DNB December 2011

DNB Final 2011 December Orthopedic Question papers

PAPER I

1. Describe the pathology, clinical features and principles of treatment of a neuropathic joint.

2. Describe the pathophysiology of Polytrauma patient and discuss the principles of Damage Control Orthopedics.

3. Discuss the etiopathology, diagnosis, prophylaxis and treatment of D.V.T.

4. Describe the pathology, diagnosis and broad principles of management of ankylosing spondylitis.

5. Discuss the pathophysiology and principles of treatment of Heterotopic ossification.

6. Discuss the surgical options in the treatment of mild medial compartment osteoarthrosis of knee in a 40 years old man.

7. a. Autonomic dysreflexia in Spinal Cord lnjury

b. Femoro-acetabular lmpingement Syndrome

8. Describe the pathology of avascular necrosis of femoral head and outline the principles of management in Ficat 3 stage of femoral head in a 30 years old man.

9. a. Pigmented villonodular synovitis

b. Carpal Tunnel Syndrome

10. a. Transient migralory osteoporosis

b. Early tendon transfer in Radial Nerve Palsy

PAPER II

1. Define osteomyelitis. Discuss the pathology, clinical features, diagnosis and treatment of acute osteomyelitis in a child.

2. List the causes of limp in an 8 years old child. Describe the differentiating features of septic arthritis with transient synovitis.

3. What is Kienbock's disease? Write briefly its etiology, diagnosis, clinical staging and management.

4. Describe "JAIPUR FOOT". Discuss the difference with 'SACH FOOT'& -MADRAS FOOT"?

5. a. SOMI brace

b. lnterferential Therapy (lFT)

6. Define ulnar claw hand. Discuss the tendon transfer for ulnar claw hand following ulnar nerve injury.

7. a. Radial Club Hand

b. Congenital Vertical Talus

8. Describe the flexor zones of hand. Discuss the principles of acute tendon repair (zone-wise).

9. a. Renal Rickets.

b. Salter's Osteotomy

10. a. Strength Duration Curve

b. Congenