: Reproduction of patient's radicular pain along the leg. Used to detect dural irritation, disc prolapse, or sciatic nerve irritation.
9. Jumper's Knee (Patellar Tendinitis). Overuse injury of the patellar tendon at its origin from the inferior pole of the patella. Common in sports involving repetitive jumping (volleyball, basketball). Features: Pain at inferior pole of patella aggravated by jumping, squatting, stairs. Treatment: Rest, NSAIDs, eccentric quadriceps exercises, patellar tendon strapping.
10. Hangman's Fracture. Traumatic spondylolisthesis of C2 vertebra with bilateral fracture through the pedicles (pars interarticularis) of C2, caused by forced hyperextension and distraction (e.g., judicial hanging, diving, motor vehicle accidents). Features: Neck pain, variable neurological deficit. Classification: Levine and Edwards. Treatment: Halo vest immobilization; surgery for unstable injuries.

Jan 2022 / Aug 2021 Session

1. Aeroplane Splint. An abduction splint that holds the shoulder in 45-90° abduction, slight forward flexion, and the elbow at 90°. Used after repair of brachial plexus injuries (Erb's palsy), axillary nerve injury, shoulder reconstructive surgeries, to relieve tension on repaired structures and allow healing in the correct position.
2. Apley Scratch Test. A functional test for shoulder range of motion. Three movements assessed:
  • Reach over the head and touch opposite scapula (abduction + external rotation)
  • Reach behind the head to touch opposite shoulder blade
  • Reach behind the back to touch opposite scapula (internal rotation + adduction) Limitations indicate rotator cuff pathology or adhesive capsulitis.
3. Piriformis Syndrome. A condition in which the piriformis muscle irritates or compresses the sciatic nerve as it passes beneath or through the muscle at the greater sciatic foramen. Features: Buttock pain, sciatica-like symptoms, pain worsened by sitting, tenderness over piriformis. Tests: FAIR test (Flexion, Adduction, Internal Rotation), Pace test. Treatment: Stretching, physiotherapy, steroid injection.
4. Delayed Union. A fracture that has not united in the expected time but still shows potential for healing. Usually diagnosed when there is no radiological union by 3-6 months (depending on bone and fracture type). Causes: Infection, poor blood supply, distraction, inadequate immobilization. Treatment: Address underlying cause, bone stimulators, bone grafting if needed.
5. Vertical Talus (Congenital Rocker Bottom Foot). A rare rigid foot deformity where the talus is plantar-flexed and the navicular dislocates dorsolaterally onto the neck of the talus. Results in a characteristic "rocker bottom" appearance. Causes: Idiopathic, arthrogryposis, spina bifida, chromosomal abnormalities. Treatment: Serial casting (reverse Ponseti), surgical correction.
6. Waddling Gait (Trendelenburg Gait). Bilateral Trendelenburg gait produces a waddling appearance, seen when both hip abductors are weak. The trunk sways excessively to both sides during walking. Causes: Bilateral CDH, bilateral coxa vara, muscular dystrophy, bilateral hip OA. Single Trendelenburg: Trunk leans to the affected side due to weak gluteus medius, seen in CDH, polio, neck of femur fractures.
7. Three-Point Principles (of Fracture Immobilization). Three-point fixation is the principle of applying three contact forces to stabilize a fracture: two forces on one side and one opposing force between them. Used in functional bracing, casting, and some orthoses. The middle force is applied at the fracture site and the two end forces are applied proximal and distal. Ensures the fracture is held in correct alignment.
8. Anterior Cruciate Ligament (ACL). The ACL runs from the anteromedial aspect of the tibial plateau to the posterolateral aspect of the lateral femoral condyle. It prevents anterior translation of the tibia and excessive internal rotation. Tests: Anterior drawer test, Lachman test (most sensitive), Pivot shift test. Injury: Common in contact sports; "pop" heard at injury, hemarthrosis, instability. Treatment: Conservative (young/low demand) or ACL reconstruction (hamstring/patellar tendon graft).
9. Madelung's Deformity. A rare congenital deformity characterized by premature closure of the volar-ulnar distal radial physis, causing ulnar and volar tilt of the distal radial articular surface, resulting in dorsal prominence of the distal ulna, short radius, and wrist deformity. More common in females, associated with Leri-Weill dyschondrosteosis (SHOX gene mutation).
10. McMurray Test. A clinical test for meniscal tears. Method: Patient supine, knee fully flexed. For medial meniscus: foot externally rotated, knee extended while applying valgus stress. For lateral meniscus: foot internally rotated with varus stress. Positive: A palpable/audible click or pain at joint line indicates a meniscal tear.

June 2022 / Feb 2022 Session

1. Lumbosacral Belt. A rigid or semi-rigid orthotic device applied around the lower back and pelvis to provide support, reduce lumbar motion, and relieve pain. Used in acute low back pain, lumber disc prolapse, spondylolisthesis, sacroiliac joint dysfunction. Reduces intervertebral pressure by increasing intra-abdominal pressure.
2. Mallet Finger. Disruption of the extensor tendon at its insertion into the distal phalanx (Zone I injury), causing inability to extend the DIP joint (DIP flexion deformity). Mechanism: Forced flexion of an actively extended finger tip. Treatment: Continuous splinting of DIP in full extension for 6-8 weeks (Stack splint). Surgical repair rarely needed.
3. Deep Vein Thrombosis (DVT). Formation of a thrombus within the deep veins, usually of the calf or thigh. A feared complication of orthopaedic surgery (especially THR, TKR) and prolonged immobilization. Features: Calf pain, swelling, Homans sign (not reliable), warmth, erythema. Diagnosis: Doppler ultrasound. Treatment: Low molecular weight heparin (LMWH), warfarin, mechanical prophylaxis.
4. Erb's Palsy (Erb-Duchenne Palsy). Upper brachial plexus palsy affecting C5-C6 nerve roots, most common birth injury. Features: Arm hangs adducted, internally rotated; elbow extended, forearm pronated, wrist flexed - "Waiter's tip" position. Muscles affected: Deltoid, supraspinatus, infraspinatus, biceps, brachioradialis. Treatment: Physiotherapy, splinting; surgical nerve repair if no recovery by 3-6 months.
5. Apley's Compression Test. A test for meniscal injury. Method: Patient prone, knee at 90°. Distraction test: lift leg while rotating (positive = ligament injury). Compression test: press foot downward while rotating (positive = meniscal injury, pain on internal rotation = lateral meniscus, pain on external rotation = medial meniscus).
6. Cozen's Test. Provocative test for lateral epicondylitis (tennis elbow). Method: Patient makes a fist and extends the wrist against resistance while the elbow is extended and forearm is pronated. Positive: Sudden severe pain at the lateral epicondyle. Another variant: patient flexes fingers while the examiner resists wrist extension.
7. Gibbus Deformity. A sharp, angular kyphotic deformity of the spine caused by collapse of one or more vertebral bodies. Classic sign of Pott's spine (spinal tuberculosis). The collapsed vertebra causes a posterior prominence. Other causes: Osteoporotic vertebral fracture, metastatic disease. Significance: Can cause spinal cord compression and paraplegia.
8. Cock-up Splint. A wrist extension splint that holds the wrist in 30-40° of dorsiflexion, keeping the fingers free to move. Used in wrist drop (radial nerve palsy), preventing flexion contracture, after wrist surgery/fractures. Allows tenodesis effect for functional grip.
9. Galeazzi Fracture. A fracture of the distal third of the radius combined with dislocation of the distal radioulnar joint (DRUJ). Termed "fracture of necessity" as it always requires surgical fixation. Treatment: ORIF of radius with anatomical reduction restores DRUJ alignment in most cases.
10. Hill-Sachs Lesion. A compression fracture of the posterolateral humeral head occurring as the humeral head impacts against the anterior glenoid rim during anterior shoulder dislocation. An osteochondral defect. Significance: Contributes to recurrent dislocations. Associated with Bankart lesion. Surgical treatment: Remplissage procedure for engaging lesions.

Oct 2022 / Aug 2022 Session

1. Difference between Coxa Vara and Coxa Valga.
Coxa VaraCoxa Valga
Neck-shaft angle <120° (normally 135°)Neck-shaft angle >135°
Varus deformity of neckValgus deformity of neck
Shortened limb, Trendelenburg gaitLimb may appear longer
Causes: Rickets, Paget's, fracture malunionCauses: Cerebral palsy, polio
2. Central Dislocation of Hip. Medial displacement of the femoral head through the acetabular floor (acetabular floor fracture). Caused by high-energy trauma - direct blow to the greater trochanter or axial loading. Features: limb shortened, internally rotated. Diagnosis on X-ray/CT. Treatment: skeletal traction, surgical ORIF for displaced fractures.
3. Define Burns and the Degrees of Burns. Burns are tissue injuries caused by heat, chemicals, electricity, or radiation.
  • 1st degree (superficial): Epidermis only; red, dry, painful (e.g., sunburn)
  • 2nd degree superficial (partial thickness): Epidermis + superficial dermis; blisters, wet, very painful
  • 2nd degree deep (deep partial thickness): Epidermis + deep dermis; less painful, white/red
  • 3rd degree (full thickness): All layers destroyed; leathery, painless, needs grafting
  • 4th degree: Extends to bone/tendon/muscle
4. Swan-Neck Deformity. A finger deformity characterized by hyperextension of the PIP joint and flexion of the DIP joint. Seen in rheumatoid arthritis. Causes: Intrinsic tightness, volar plate laxity at PIP, mallet finger deformity. Treatment: Ring splints (swan neck splint), surgical correction for severe cases.
5. Genu Recurvatum. Hyperextension deformity of the knee joint (knee bends backward beyond 0°). Causes: Ligamentous laxity, polio (hamstring and quadriceps weakness), cerebral palsy, knee joint effusion, genu recurvatum brace. Treatment: Strengthening exercises, knee-ankle-foot orthosis (KAFO), corrective surgery.
6. Define Dislocation and Subluxation.
  • Dislocation: Complete loss of contact between articular surfaces of a joint
  • Subluxation: Partial/incomplete displacement where some articular contact remains
7. Metatarsalgia. Pain arising from the metatarsal heads due to abnormal pressure distribution. Commonly affects the 2nd and 3rd metatarsal heads. Causes: High heels, hallux valgus, pes cavus, rheumatoid arthritis, Morton's neuroma. Treatment: Metatarsal bar, orthotics, corrective shoes, surgical shortening osteotomy.
8. Chest Wall Deformities.
  • Pectus excavatum (funnel chest): Sunken sternum; associated with Marfan syndrome
  • Pectus carinatum (pigeon chest): Prominent sternum; from childhood respiratory disease
  • Harrison's sulcus: Groove along lower chest wall from rickets
  • Barrel chest: Increased AP diameter in COPD
9. Causes of Foot Drop.
  • Common peroneal nerve palsy (most common)
  • L4-L5 disc prolapse
  • Sciatic nerve injury
  • Stroke / UMN lesion
  • Poliomyelitis
  • Charcot-Marie-Tooth disease
  • Compartment syndrome of anterior leg
10. Wry Neck (Torticollis). Head tilted to one side with rotation to the opposite side due to sternocleidomastoid muscle tightness or spasm. Types: Congenital muscular torticollis (SCM fibrosis), spasmodic torticollis (cervical dystonia), bony torticollis (Klippel-Feil syndrome). Treatment: Physiotherapy (stretching), Botox for spasmodic type, surgical release for resistant congenital type.

April 2023 / Feb 2023 Session

1. Types of CTEV (Congenital Talipes Equino Varus). Components (CAVE mnemonic):
  • Cavus (high arch)
  • Adductus (forefoot adduction)
  • Varus (hindfoot inversion)
  • Equinus (plantar flexion) Classification: Ponseti classification - flexible vs. rigid. Dimeglio's classification - Grade I-IV based on reducibility.
2. Q Angle. The quadriceps angle - formed between the line from ASIS to centre of patella and the line from centre of patella to tibial tuberosity. Normal: Males 10-14°, Females 15-17°. Increased Q angle predisposes to lateral patellar subluxation, chondromalacia patella, patellofemoral pain syndrome. Measured with knee extended and quadriceps relaxed.
3. SLR Test (Straight Leg Raise Test). Test for lumbar disc herniation / sciatic nerve irritation. Method: Patient supine, examiner passively raises the leg with knee extended. Positive: Radicular pain in dermatomal distribution below the knee at 30-60° of elevation (Lasegue's sign). Dorsiflexion of foot (Bragard's test) increases pain. Normal range: 80-90°.
4. Cold Abscess. An abscess with little or no surrounding inflammation, heat, or redness - characteristic of tuberculosis. Formed by the accumulation of caseous material and liquefied tissue. In TB spine (Pott's disease), psoas abscess tracks along the psoas sheath and may present in the groin or thigh. Treatment: Anti-TB drugs; surgical drainage if not resolving.
5. De Quervain's Disease. Stenosing tenosynovitis of the 1st dorsal extensor compartment affecting the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. Features: Pain and swelling over radial styloid, tenderness over 1st dorsal compartment. Finkelstein test: Positive (pain on ulnar deviation with thumb enclosed in fist). Treatment: Rest, splint, steroid injection, surgical release.
6. Erb's Point. The point at the upper trunk of the brachial plexus where C5 and C6 nerve roots merge, located 2-3 cm above the clavicle at the posterior triangle of the neck. The most vulnerable point of the brachial plexus to traction injuries. Injury here causes Erb-Duchenne palsy (C5-C6 palsy) - "waiter's tip" deformity.
7. Phantom Limb Pain. A painful sensation perceived as arising from an amputated or deafferented limb. Felt as burning, cramping, shooting pain. Distinct from stump pain. Mechanism: Cortical reorganization, peripheral sensitization, spinal mechanisms. Treatment: Mirror therapy (most evidence), medication (gabapentin, amitriptyline), TENS, psychological therapy.
8. Z-Thumb Deformity. A deformity of the thumb seen in rheumatoid arthritis characterized by flexion of the MCP joint and hyperextension of the IPJ of the thumb, giving a Z-shaped appearance when viewed from the side. Also called "Z" deformity of the thumb. Treatment: splinting, MCP joint fusion.
9. Ely's Test. Tests for tightness of the rectus femoris muscle. Method: Patient prone; examiner passively flexes the knee. Positive: If the hip spontaneously flexes and the pelvis rises off the table, it indicates rectus femoris tightness. Also used as a provocation test for femoral nerve tension.
10. Hoffa's Fracture. A coronal plane fracture of the posterior femoral condyle. Usually involves the lateral femoral condyle. Caused by high-energy trauma (RTA). Classified by Letenneur. Difficult to see on AP X-ray; CT scan confirms. Requires surgical fixation (lag screw fixation from anterior to posterior).

Nov 2023 / Aug 2023 Session

1. P.A. Shoulder (Periarthritis Shoulder). See Dec 2020 answer above.
2. Bamboo Spine. Radiological appearance of the spine in advanced ankylosing spondylitis. The intervertebral disc spaces are ossified with bridging syndesmophytes forming continuous bony columns along the anterior and lateral aspect of the spine, resembling a bamboo stick on X-ray. Associated with fusion of facet joints, squaring of vertebrae.
3. Gun Stock Deformity (Cubitus Varus). A deformity where the carrying angle of the elbow is reduced below normal (normal 5-15° valgus). The arm appears angled inward (varus), resembling a gun stock. Most commonly a late complication of malunited supracondylar fracture of humerus in children. Treatment: Lateral closing wedge osteotomy of distal humerus.
4. Trigger Finger (Stenosing Tenosynovitis). A condition in which the finger flexor tendon catches or locks as it passes through a narrowed A1 pulley at the base of the finger. Features: Clicking, triggering, or locking of the finger; tender nodule over MCP joint. Causes: Overuse, RA, diabetes. Treatment: Steroid injection, surgical pulley release.
5. Malunion. Union of a fracture in a suboptimal position (with shortening, angulation, or rotational deformity). Results in functional impairment and cosmetic deformity. Treatment: Corrective osteotomy if symptomatic. Distinguished from non-union (failure to unite) and delayed union.
6. Hangman's Fracture. See Sept 2021 answer above.
7. Brodie's Abscess. A subacute form of haematogenous osteomyelitis presenting as a localized bone abscess, most commonly in the distal tibia metaphysis in young adults. The infection is walled off by host defenses. X-ray: Radiolucent lesion with sclerotic rim. Treatment: Curettage + bone grafting + antibiotics.
8. Coxa Vara. See Oct 2022 answer above.
9. Torticollis. See Oct 2022 (Wry Neck) answer above.
10. Phantom Limb. See April 2023 answer above.

Aug 2024 Session

1. Hallux Valgus. Lateral deviation of the great toe at the first MTP joint with medial deviation of the first metatarsal, producing a bunion. Causes: Ill-fitting shoes, flat feet, hereditary, rheumatoid arthritis. Features: Bunion pain, skin thickening, bursitis, hammer toes. Measurement: Hallux valgus angle (HVA) >15°, intermetatarsal angle (IMA) >9°. Treatment: Conservative (wide shoes, orthotics); surgical (chevron osteotomy, SCARF osteotomy).
2. Non-Union. Failure of a fracture to heal after an expected time period, typically 6-9 months, with no evidence of progression of healing. Types: Hypertrophic (elephant's foot - adequate blood supply, inadequate stability) vs. Atrophic (adequate stability, inadequate blood supply). Treatment: Hypertrophic - rigid fixation; Atrophic - bone grafting + fixation; Infected - debridement, antibiotics.
3. Kyphosis. Increased posterior convexity of the thoracic spine (normal thoracic kyphosis 20-50°). Types: Postural (flexible), Scheuermann's (rigid, structural), Congenital, Pathological (TB gibbus, osteoporosis). Features: Rounded back, chest deformity, dyspnoea if severe. Treatment: Postural exercises, bracing (Milwaukee brace); surgery for >75° or neurological deficit.
4. Bamboo Spine. See Nov 2023 answer above.
5. Ape Thumb Deformity. A deformity caused by median nerve injury (high or low) characterized by thenar muscle wasting leading to loss of the normal "saddle" position of the thumb. The thumb lies flat in the plane of the palm (loss of opposition). Cause: Median nerve palsy at wrist (carpal tunnel) or forearm. Treatment: Opponens splint, opponensplasty.
6. Ulnar Claw Hand. A deformity due to ulnar nerve injury characterized by hyperextension of the MCP joints and flexion of the PIP and DIP joints of the ring and little fingers (intrinsic minus position). The 4th and 5th fingers are predominantly affected. Cause: Ulnar nerve injury at wrist (low lesion gives worse claw due to intact FDP). Treatment: Knuckle-bender splint, Zancolli lasso, Bouvier's maneuver assessment.
7. Osteochondroma. The most common benign bone tumour. A cartilage-capped bony exostosis (outgrowth) that arises from the surface of bone, growing away from the nearest joint. Sites: Distal femur, proximal tibia, proximal humerus. X-ray: Pedunculated or sessile bony projection with cortical continuity. Risk: Malignant transformation to chondrosarcoma (<1% solitary; higher in hereditary multiple exostosis).
8. Onion Peel Appearance. A classic radiological finding of Ewing's sarcoma - multiple layers of periosteal new bone formation resembling the layers of an onion, seen on X-ray of the diaphysis of long bones. Also associated with the "sunburst" pattern (in Osteosarcoma) and "moth-eaten" lytic lesions.
9. Cubitus Varus. See Nov 2023 (Gun Stock Deformity) answer above.
10. Erb's Point. See April 2023 answer above.

Feb 2025 Session

1. Alkaline Phosphatase. An enzyme found in bone, liver, kidney, and intestine. In orthopaedics: elevated in conditions with increased bone turnover - Paget's disease, osteosarcoma, osteomalacia, bone metastases, fracture healing, hyperparathyroidism. Normal: 44-147 IU/L (adults). Very high levels (10x normal) seen in Paget's disease.
2. Dennis Brown Splint. A boots-and-bar splint used in the management of clubfoot (CTEV) and in-toeing. Two specially designed shoes are attached to a bar that maintains foot abduction (60-70° external rotation). Used in the maintenance phase of Ponseti treatment for CTEV after full correction, worn full time then reducing to nighttime only until age 4-5 years.
3. Scoliosis. A three-dimensional deformity of the spine with lateral curvature >10° (Cobb's angle) combined with vertebral rotation. Types: Idiopathic (most common), congenital, neuromuscular. Clinical features: Uneven shoulders, rib hump (Adam's forward bend test), uneven waist. Treatment: Observation (<20°), bracing (20-40°), surgery (>45-50° or progressive).
4. Ankylosis. Fusion/immobility of a joint. Types: Bony ankylosis (fibrous tissue replaced by bone - true ankylosis) and fibrous ankylosis (joint surfaces connected by fibrous tissue but bone not fused). Causes: Infection (septic arthritis), TB, ankylosing spondylitis, advanced OA. Bony ankylosis is painless; fibrous ankylosis is painful.
5. Compression Fractures of Vertebrae. Fractures where the anterior column of the vertebra is compressed, causing loss of vertebral height. Causes: Osteoporosis (most common), trauma, metastatic disease, TB. Features: Acute back pain, kyphosis (gibbus in TB). Treatment: Conservative (bracing, analgesia); vertebroplasty/kyphoplasty for osteoporotic fractures; surgery for neurological deficit.
6. Chronic Synovitis. Persistent inflammation of the synovial membrane lining a joint. Causes: Rheumatoid arthritis, TB, pigmented villonodular synovitis (PVNS), crystal arthropathies. Features: Warm, swollen joint; boggy synovial thickening; restricted movement; joint effusion; cartilage destruction over time. Treatment: Disease-specific; may require synovectomy.
7. Osteoid Osteoma. A benign bone tumour composed of a central nidus (<2 cm) of osteoid and woven bone surrounded by reactive sclerosis. Sites: Femoral neck, tibial cortex (most common in cortical bone of long bones). Features: Night pain classically relieved by aspirin/NSAIDs. X-ray: Small radiolucent nidus with surrounding dense sclerosis. Treatment: Radiofrequency ablation (RFA) or surgical excision.
8. Taylor Knight Brace (TK Brace). A thoracolumbosacral orthosis (TLSO) consisting of two posterior uprights, two lateral uprights, and a pelvic band with thoracic band. Used for mechanical low back pain, lumbar compression fractures, spondylolisthesis, post-spinal surgery rehabilitation. Controls lumbar flexion and extension.
9. Kyphosis. See Aug 2024 answer above.
10. Bisphosphonates. A class of drugs that inhibit osteoclast-mediated bone resorption by binding to hydroxyapatite crystals in bone. Uses in orthopaedics: Osteoporosis (most common), Paget's disease, metastatic bone disease, osteogenesis imperfecta, hypercalcaemia of malignancy. Examples: Alendronate (oral), Zoledronic acid (IV), Pamidronate (IV). Side effects: Osteonecrosis of jaw, atypical femoral fractures.

Feb 2026 Session

1. Pointing Index. Seen in low ulnar nerve palsy. The index finger points (extends) relative to the other fingers when the patient tries to make a fist. Due to intact median-innervated lumbricals for index and middle fingers (causing extension of IP joints when FDP is weak) or in combined nerve palsies.
2. Coin Test. Used to detect tracheal deviation and assess the midline position of the trachea - a clinical test for pneumothorax, pleural effusion, or mediastinal shift. Also used in the context of Pott's spine to detect paravertebral cold abscesses by percussing over bony prominences.
3. Dinner Fork Deformity. The classic deformity of a Colles' fracture when seen from the side - a lateral profile resembling a dinner fork, with the distal fragment displaced dorsally and radially, giving a "step" appearance. There is also radial shortening, dorsal tilt, and radial tilt of the articular surface.
4. Antalgic Gait. A limp caused by pain in the lower limb during the stance phase. The patient shortens the stance phase on the affected side to minimize weight-bearing and pain. Causes: Hip OA, fracture, infection, tumour. Distinguished from Trendelenburg gait (hip abductor weakness) and short leg gait.
5. Osteotomy. A surgical procedure in which a bone is deliberately cut to realign, shorten, lengthen, or correct a deformity. Types: Corrective (valgus/varus), closing/opening wedge, rotation osteotomy. Uses: Realignment in OA (high tibial osteotomy), correcting coxa vara, DDH, malunion.
6. Skin Traction. A method of traction in which pulling force is applied to the skin and soft tissues using adhesive/non-adhesive bandages or foam traction boots, which then transmit force to the underlying bone. Examples: Buck's traction (knee conditions, pre-op NOF fractures), Pugh's traction. Limitation: Max weight 5 kg; not suitable for displaced fractures.
7. Cervical Rib. An accessory rib arising from the C7 vertebra, present in ~0.5% of population. Significance: Causes thoracic outlet syndrome by compressing the brachial plexus (lower trunk - T1, causing Klumpke's palsy type changes) or subclavian vessels. Features: Wasting of small muscles of hand, tingling in ulnar distribution, vascular symptoms. Treatment: Physiotherapy; surgical excision if symptomatic.
8. Dorsiflexion Test. Applied at the ankle: passive dorsiflexion of the foot tests for tight Achilles tendon or equinus contracture. In the context of CTEV assessment, the Silfverskiold test differentiates gastrocnemius (knee extended) vs. soleus (knee flexed) tightness. Also used to test for tarsal tunnel syndrome.
9. Bumper Injury (Bumper Fracture / Fender Fracture). A fracture of the lateral tibial plateau caused by a car bumper striking the lateral aspect of the extended knee, forcing the knee into valgus and causing a lateral tibial plateau fracture with or without MCL and lateral meniscus injury. Corresponds to Schatzker Type I-III tibial plateau fracture.
10. Cock-up Splint. See June 2022 answer above.

PDF 2: 2011-2026 (4th Year, Sub Code 6266)

Aug 2011

1. Green Stick Fracture. An incomplete fracture seen in children where the bone bends and breaks on one cortex like a green stick, while the other cortex remains intact. Mechanism: Bending force. Features: Angular deformity, incomplete break. Treatment: Completion of fracture if needed to prevent re-angulation, then cast immobilization.
2. Hallux Valgus. See Aug 2024 (PDF 1) answer above.
3. Subluxation. See Oct 2022 (PDF 1) answer above.
4. Carpal Bones. Eight bones arranged in two 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"
5. Delayed Union. See Jan 2022 (PDF 1) answer above.
6. Volkmann's Sign. An early sign of impending Volkmann's ischaemic contracture: pain on passive extension of the fingers when the wrist is held in neutral or extension. Indicates ischemia of the forearm muscles. A critical warning sign following supracondylar fracture of the humerus.
7. McMurray's Test. See Jan 2022 (PDF 1) answer above.
8. Scapulohumeral Rhythm. The coordinated movement of the scapula and humerus during shoulder abduction. Normal ratio: 2:1 (glenohumeral : scapulothoracic movement). For every 3° of arm elevation, 2° occurs at the glenohumeral joint and 1° at the scapulothoracic joint. Total 180° abduction = 120° GH + 60° scapulothoracic. Disrupted in adhesive capsulitis, rotator cuff tears.
9. Antalgic Gait. See Feb 2026 (PDF 1) answer above.
10. Hypothenar Muscles of Hand. The four hypothenar muscles (medial group), all innervated by the deep branch of the ulnar nerve (C8-T1):
  • Abductor digiti minimi (abducts little finger)
  • Flexor digiti minimi brevis (flexes little MCP joint)
  • Opponens digiti minimi (opposes little finger)
  • Palmaris brevis (wrinkles skin over hypothenar, deepens palm)

Feb 2012

1. Z-Thumb Deformity. See April 2023 (PDF 1) answer above.
2. Hallux Valgus. See Aug 2024 answer above.
3. Guillotine Amputation. A type of open (immediate) amputation where the limb is transected in a single straight cut perpendicular to the long axis, without skin flap fashioning. Done as an emergency (gas gangrene, blast injuries, severe infection). The stump remains open to drain, packed with dressing, and later revised into a formal amputation with flap closure.
4. Mallet Finger. See June 2022 (PDF 1) answer above.
5. Ely's Test. See April 2023 (PDF 1) answer above.
6. Complications of Scaphoid Fracture.
  • Avascular necrosis of the proximal pole (most common - due to retrograde blood supply)
  • Non-union (waist fractures most susceptible)
  • Malunion (humpback deformity)
  • Carpal instability / DISI (dorsal intercalated segment instability)
  • Post-traumatic osteoarthritis
  • SNAC wrist (Scaphoid Non-union Advanced Collapse)
7. Attachments and Nerve Supply of Hamstring Muscles.
  • Biceps femoris (long head): Ischial tuberosity → fibular head; Sciatic nerve (tibial division, L5-S2)
  • Biceps femoris (short head): Linea aspera → fibular head; Common peroneal division (L5-S2)
  • Semitendinosus: Ischial tuberosity → upper medial tibia (pes anserinus); Tibial division (L5-S1)
  • Semimembranosus: Ischial tuberosity → posterior medial condyle of tibia; Tibial division (L5-S1) All cross the hip (flexion) and knee (flexion) joints.
8. Complications of Supracondylar Fracture of Humerus. Immediate: Vascular injury (anterior interosseous / brachial artery), nerve injury (AIN most common, radial, median), compartment syndrome. Early: Volkmann's ischaemic contracture, Myositis ossificans. Late: Cubitus varus (gun stock deformity - most common late complication), cubitus valgus, tardy ulnar nerve palsy (from cubitus valgus), stiffness, malunion.
9. Clarke's Test. A provocative test for chondromalacia patella. Method: Patient supine with knee extended; examiner presses the superior pole of the patella distally and asks the patient to contract the quadriceps. Positive: Pain and inability to maintain contraction indicates articular cartilage damage of the patella. (Note: Low specificity).
10. Q-Angle. See April 2023 (PDF 1) answer above.

Aug 2012

1. Swan-Neck Deformity. See Oct 2022 (PDF 1) answer above.
2. Thenar Muscles of Hand. Four thenar muscles (lateral group), all innervated by the recurrent branch of the median nerve (C8-T1), except adductor pollicis (ulnar nerve):
  • Abductor pollicis brevis (abducts thumb)
  • Flexor pollicis brevis (superficial head - median; deep head - ulnar)
  • Opponens pollicis (opposition)
  • Adductor pollicis (adducts thumb - ulnar nerve)
3. Four Entrapment Neuropathies.
  1. Carpal tunnel syndrome (median nerve at wrist)
  2. Cubital tunnel syndrome (ulnar nerve at elbow)
  3. Tarsal tunnel syndrome (posterior tibial nerve at ankle)
  4. Meralgia paraesthetica (lateral femoral cutaneous nerve at ASIS) Also: Piriformis syndrome, Guyon's canal (ulnar nerve at wrist), radial tunnel syndrome.
4. Genu Valgum (Knock Knee). See Sept 2021 (PDF 1) answer above.
5. Anterior Drawer Test. A test for ACL integrity. Method: Patient supine, hip flexed 45°, knee at 90°. Examiner sits on the foot and pulls the tibia anteriorly. Positive: Excessive anterior translation (>5 mm more than normal side) indicates ACL tear. Less sensitive than Lachman test. Also performed at the ankle for anterior talofibular ligament (ATFL) assessment.
6. Dugas Sign. A test for anterior dislocation of the shoulder. Method: Patient is asked to place the hand on the opposite shoulder and simultaneously bring the elbow to the chest. Positive Dugas sign: Inability to perform this movement (elbow cannot touch chest while hand is on opposite shoulder) confirms shoulder dislocation.
7. Bunion. A bony prominence over the medial aspect of the first metatarsophalangeal joint, typically associated with hallux valgus. The medial capsule stretches, the first metatarsal deviates medially (metatarsus primus varus), and a bursa forms over the prominence. Treatment: Wide footwear, protective padding, bunionectomy + corrective osteotomy.
8. External Rotators of the Hip. Six short external rotators (all supplied by sacral plexus):
  1. Piriformis (S1-S2)
  2. Obturator internus (L5-S1)
  3. Obturator externus (L3-L4, obturator nerve)
  4. Superior gemellus (L5-S1)
  5. Inferior gemellus (L4-S1)
  6. Quadratus femoris (L4-S1)
  • Gluteus maximus (main external rotator - inferior gluteal nerve)
9. Tinel's Sign. Percussion over a compressed or regenerating nerve that produces tingling in the distribution of that nerve. Uses: Carpal tunnel syndrome (percuss over carpal tunnel at wrist), cubital tunnel (over ulnar groove at elbow), tarsal tunnel, after nerve repair to assess regeneration (advancing Tinel's sign indicates nerve recovery).
10. Monteggia Fracture-Dislocation. A fracture of the proximal third of the ulna combined with anterior dislocation of the radial head (Bado Type I - most common). Bado classification: Type I - anterior dislocation (apex anterior ulna fracture); Type II - posterior dislocation; Type III - lateral dislocation; Type IV - both bone fractures. Treatment: ORIF of ulna restores radial head alignment.

Feb 2013

1. Management of Fracture Neck of Femur.
  • Undisplaced (Garden I, II): Internal fixation (cannulated screws)
  • Displaced young patient (<60 years): Urgent reduction and fixation
  • Displaced elderly (>60 years): Hemiarthroplasty (unipolar/bipolar) or THR (if active)
  • Pre-operative: DVT prophylaxis, medical optimization
  • Post-operative: Early mobilization, physiotherapy
2. Erb's Point. See April 2023 (PDF 1) answer above.
3. Involucrum. A sheath of new periosteal bone that forms around a sequestrum (dead bone) in chronic osteomyelitis. The periosteum lifts off the infected bone and lays down new bone around the sequestrum. Significance: Represents the body's attempt to wall off infection. May have holes (cloaca) through which pus and small pieces of sequestrum escape. Seen on X-ray as a thick bony shell.
4. Osteotomy. See Feb 2026 (PDF 1) answer above.
5. Hugh Owen Thomas. The father of modern orthopaedic surgery. A Welsh surgeon (1834-1891) who invented the Thomas splint (used for femur fractures and hip traction), the Thomas wrench, the Thomas collar, and advocated rest as the basis of treatment. His nephew was Sir Robert Jones who further advanced orthopaedics.
6. Cold Abscess. See April 2023 (PDF 1) answer above.
7. Genu Valgum. See Sept 2021 (PDF 1 - Knock Knee) answer above.
8. Barton's Fracture. An intra-articular fracture-subluxation of the distal radius where a fragment of the dorsal (dorsal Barton's) or volar (volar Barton's - reverse Barton's) rim of the distal radius is fractured and the carpus subluxes with the fragment. Unstable fracture requiring surgical fixation (volar plate fixation for volar Barton's).
9. De Quervain's Disease. See April 2023 (PDF 1) answer above.
10. Triple Dislocation. Simultaneous dislocation of the hip, knee, and ankle joints in the same limb. An extremely rare, high-energy injury. It may also refer specifically to a combination of hip dislocation with knee and ankle dislocations.

Aug 2013

1. Define Periarthritis Shoulder. List the clinical features. See Dec 2020 (PDF 1) answer above.
2. List the splints for Upper extremity Peripheral nerve injuries. See Dec 2020 (PDF 1) answer above.
3. Straight Leg Raising Test. See April 2023 (PDF 1) answer above.
4. List the levels of Lower limb Amputation. See Dec 2020 (PDF 1) answer above.
5. Difference between dislocation and subluxation. See Dec 2020 (PDF 1) answer above.
6. List the causes for shoulder impingement syndrome. See Dec 2020 (PDF 1) answer above.
7. Difference between Tidy and Untidy injuries of hand. See Dec 2020 (PDF 1) answer above.
8. Q Angle. See April 2023 (PDF 1) answer above.
9. List the types of Leprosy. See Dec 2020 (PDF 1) answer above.
10. Types of CTEV. See April 2023 (PDF 1) answer above.

Feb 2014

1. Deformities of Rheumatoid Arthritis.
  • Z-thumb deformity (thumb)
  • Swan-neck deformity (PIP hyperextension, DIP flexion)
  • Boutonniere deformity (PIP flexion, DIP hyperextension)
  • Ulnar drift / ulnar deviation at MCP joints
  • Mallet finger
  • Valgus deformity of knee and hindfoot
  • Protrusio acetabuli (hip)
  • Bamboo spine (AA instability in cervical spine)
  • Hallux valgus
2. Bamboo Spine. See Nov 2023 (PDF 1) answer above.
3. Cervical Rib. See Feb 2026 (PDF 1) answer above.
4. Wry Neck. See Oct 2022 (PDF 1) answer above.
5. Malunion. See Nov 2023 (PDF 1) answer above.
6. Carpal Tunnel Syndrome. Compression of the median nerve within the carpal tunnel at the wrist. Causes: Idiopathic, pregnancy, hypothyroidism, rheumatoid arthritis, diabetes, ganglia. Features: Tingling and numbness in lateral 3.5 fingers (median nerve distribution), nocturnal symptoms, thenar wasting, weak pinch. Tests: Tinel's, Phalen's, Carpal tunnel compression test. Treatment: Splinting, steroid injection, surgical decompression.
7. Kernig's Sign. A sign of meningeal irritation. Patient supine, hip flexed 90°; extension of the knee beyond 135° is resisted by hamstring spasm and causes pain. Positive in meningitis, subarachnoid hemorrhage. (Note: "Kernicks sign" in paper is likely Kernig's sign.)
8. Cobb's Angle. See Dec 2020 (PDF 1) answer above.
9. Hallux Valgus. See Aug 2024 (PDF 1) answer above.
10. Genu Varum (Bow Legs). Varus deformity of the knees - the knees are separated when ankles are together. Normal in infants up to 18 months. Causes: Physiological (resolves by age 2), rickets, Blount's disease (tibia vara), Paget's disease, osteomalacia. Measurement: Intercondylar distance. Treatment: Address cause; corrective osteotomy or guided growth (8-plate) for pathological valgum.

Aug 2014

1. Stages of Bone Healing.
  1. Haematoma formation (0-48 hrs): Fracture haematoma, fibrin clot
  2. Inflammatory stage (days 1-7): Vascular response, osteoclast/osteoblast recruitment
  3. Soft callus (weeks 1-4): Fibrocartilaginous callus bridges fracture; bone mobile but painless
  4. Hard callus (weeks 4-12): Mineralization of callus, visible on X-ray
  5. Remodelling (months-years): Wolff's law - callus remodelled to lamellar bone
2. Metatarsalgia. See Oct 2022 (PDF 1) answer above.
3. Excisional Arthroplasty (Resection Arthroplasty). Surgical removal of one or both articular surfaces of a joint, allowing a pseudoarthrosis (false joint) to form. Examples: Girdlestone procedure (femoral head excision), Keller's procedure (base of proximal phalanx for hallux valgus), Darrach procedure (distal ulna excision). Used when joint replacement is not feasible.
4. Bennett's Fracture. An intra-articular fracture-dislocation of the base of the first metacarpal (thumb). The volar-ulnar fragment remains attached to the anterior oblique ligament while the remainder of the metacarpal dislocates radially and proximally by pull of abductor pollicis longus. Treatment: Requires surgical fixation (K-wires or screw).
5. Osteomyelitis. Infection of bone, usually haematogenous in children (metaphysis of long bones). Organisms: Staphylococcus aureus (most common). Features: Pain, tenderness, swelling, fever, raised WBC, ESR, CRP. X-ray changes appear after 10-14 days. MRI is most sensitive early. Treatment: IV antibiotics, surgical drainage if abscess formed.
6. Chest Wall Deformities. See Oct 2022 (PDF 1) answer above.
7. Painful Arc Syndrome. See Sept 2021 (PDF 1) answer above.
8. Myositis Ossificans. Heterotopic ossification within muscle following trauma, characterized by deposition of bone within muscle tissue. Predisposing factors: Head injury, burns, aggressive physiotherapy, repeated trauma. X-ray: Peripheral calcification with clear zone (eggshell pattern). Treatment: Avoid aggressive passive mobilization; NSAIDs (indomethacin); excision after maturation (>6-12 months).
9. Volkmann's Ischaemic Contracture. See Sept 2021 (PDF 1) answer above.
10. Boxer's Fracture. See Sept 2021 (PDF 1) answer above.

Feb 2015

1. Define Congenital Dislocation of Hip (CDH/DDH). List clinical features. DDH is a spectrum of hip instability in the developing hip - from dysplasia to frank dislocation. The femoral head is partially or completely outside the acetabulum. Clinical features: Limited hip abduction, Barlow and Ortolani positive tests (infants), shortening of the limb, Galeazzi sign (unequal knee heights), Trendelenburg gait (older children), asymmetric skin folds, waddling gait.
2. Define Foot Drop. List clinical features. Inability to dorsiflex the foot due to weakness/paralysis of the dorsiflexors (tibialis anterior, extensors). Clinical features: High steppage gait, inability to walk on heels, foot slaps the ground, dragging of toes. Cause: Common peroneal nerve palsy, L4-L5 disc, stroke. Foot drop brace/AFO used.
3. Complications of Patellectomy.
  • Reduced quadriceps strength (20-30% reduction)
  • Extensor lag
  • Difficulty with stair climbing
  • Increased patellofemoral joint contact pressure (if partial)
  • Knee stiffness
  • Scar formation
4. Levels of Upper Limb Amputation.
  • Forequarter (interscapulothoracic)
  • Shoulder disarticulation
  • Above elbow (transhumeral) - short/long
  • Elbow disarticulation
  • Below elbow (transradial) - short/long
  • Wrist disarticulation
  • Partial hand / ray amputation
  • Finger amputation
5. Define Dislocation and Subluxation. See Oct 2022 (PDF 1) answer above.
6. Causes for Shoulder Hand Syndrome (Reflex Sympathetic Dystrophy / CRPS Type I).
  • Myocardial infarction
  • Stroke (hemiplegia)
  • Trauma to shoulder, arm, or hand
  • Cervical spondylosis
  • Colles' fracture
  • Shoulder surgery
  • Herpes zoster
  • Prolonged immobilization
7. Define Claw Hand and list clinical features. Intrinsic minus hand deformity with hyperextension of MCP joints and flexion of IP joints. Types: Ulnar claw (ring and little fingers - ulnar nerve) and Total claw (all fingers - combined median + ulnar nerve). Clinical features: Claw posture, loss of intrinsic muscle function, inability to extend IP joints or flex MCP joints, impaired grip, thenar/hypothenar wasting.
8. Define Genu Recurvatum. See Oct 2022 (PDF 1) answer above.
9. Types of Fractures. By skin integrity: Open (compound) vs. Closed (simple) By pattern: Transverse, oblique, spiral, comminuted, segmental, greenstick, buckle (torus) By cause: Traumatic, stress, pathological By number of fragments: Simple (2 fragments), comminuted (>2) Special: Avulsion, impacted, intra-articular, periarticular
10. Define Prepatellar Bursitis and list causes. Inflammation of the prepatellar bursa (located between the skin and the anterior surface of the patella), causing swelling in front of the kneecap. Also called "Housemaid's knee." Causes: Repeated kneeling (carpet layers, miners), direct trauma, infection (septic bursitis), gout, rheumatoid arthritis.

Aug 2015

1. Extensor Zones of Hand. The hand is divided into 8 extensor zones for classifying extensor tendon injuries:
  • Zone I: Over DIP joint (mallet injury)
  • Zone II: Over middle phalanx
  • Zone III: Over PIP joint (boutonniere injury)
  • Zone IV: Over proximal phalanx
  • Zone V: Over MCP joint
  • Zone VI: Over dorsum of hand (metacarpals)
  • Zone VII: Over wrist (retinaculum)
  • Zone VIII: Forearm
2. Deltoid Fibrosis - Definition and Causes. Fibrosis of the deltoid muscle causing limited shoulder abduction and abnormal gait-like scapulohumeral movement. The muscle contracts, causing a painful shoulder with limited ROM. Causes: Repeated intramuscular injections (IM chloroquine, antibiotics - common in children), trauma, ischaemia.
3. Define Kyphosis and list complications. See Aug 2024 (PDF 1) answer above. Complications: Back pain, respiratory compromise (reduced vital capacity), cor pulmonale, spinal cord compression (if severe angular), psychological impact, cosmetic deformity.
4. Difference between Coxa Vara and Coxa Valga. See Oct 2022 (PDF 1) answer above.
5. Define Burns and list degrees. See Oct 2022 (PDF 1) answer above.
6. Complications of fracture. Immediate: Haemorrhage, nerve/vessel injury, visceral injury, fat embolism. Early: Infection, compartment syndrome, DVT, PE, pneumonia, pressure sores. Late: Malunion, non-union, delayed union, avascular necrosis, joint stiffness, osteoarthritis, reflex sympathetic dystrophy.
7. Plantar Fasciitis - Definition and clinical features. Plantar fasciitis is inflammation at the origin of the plantar fascia from the medial tubercle of the calcaneum. Clinical features: Heel pain, worst on first steps in the morning, improves with walking but worsens after prolonged activity, tenderness at the medial calcaneal tubercle, calcaneal spur on X-ray.
8. Central Dislocation of Hip. See Oct 2022 (PDF 1) answer above.
9. Carpal Tunnel Syndrome. See Feb 2014 (PDF 2) answer above.
10. Clinical features of TB Spine (Pott's Disease).
  • Back pain at involved level
  • Fever, weight loss, night sweats (systemic)
  • Gibbus deformity (angular kyphosis)
  • Paraspinal muscle spasm
  • Neurological deficit (Pott's paraplegia)
  • Cold abscess (psoas abscess tracking to groin)
  • Spinal tenderness on percussion
  • Elevated ESR/CRP

Feb 2016

1. Barton's Fracture. See Feb 2013 (PDF 2) answer above.
2. Tenosynovitis. Inflammation of the tendon sheath (synovial lining). Causes: Repetitive use, rheumatoid arthritis, infection (pyogenic or TB), crystal deposition. Features: Pain along tendon, swelling, crepitus, restricted movement. Examples: De Quervain's (1st dorsal compartment), trigger finger (A1 pulley). Treatment: Rest, NSAIDs, splinting, steroid injection, surgical release.
3. Reflex Grading (MRC Scale). Deep tendon reflexes graded 0-4+:
  • 0: Absent
  • 1+: Diminished (trace)
  • 2+: Normal
  • 3+: Brisk (slightly increased)
  • 4+: Very brisk, with clonus (pathological, UMN lesion)
4. Cozen's Test. See June 2022 (PDF 1) answer above.
5. Swan-Neck Deformity. See Oct 2022 (PDF 1) answer above.
6. Mallet Finger. See June 2022 (PDF 1) answer above.
7. Thomas Test. Tests for fixed flexion deformity (FFD) of the hip. Method: Patient supine, both hips fully flexed to obliterate lumbar lordosis. One hip then extended; the angle at which the thigh leaves the couch is the FFD. Positive: Any inability to fully extend hip indicates FFD due to capsular contracture, hip OA, or psoas spasm. Normal = hip fully extends to neutral.
8. Non-Union. See Aug 2024 (PDF 1) answer above.
9. Apprehension Sign (Apprehension Test). A test for recurrent anterior shoulder dislocation. Method: Arm at 90° abduction + external rotation applied. Positive: Patient shows apprehension (facial/verbal expression of fear) that the shoulder will dislocate. Jobe relocation test (posterior pressure on humeral head relieves apprehension) confirms the diagnosis.
10. Ober's Test. Tests for iliotibial band (ITB) tightness. Method: Patient side-lying with affected side up, hip extended, knee flexed 90°; examiner abducts and then releases the leg. Positive: Leg does not adduct to neutral due to tight ITB/tensor fascia lata. Associated with IT band syndrome, lateral knee pain, hip abductor contracture.

Aug 2016

1. Coxa Vara. See Nov 2023 (PDF 1) answer above.
2. Taylor's Brace. A thoracolumbosacral orthosis (TLSO) with two posterior uprights connected by a pelvic band and shoulder straps, used for thoracic and lumbar fractures, post-op spinal surgery, spinal tuberculosis, and scoliosis. Provides support and limits flexion of the thoracolumbar spine.
3. Bankart Lesion. A Bankart lesion is a detachment of the anterior glenoid labrum from the anterior inferior glenoid rim, occurring during anterior shoulder dislocation. It is the pathological lesion responsible for recurrent anterior shoulder dislocations. Bony Bankart: Also involves a fracture of the anterior glenoid rim. Treatment: Arthroscopic or open Bankart repair (labral reattachment with suture anchors).
4. Gunstock Deformity. See Nov 2023 (PDF 1) answer above.
5. Q Angle in Knee. See April 2023 (PDF 1) answer above.
6. Deformities of Rheumatoid Hand. See Feb 2014 (PDF 2) answer above.
7. Pseudogout. A crystal arthropathy caused by deposition of calcium pyrophosphate dihydrate (CPPD) crystals in joints. Features: Acute self-limiting monoarthritis (similar to gout), commonly affects the knee, wrist, or ankle. Middle-aged and elderly patients. X-ray: Chondrocalcinosis (calcification of articular cartilage). Diagnosis: Synovial fluid - weakly positive birefringent, rhomboid-shaped crystals. Treatment: NSAIDs, colchicine, joint aspiration.
8. Cold Abscess. See April 2023 (PDF 1) answer above.
9. Erb's Palsy. See June 2022 (PDF 1) answer above.
10. Dupuytren's Contracture. Progressive fibrosing disease of the palmar fascia causing gradual flexion contracture of the fingers, most commonly ring and little fingers. Features: Palpable cord in palm, flexion contracture at MCP and PIP joints, dimpling of skin, skin adherence. Pathology: Myofibroblast proliferation in palmar fascia. Treatment: Needle aponeurotomy, collagenase injection (Xiapex), surgical fasciectomy.

Feb 2017

1. Tennis Elbow (Lateral Epicondylitis). Tendinopathy at the origin of extensor carpi radialis brevis (ECRB) at the lateral epicondyle. Common in racquet sports and manual workers. Features: Lateral elbow pain, tenderness over lateral epicondyle, pain on resisted wrist extension. Tests: Cozen's test, Mill's test. Treatment: Rest, physiotherapy (eccentric exercises), steroid injection, PRP, surgical release.
2. Genu Valgum. See Sept 2021 (PDF 1) answer above.
3. Complications of Colles' Fracture. Immediate: Median nerve injury, acute carpal tunnel. Early: CRPS/Sudeck's atrophy, tendon rupture (EPL), malunion. Late: Stiffness, malunion (dinner fork deformity), post-traumatic OA, EPL rupture (3-4 weeks), shoulder-hand syndrome, carpal tunnel syndrome, radiocarpal OA.
4. Compound Fracture (Open Fracture). A fracture in which the skin overlying the fracture is broken, creating communication with the external environment. Gustilo-Anderson classification: Type I (<1 cm wound), Type II (1-10 cm), Type IIIA (>10 cm, adequate soft tissue), Type IIIB (periosteal stripping), Type IIIC (vascular injury). Treatment: IV antibiotics, tetanus prophylaxis, wound debridement within 6-8 hours, stabilization.
5. Trigger Finger. See Nov 2023 (PDF 1) answer above.
6. Entrapment Neuropathy. See Aug 2012 (PDF 2) - Four Entrapment Neuropathies.
7. Barton's Fracture. See Feb 2013 (PDF 2) answer above.
8. De Quervain's Disease. See April 2023 (PDF 1) answer above.
9. Types of Scoliosis. By cause: Idiopathic (infantile, juvenile, adolescent), congenital (failure of formation/segmentation), neuromuscular (cerebral palsy, polio, muscular dystrophy), degenerative (adult). By direction: Dextroscoliosis (right), levoscoliosis (left). By flexibility: Structural (fixed) vs. Non-structural (postural, correctable).
10. Smith's Fracture. A fracture of the distal radius with volar (anterior) displacement of the distal fragment - "reverse Colles' fracture." Caused by fall on the back of the hand (dorsum) or direct blow. Results in a "garden spade" or volar deformity. Treatment: ORIF with volar locking plate in most cases.

Aug 2017

1. Hangman's Fracture. See Sept 2021 (PDF 1) answer above.
2. Trendelenburg Gait. See Jan 2022 (PDF 1 - Waddling Gait) answer above. The trunk leans to the affected side due to ipsilateral hip abductor weakness. Positive Trendelenburg sign: the contralateral pelvis drops when the affected limb is in stance phase.
3. Madelung's Deformity. See Jan 2022 (PDF 1) answer above.
4. Bone Graft. Transplanted bone tissue used to fill bone defects, promote healing, or aid in fusion. Types: Autograft (patient's own bone - iliac crest, gold standard), Allograft (cadaveric/donor bone), Xenograft (animal-derived), Synthetic (hydroxyapatite, tricalcium phosphate). Properties of ideal graft: Osteogenesis (cells that form bone), Osteoinduction (stimulate host cells - BMP), Osteoconduction (scaffold for new bone growth).
5. Cobb's Angle. See Dec 2020 (PDF 1) answer above.
6. Sprengel's Shoulder. A congenital elevation of the scapula due to failure of the scapula to descend from its original cervical position during embryological development. Often associated with omovertebral bone (bony bar connecting scapula to spine). Features: Elevated scapula, limited shoulder abduction, neck asymmetry. Treatment: Woodward procedure (surgical repositioning of scapula).
7. Bennett's Fracture. See Aug 2014 (PDF 2) answer above.
8. Scapular Winging. Prominence of the medial border/inferior angle of the scapula away from the chest wall. Causes:
  • Long thoracic nerve palsy (serratus anterior weakness - medial scapular winging)
  • Spinal accessory nerve palsy (trapezius weakness - lateral winging)
  • Rhomboid palsy (dorsal scapular nerve) Tests: Wall push-up test. Treatment: Physiotherapy, scapular stabilization exercises, surgical bracing.
9. Nursemaid's Elbow (Pulled Elbow). A subluxation of the radial head under the annular ligament, occurring in children (typically 2-5 years old) when the forearm is pulled while extended and pronated (e.g., child suddenly lifted by the hand). Features: Child holds arm in slight flexion, pronated, refuses to use arm. Treatment: Reduction by supination + flexion (or hyperpronation technique).
10. Boutonniere Deformity. A finger deformity characterized by flexion at the PIP joint and hyperextension at the DIP joint. Caused by rupture or avulsion of the central slip of the extensor tendon at the PIP joint, allowing the lateral bands to sublux volarly. Causes: Rheumatoid arthritis, trauma. Treatment: Splinting PIP in extension; surgical repair.

Feb 2018

1. Stages of Bone Healing. See Aug 2014 (PDF 2) answer above.
2. Prosthesis. An artificial device used to replace a missing limb or body part. In orthopaedics: limb prosthesis (transtibial, transfemoral, upper limb) or joint prosthesis (hip, knee arthroplasty). Types: Endoprosthesis (internal, e.g., hip replacement) and Exoprosthesis (external, e.g., below-knee prosthetic limb). Components of lower limb prosthesis: Socket, suspension system, knee joint, pylon, foot (SACH foot).
3. Arthroplasty. Surgical reconstruction or replacement of a joint to restore motion and relieve pain. Types: Total joint replacement (both surfaces replaced - THR, TKR), hemiarthroplasty (one surface - hip hemiarthroplasty), excisional arthroplasty (Girdlestone), interposition arthroplasty, resurfacing arthroplasty.
4. Bennett's Fracture and Dislocation. See Aug 2014 (PDF 2) answer above.
5. Pes Cavus. See Dec 2020 (PDF 1) answer above.
6. Pelvic Tilt. Movement of the pelvis in the frontal or sagittal plane. Anterior pelvic tilt: ASIS drops, PSIS rises, lumbar lordosis increases - caused by tight hip flexors, weak abdominals. Posterior pelvic tilt: ASIS rises, PSIS drops - caused by tight hamstrings. Lateral pelvic tilt: One side drops lower - seen in leg length discrepancy, hip abductor weakness. Measured by ASIS levels and lumbar lordosis.
7. Slump Test. See Sept 2021 (PDF 1) answer above.
8. Medical Management of Rheumatoid Arthritis.
  • NSAIDs: First-line for symptom relief (ibuprofen, naproxen)
  • DMARDs: Methotrexate (gold standard), sulfasalazine, hydroxychloroquine, leflunomide
  • Biologics: Anti-TNF (etanercept, infliximab), IL-6 inhibitors (tocilizumab), rituximab
  • Steroids: For acute flares; intra-articular injections
  • JAK inhibitors: Tofacitinib, baricitinib
9. Paget's Disease. A metabolic bone disease characterized by abnormal bone remodelling - excessive bone resorption followed by disorganized new bone formation, producing enlarged, deformed, structurally weak bones. Features: Bone pain, bowing of tibia, skull enlargement (hat size increase), deafness. Lab: Very high alkaline phosphatase, normal calcium. Treatment: Bisphosphonates.
10. Boxer's Fracture. See Sept 2021 (PDF 1) answer above.

Aug 2018

1. Ape Thumb Deformity. See Aug 2024 (PDF 1) answer above.
2. Phalen's Test. A provocative test for carpal tunnel syndrome. Method: Patient holds both wrists in full flexion (opposite wrists pressed together) for 60 seconds. Positive: Tingling and numbness in the median nerve distribution (lateral 3.5 fingers) reproduced within 60 seconds. Sensitivity ~75%.
3. Avulsion Fracture. A fracture where a fragment of bone is pulled off at the insertion of a tendon or ligament due to sudden forceful muscle contraction or ligamentous stress. Examples: Avulsion of the base of 5th metatarsal (peroneus brevis), medial epicondyle avulsion, tibial spine avulsion (ACL), calcaneal apophysis.
4. Malunion. See Nov 2023 (PDF 1) answer above.
5. Swan-Neck Deformity. See Oct 2022 (PDF 1) answer above.
6. Tendinitis. Inflammation and micro-tearing of a tendon, usually from repetitive overuse. Features: Pain along the tendon, worse with activity, tenderness, swelling, crepitus. Examples: Supraspinatus tendinitis, patellar tendinitis (jumper's knee), Achilles tendinitis. Treatment: Rest, ice, NSAIDs, eccentric exercises, physiotherapy.
7. Flat Foot (Pes Planus). See Dec 2020 (PDF 1) answer above.
8. Erb's Point. See April 2023 (PDF 1) answer above.
9. Painful Arc Syndrome. See Sept 2021 (PDF 1) answer above.
10. Metatarsalgia. See Oct 2022 (PDF 1) answer above.

Feb 2019

1. Gaenslen's Test. A test for sacroiliac joint (SIJ) pathology. Method: Patient supine at edge of table; affected side hip extended off the edge while opposite hip is maximally flexed. Pressure applied to both hips simultaneously, stressing the SIJ. Positive: Pain in the sacroiliac region indicates SIJ dysfunction or sacroiliitis (as in ankylosing spondylitis).
2. Risser's Sign. A radiological indicator of skeletal maturity based on the ossification of the iliac apophysis. Graded 0-5: Grade 0 = no ossification; Grade 5 = complete fusion of apophysis to iliac crest. Used in scoliosis management to predict growth remaining. Bracing most effective when Risser 0-1; Risser 4-5 = skeletally mature.
3. Pavlik Harness. A dynamic abduction device used in the treatment of developmental dysplasia of the hip (DDH) in infants up to 6 months of age. It maintains the hip in flexion (90-100°) and abduction, allowing spontaneous reduction of the dislocated femoral head into the acetabulum while allowing leg movement. Success rate: ~90-95% in neonatal DDH.
4. Bone Graft. See Aug 2017 (PDF 2) answer above.
5. Tardy Ulnar Nerve Palsy. Late-onset ulnar nerve palsy occurring years after a childhood cubitus valgus deformity (from malunited lateral condyle fracture). The increased valgus causes progressive stretching of the ulnar nerve in the cubital tunnel over time. Features: Ulnar nerve symptoms - clawing of ring and little fingers, hypothenar wasting, sensory loss. Treatment: Ulnar nerve anterior transposition.
6. Round Back (Postural Kyphosis). An increase in thoracic kyphosis due to poor posture, typically in adolescents. It is flexible and fully correctable by voluntary effort. Distinct from Scheuermann's kyphosis (rigid, structural, vertebral wedging seen on X-ray). Treatment: Postural correction exercises, strengthening back extensors.
7. Jersey Finger. Avulsion of the flexor digitorum profundus (FDP) tendon from its insertion into the distal phalanx, typically affecting the ring finger. Occurs when the flexed fingertip is forcibly extended (e.g., grabbing a jersey). Features: Inability to flex the DIP joint of the affected finger. Leddy-Packer classification. Treatment: Surgical reattachment within 10 days.
8. Fracture Classification. Common systems:
  • AO/OTA: Based on bone, location, and complexity
  • Gustilo-Anderson: Open fractures (I, II, IIIA, IIIB, IIIC)
  • Garden: Femoral neck (I-IV)
  • Neer: Proximal humerus
  • Salter-Harris: Physeal fractures (I-V)
  • Gartland: Supracondylar (I-III)
9. Volkmann's Ischaemic Contracture. See Sept 2021 (PDF 1) answer above.
10. Rotator Cuff Injury - Special Tests.
  • Empty can test (Jobe's): Supraspinatus tear
  • Full can test: Supraspinatus
  • External rotation lag sign: Infraspinatus tear
  • Gerber's lift-off test: Subscapularis tear
  • Belly press test: Subscapularis tear
  • Drop arm test: Full thickness supraspinatus tear
  • Painful arc (60-120°): Supraspinatus impingement

Aug 2019

1. Pott's Fracture. A bimalleolar fracture-dislocation of the ankle joint involving the medial and lateral malleoli, often with posterior malleolus involvement and lateral talar subluxation. Caused by eversion/abduction or external rotation forces. Note: Historical term; modern classification uses Lauge-Hansen or Danis-Weber systems. Treatment: Non-displaced - cast; displaced - ORIF.
2. Fracture Disease. A group of complications arising from prolonged immobilization of a fractured limb in a cast: muscle wasting and weakness, joint stiffness, disuse osteoporosis, DVT, pressure sores, and psychological effects. Proposed by Hugh Owen Thomas; modern functional bracing (e.g., Sarmiento brace) minimizes fracture disease.
3. CTEV Boot. A specially designed boot/shoe used in the maintenance phase of CTEV (clubfoot) treatment. Used after full correction by Ponseti casting and Achilles tenotomy. Worn with Denis Browne bar maintaining 60-70° of external rotation. Protects correction and prevents relapse.
4. Bamboo Spine. See Nov 2023 (PDF 1) answer above.
5. Axonotmesis. Peripheral nerve injury (Seddon Class II) in which the axons are disrupted but the connective tissue sheaths (endoneurium, perineurium, epineurium) remain intact. Features: Complete motor and sensory loss, muscle wasting, positive Wallerian degeneration. Prognosis: Complete recovery possible by axonal regrowth (1 mm/day), but may take months. No surgical intervention needed unless mixed with neurotmesis.
6. Klumpke's Palsy. Lower brachial plexus palsy affecting C8-T1. Caused by excessive abduction force (birth injury with arm over head, or reaching overhead to break a fall). Features: Intrinsic hand muscle weakness, claw deformity of all fingers, sensory loss over ulnar border of hand and forearm, Horner's syndrome (if T1 ramus communicans involved). Treatment: Physiotherapy, splinting, nerve repair.
7. Compound Fracture. See Feb 2017 (PDF 2) answer above.
8. Painful Arc Syndrome. See Sept 2021 (PDF 1) answer above.
9. Osteomalacia. A metabolic bone disease in adults characterized by defective mineralization of newly formed bone matrix (osteoid), causing soft, weak bones. Equivalent to rickets in children. Causes: Vitamin D deficiency (most common), renal osteodystrophy, malabsorption, anticonvulsant therapy. Features: Bone pain, proximal muscle weakness, Looser's zones (pseudofractures) on X-ray, "codfish vertebrae." Lab: Low serum calcium, phosphate; elevated PTH and ALP.
10. Cross Union. Abnormal bony bridge between the radius and ulna following fractures of both forearm bones, severely restricting (or eliminating) forearm rotation (pronation/supination). Also called radio-ulnar synostosis. Treatment: Surgical resection of the bony bridge (synostosis resection), with interposition of fat or silastic sheet.

Feb 2020

1. Types of Fracture. See Feb 2015 (PDF 2) answer above.
2. Radiological Features of Colles' Fracture. On AP and lateral wrist X-ray:
  • Fracture of distal radius, ~2 cm from articular surface
  • Dorsal displacement and dorsal angulation of distal fragment
  • Radial shortening (loss of radial length)
  • Loss of radial inclination (normal 15-25°, reduced in Colles')
  • Dorsal tilt of radial articular surface (normal 10-15° volar tilt, reversed)
  • Radial displacement
  • "Dinner fork" deformity on lateral view
  • Associated ulnar styloid fracture (~50%)
3. Dislocation. See Oct 2022 (PDF 1) answer above (Dislocation definition).
4. Pen Test. A quick bedside screening test for wrist extension weakness (radial nerve assessment). The patient is asked to pick up a pen from a table using a lateral pinch. Inability to extend the wrist to pick up the pen suggests radial nerve palsy / wrist drop.
5. Neuropraxia. See Sept 2021 (PDF 1) answer above.
6. Arthroplasty. See Feb 2018 (PDF 2) answer above.
7. Genu Recurvatum. See Oct 2022 (PDF 1) answer above.
8. Costochondritis. Inflammation of the costal cartilages where the ribs meet the sternum. Causes chest pain that may mimic cardiac pain. Characterized by tenderness on palpation of the costochondral junction (2nd-5th ribs most common). Tietze syndrome is similar but has localized swelling. Treatment: NSAIDs, local steroid injection, rest.
9. Erb's Palsy. See June 2022 (PDF 1) answer above.
10. Straight Leg Raising (SLR) Test. See April 2023 (PDF 1) answer above.

Dec 2020 (4th Year, Sub Code 6266)

1. Repetitive Stress Injury (RSI). Cumulative trauma disorder caused by repetitive movements, sustained postures, or overuse, leading to pain and dysfunction in tendons, muscles, and nerves. Common in typists, musicians, assembly-line workers. Examples: Carpal tunnel syndrome, De Quervain's tenosynovitis, tennis elbow, rotator cuff tendinopathy. Treatment: Ergonomic modification, rest, physiotherapy, NSAIDs.
2. Boxer's Fracture. See Sept 2021 (PDF 1) answer above.
3. Mallet Thumb. Inability to extend the interphalangeal joint of the thumb due to injury to the extensor pollicis longus (EPL) at or near its insertion. Functionally and structurally similar to mallet finger but involves the thumb. Treatment: Stack splint of thumb IP joint in extension for 6-8 weeks.
4. Green Stick Fracture. See Aug 2011 (PDF 2) answer above.
5. Bankart's Repair. Surgical procedure to reattach the detached anterior inferior glenoid labrum (Bankart lesion) back to the glenoid rim using suture anchors. Can be done arthroscopically or open (Latarjet procedure preferred if significant bony Bankart). Restores normal glenohumeral anatomy and prevents recurrent anterior shoulder dislocations.
6. Tinel's Sign. See Aug 2012 (PDF 2) answer above.
7. Prone Knee Bend Test (Femoral Nerve Stretch Test). Tests for L2-L3-L4 nerve root irritation or femoral nerve compression. Method: Patient prone; examiner passively flexes the knee. Positive: Anterior thigh pain or buttock pain reproduced at <90° of knee flexion indicates L3-L4 disc prolapse or femoral nerve irritation.
8. Bursitis. Inflammation of a bursa (fluid-filled sac that reduces friction). Examples: Prepatellar bursitis (housemaid's knee), subacromial bursitis, olecranon bursitis (student's elbow), retrocalcaneal bursitis. Causes: Repetitive friction, trauma, infection, gout. Treatment: Rest, NSAIDs, aspiration, steroid injection; surgical excision for chronic bursitis.
9. Golfer's Elbow (Medial Epicondylitis). Tendinopathy at the origin of flexor-pronator muscle group at the medial epicondyle. Common in golfers, throwing athletes. Features: Medial elbow pain, tenderness over medial epicondyle, pain on resisted wrist flexion and forearm pronation. Treatment: Rest, physiotherapy, steroid injection; surgical release for refractory cases.
10. Costochondritis. See Feb 2020 (PDF 2) answer above.

Sept 2021 (4th Year)

1. Delayed Union. See Jan 2022 (PDF 1) answer above.
2. Carpal Bones. See Aug 2011 (PDF 2) answer above.
3. Pes Cavus. See Dec 2020 (PDF 1) answer above.
4. Resting Position of Hand. The position of the hand at rest (intrinsic plus position): wrist in slight extension (10-15°), MCP joints flexed (~45°), IP joints slightly flexed, thumb in abduction and slight opposition. This is the position that minimizes joint capsule tension and is used for post-injury splinting to prevent contracture. Also called the "position of safe immobilization" or "James position."
5. Compartment Syndrome. A surgical emergency in which elevated pressure within a fascial compartment compromises circulation and viability of the tissues. Causes: fractures (especially tibia, forearm), casts, crush injuries. The 6 P's: Pain (severe, out of proportion), Pressure (tense compartment), Pallor, Paresthesia (earliest sign of nerve ischemia), Paralysis, Pulselessness (late sign). Treatment: Immediate fasciotomy.
6. Klippel-Feil Syndrome. A congenital fusion of two or more cervical vertebrae, resulting from failure of normal segmentation. Classic triad: Short neck, low posterior hairline, limited cervical movement. Associated conditions: Sprengel's shoulder, scoliosis, renal and cardiac abnormalities, deafness. Treatment: Symptomatic; cervical fusion for instability.
7. Dennis Brown Splint. See Feb 2025 (PDF 1) answer above.
8. Ely's Test. See April 2023 (PDF 1) answer above.
9. Q Angle. See April 2023 (PDF 1) answer above.
10. Cubitus Varus. See Nov 2023 (PDF 1) answer above.

Jan 2022 (4th Year)

1. Jefferson's Fracture. A burst fracture of C1 (atlas) characterized by bilateral fractures of the anterior and posterior arches of the atlas, caused by axial compression (e.g., diving into shallow water, heavy object falling on head). Steele's rule of thirds: Spinal canal divided into three equal parts: odontoid, free space, and spinal cord. May be unstable if transverse ligament disrupted. Treatment: Halo vest or surgical stabilization.
2. Osteoblastoma. A rare benign bone tumour (>2 cm nidus, unlike osteoid osteoma) occurring in the spine (posterior elements), long bones. Features: Dull aching pain, not typically relieved by aspirin. X-ray: Well-defined expansile lytic lesion with surrounding reactive bone, may show calcification. Treatment: Curettage and bone grafting; local recurrence common.
3. Coxa Vara. See Nov 2023 (PDF 1) answer above.
4. C-Splint. A thumb spica-type splint shaped like the letter C that holds the thumb in abduction and mild opposition, used in De Quervain's disease, scaphoid fractures, first CMC joint OA, and Bennett's fracture post-reduction.
5. Rickets. A metabolic bone disease in children caused by deficiency of Vitamin D, calcium, or phosphorus, resulting in defective mineralization of growing bone. Features: Bowlegs (genu varum), Rachitic rosary (beading of ribs), Harrison's sulcus, craniotabes, frontal bossing, widened wrists (metaphyseal cupping on X-ray), delayed dentition, reduced serum calcium and phosphate, elevated ALP and PTH. Treatment: Vitamin D and calcium supplementation.
6. Anterior Drawer Test. See Aug 2012 (PDF 2) answer above.
7. Jersey Finger. See Feb 2019 (PDF 2) answer above.
8. Phalen's Test. See Aug 2018 (PDF 2) answer above.
9. Smith's Fracture. See Feb 2017 (PDF 2) answer above.
10. Cortical Bone. Dense outer bone also called compact bone. Composed of Haversian systems (osteons) - concentric lamellae surrounding a central Haversian canal containing blood vessels and nerves. Properties: dense (80% of total bone mass), strong in compression, low porosity (5-10%). Forms the cortex of long bones, protects cancellous bone, provides mechanical support.

June 2022 (4th Year)

1. Bamboo Spine. See Nov 2023 (PDF 1) answer above.
2. Egawa Test. A test for interosseous muscle function of the fingers. The patient is asked to abduct and adduct the middle finger while the hand is flat on the table. Weakness or inability indicates ulnar nerve palsy (interosseous muscle weakness).
3. Myositis Ossificans. See Aug 2014 (PDF 2) answer above.
4. Tabes Dorsalis. A late manifestation of tertiary syphilis (Treponema pallidum) affecting the posterior columns and dorsal nerve roots. Features in orthopaedics: Charcot's (neuropathic) joints - painless progressive joint destruction due to loss of proprioception and protective sensation (commonly knee, ankle, hip). Broad-based ataxic gait, positive Romberg's sign, lightning pains, Argyll-Robertson pupils.
5. Ankle Foot Orthosis (AFO). An external orthotic device worn over the foot and ankle inside the shoe to provide support, control motion, and correct deformity. Types: Rigid AFO (foot drop), articulated AFO, hinged AFO (allows dorsiflexion), posterior leaf spring AFO (mild foot drop). Uses: Foot drop (peroneal nerve palsy, polio, stroke), spastic equinovarus (cerebral palsy), Achilles tendon repair.
6. Nerve Graft. A surgical technique to bridge a gap in a severed nerve using a segment of donor nerve. Used when direct repair under tension is not possible (gap >2-3 cm). Donor nerves: Sural nerve (most common), medial cutaneous nerve of arm, lateral cutaneous nerve of thigh. Types: Cable graft (multiple fascicles), nerve conduit (synthetic), vascularized nerve graft.
7. Cubitus Valgus. An increased carrying angle of the elbow >15-20°. Causes: Malunited lateral condyle fracture of humerus (most common), Turner syndrome. Complication: Tardy ulnar nerve palsy (delayed ulnar neuropathy due to progressive nerve stretching). Treatment: Medial closing/lateral opening wedge osteotomy + ulnar nerve transposition.
8. Pelvic Harness (Pavlik Harness). See Feb 2019 (PDF 2) answer above.
9. Paget's Disease. See Feb 2018 (PDF 2) answer above.
10. Scurvy. Vitamin C (ascorbic acid) deficiency causing defective collagen synthesis. Orthopaedic features: Periosteal bleeding causing subperiosteal haematomas (visible on X-ray as periosteal elevation), tender limbs, joint swelling, Trümmerfeld zone (zone of rarefaction), Frankel's line (zone of calcification), Pelkan spurs on X-ray. Treatment: Vitamin C supplementation.

Oct 2022 (4th Year)

1. Green Stick Fracture. See Aug 2011 (PDF 2) answer above.
2. Morton's Fracture (March Fracture / Stress Fracture). A stress fracture typically occurring in the shaft of the 2nd or 3rd metatarsal, caused by repetitive loading (marching soldiers, runners, military recruits). Features: Gradual onset forefoot pain, point tenderness over metatarsal shaft. X-ray: May be normal initially; periosteal reaction seen later. Treatment: Activity modification, stiff-soled shoe, cast if severe.
3. SLR (Straight Leg Raising Test). See April 2023 (PDF 1) answer above.
4. Arthrodesis. Surgical fusion of a joint, eliminating movement and providing stability and pain relief. Uses: End-stage OA/RA (ankle, wrist, finger joints), infected arthroplasty, Charcot joint, tuberculosis. Ideal position: Functional position. Disadvantages: Loss of movement, increased stress on adjacent joints.
5. Subluxation vs. Dislocation. See Oct 2022 (PDF 1) answer above.
6. Erb's Palsy. See June 2022 (PDF 1) answer above.
7. Genu Valgum. See Sept 2021 (PDF 1) answer above.
8. Cobb's Angle. See Dec 2020 (PDF 1) answer above.
9. McMurray's Test. See Jan 2022 (PDF 1) answer above.
10. Radial Club Hand. A congenital upper limb deformity characterized by absence or hypoplasia of the radius, causing radial deviation of the hand (wrist in radial deviation). Associated with systemic conditions (TAR syndrome, Fanconi anaemia, VACTERL). Classification: Bayne and Klug (Type I-IV). Treatment: Centralization/radialization of the carpus over the ulna, tendon transfers.

April 2023 (4th Year)

1. Trendelenburg Gait. See Jan 2022 (PDF 1) answer above.
2. Madelung's Deformity. See Jan 2022 (PDF 1) answer above.
3. Bennett's Fracture. See Aug 2014 (PDF 2) answer above.
4. Tennis Elbow. See Feb 2017 (PDF 2) answer above.
5. Calcaneal Spur. A bony prominence (osteophyte) arising from the inferior or posterior surface of the calcaneum. Inferior calcaneal spur at the origin of plantar fascia (associated with plantar fasciitis). Posterior calcaneal spur at Achilles tendon insertion. Usually asymptomatic but may cause heel pain. Treatment: Heel pads, orthotics, steroid injection, rarely surgical excision.
6. Sprain vs. Strain.
SprainStrain
Injury to a ligamentInjury to a muscle or tendon
Graded I-III (mild-complete tear)Graded I-III
E.g., ankle lateral ligament sprainE.g., hamstring strain
Treated with RICE principleTreated with RICE principle
7. Triple Nerve Palsy. Combined paralysis of the radial, median, and ulnar nerves, resulting in a completely flail hand with loss of all intrinsic and extrinsic muscle function. Causes: High brachial plexus injury, severe trauma to the arm. Presents with total claw hand, wrist drop, thenar and hypothenar wasting.
8. MRI (Magnetic Resonance Imaging) in Orthopaedics. Uses magnetic fields and radio waves to produce detailed images of soft tissues and bone. Advantages: Excellent soft tissue contrast (tendons, ligaments, cartilage, menisci, nerves), no radiation, multiplanar imaging. Indications: ACL/meniscal tears, spinal disc prolapse, osteonecrosis (earliest detection), bone marrow pathology, soft tissue tumours, infection.
9. Bursitis. See Dec 2020 (PDF 2) answer above.
10. Stump. The residual limb remaining after amputation. Characteristics of an ideal stump: adequate length (transtibial: 12-15 cm below tibial tuberosity), good skin cover (no tension), non-tender, cylindrical shape, healthy soft tissue, no neuromata, no bony prominences, good muscle padding, healed wound. Requires stump care and shaping with elastic bandaging prior to prosthetic fitting.

Nov 2023 (4th Year)

1. Segmental Fracture. A fracture in which two fracture lines isolate a segment of bone (the bone is broken in two places with a free floating middle fragment). High-energy injury. Complications: High rate of non-union, AVN of isolated segment, compartment syndrome. Treatment: Typically requires intramedullary nailing or plate fixation.
2. Tenosynovitis. See Feb 2016 (PDF 2) answer above.
3. CT Scan in Orthopaedics. Computed Tomography uses X-rays from multiple angles to produce cross-sectional images. Advantages: Excellent bony detail, 3D reconstruction, quantifies comminution. Indications: Tibial plateau, acetabular, calcaneal, pilon, and spinal fractures (to assess fragment displacement); bone tumours (cortical destruction, matrix calcification); implant planning.
4. Smith's Fracture. See Feb 2017 (PDF 2) answer above.
5. Trigger Finger. See Nov 2023 (PDF 1) answer above.
6. Speed Test. A test for bicipital tendinitis (long head of biceps). Method: Patient's shoulder in 90° of flexion, elbow extended, forearm supinated. Examiner applies downward resistance while patient tries to maintain position. Positive: Anterior shoulder pain in the region of the bicipital groove indicates bicipital tendinitis or SLAP lesion. Also called Straight Arm test.
7. Vertical Talus. See Jan 2022 (PDF 1) answer above.
8. Rotator Cuff Tear. A tear of one or more of the four rotator cuff tendons (supraspinatus, infraspinatus, teres minor, subscapularis). Most common: supraspinatus tear at its insertion into the greater tuberosity. Causes: Degenerative (>50 years), traumatic. Features: Shoulder pain, weakness in abduction/rotation, positive drop arm test, empty can test. Treatment: Conservative (physiotherapy); surgical arthroscopic repair for full-thickness tears.
9. Thomas Splint. A traction splint devised by Hugh Owen Thomas for immobilizing femur fractures and applying traction. Consists of a ring (around the thigh/groin) and two side bars extending distally. Traction is applied to the distal end. Used in emergency transport and as a definitive measure in children with femoral shaft fractures (Bryant's traction, Gallows traction for infants).
10. Night Stick Fracture. An isolated fracture of the shaft of the ulna, typically caused by a direct blow (raising the forearm to protect against a stick or club blow). Important: Must rule out associated radial head dislocation (Monteggia). Isolated, non-displaced ulnar shaft fractures can be treated with functional bracing; displaced fractures need ORIF.

Aug 2024 (4th Year)

1. Tenosynovitis. See Feb 2016 (PDF 2) answer above.
2. Cozen's Test. See June 2022 (PDF 1) answer above.
3. Swan-Neck Deformity. See Oct 2022 (PDF 1) answer above.
4. Pott's Fracture. See Aug 2019 (PDF 2) answer above.
5. Painful Arc Syndrome. See Sept 2021 (PDF 1) answer above.
6. Bamboo Spine. See Nov 2023 (PDF 1) answer above.
7. Osteomalacia. See Aug 2019 (PDF 2) answer above.
8. SLR. See April 2023 (PDF 1) answer above.
9. Erb's Palsy. See June 2022 (PDF 1) answer above.
10. Cobb's Angle. See Dec 2020 (PDF 1) answer above.

Feb 2025 (4th Year)

1. Define Sprain. A sprain is a stretching or tearing injury to a ligament caused by sudden force that takes the joint beyond its normal range of motion. Grading: Grade I (microscopic tear, full function), Grade II (partial tear, some instability), Grade III (complete tear, gross instability). Most common: lateral ankle sprain (ATFL).
2. Swan-Neck Deformity with Diagram. See Oct 2022 (PDF 1) answer above. Diagram: The deformity shows: Normal finger → PIP joint hyperextended (PIP↑) + DIP joint flexed (DIP↓)
3. Coxa Magma. Enlargement of the femoral head, typically seen as a residual deformity following Legg-Calvé-Perthes disease or avascular necrosis, where the femoral head remodels into a larger, flattened (coxa plana) and broadened shape. Results in loss of spherical congruency and secondary OA.
4. Dupuytren's Contracture. See Aug 2016 (PDF 2) answer above.
5. Smith's Fracture. See Feb 2017 (PDF 2) answer above.
6. Jones Fracture. A transverse fracture at the metaphyseal-diaphyseal junction of the proximal fifth metatarsal (Zone 2 - junction of metaphysis and diaphysis). Prone to non-union due to watershed blood supply. Distinct from pseudo-Jones fracture (avulsion at base of 5th MT). Treatment: Non-weight-bearing cast; surgical fixation (intramedullary screw) for athletes or delayed/non-union.
7. Biceps Tendinitis. Inflammation of the proximal biceps tendon (long head) in the bicipital groove. Features: Anterior shoulder pain, tenderness in bicipital groove, pain on resisted elbow flexion and forearm supination. Tests: Speed test, Yergason test. Treatment: Rest, NSAIDs, physiotherapy, steroid injection, surgical tenodesis for chronic/recurrent cases.
8. Define Lordosis. An exaggeration of the normal lumbar (or cervical) anterior concavity (lordotic curve). Causes: Increased lumbar lordosis in pregnancy (compensatory), hip flexion contracture (compensatory), spondylolisthesis. Types: Physiological vs. pathological. Features: Prominent buttocks, protuberant abdomen, low back pain. Treatment: Core strengthening, hip flexor stretching.
9. Adhesive Capsulitis. See the Periarthritis Shoulder answer (Dec 2020, PDF 1) above.
10. Arthrogryposis (Arthrogryposis Multiplex Congenita - AMC). A condition characterized by multiple congenital joint contractures in two or more body areas, due to decreased fetal movements in utero. Features: Rigid joints, muscle hypoplasia, dislocated hips, CTEV, knee contractures. Causes: Neurological (anterior horn cell disease), muscular, or connective tissue. Treatment: Serial casting, physiotherapy, corrective surgery.

Aug 2025 (4th Year)

1. Axonotmesis. See Aug 2019 (PDF 2) answer above.
2. Radiological Features of Colles' Fracture. See Feb 2020 (PDF 2) answer above.
3. Dislocation. See Oct 2022 (PDF 1) answer above.
4. Pen Test. See Feb 2020 (PDF 2) answer above.
5. Neuropraxia. See Sept 2021 (PDF 1) answer above.
6. Arthroplasty. See Feb 2018 (PDF 2) answer above.
7. Genu Recurvatum. See Oct 2022 (PDF 1) answer above.
8. CTEV Boot. See Aug 2019 (PDF 2) answer above.
9. Fracture Disease. See Aug 2019 (PDF 2) answer above.
10. SLR Test. See April 2023 (PDF 1) answer above.

Feb 2026 (4th Year)

1. Arches of Foot. The foot has three arches:
  • Medial longitudinal arch (highest): Calcaneum - talus - navicular - 3 cuneiforms - 1st, 2nd, 3rd metatarsals; maintained by tibialis posterior, FHL, plantar fascia, spring ligament.
  • Lateral longitudinal arch (lower): Calcaneum - cuboid - 4th and 5th metatarsals; maintained by peroneus longus, plantar fascia.
  • Transverse arch: Across the midfoot (cuneiforms and cuboid); maintained by peroneus longus.
2. Mallet Finger. See June 2022 (PDF 1) answer above.
3. Subluxation. See Oct 2022 (PDF 1) answer above.
4. Ulnar Claw Hand. See Aug 2024 (PDF 1) answer above.
5. Tinel's Sign. See Aug 2012 (PDF 2) answer above.
6. Scaphoid Fracture. The most common carpal fracture. Site: Waist (most common - 70%), proximal pole, distal pole. Mechanism: Fall on outstretched hand. Features: Snuffbox tenderness, scaphoid tubercle tenderness, pain on axial compression of thumb. X-ray: May be normal initially (MRI/bone scan for occult fractures). Treatment: Distal pole/undisplaced waist - thumb spica 8-12 weeks; displaced/proximal pole - ORIF (Herbert screw).
7. Radiological Features of Ankylosing Spondylitis.
  • Squaring of vertebral bodies (loss of normal concavity)
  • Marginal syndesmophytes (ossification of outer annulus fibrosus)
  • Bamboo spine (bridging syndesmophytes)
  • Erosion and sclerosis of sacroiliac joints (earliest change - sacroiliitis)
  • Romanus lesion (corner erosions)
  • Dagger sign (ossification of interspinous ligament)
  • "Trolley track" sign
8. Flat Foot. See Dec 2020 (PDF 1) answer above.
9. Froment's Sign. A test for ulnar nerve palsy (adductor pollicis weakness). Method: Patient is asked to hold a piece of paper between the thumb and index finger while the examiner tries to pull it away. Positive: Patient compensates by flexing the IP joint of the thumb (using flexor pollicis longus, median nerve) rather than adducting using adductor pollicis (ulnar nerve). Indicates ulnar nerve palsy.
10. Arthrodesis. See Oct 2022 (PDF 2) answer above.
Summary: The above compilation covers all 2-mark short answer questions from both PDFs (PDF 1: 2020-2026, 10 question papers / 100 questions; PDF 2: 2011-2026, 29 question papers / 290 questions), with concise but complete answers appropriate for 2-mark examination responses. Where the same question appeared in multiple papers, the answer is given once with a cross-reference.
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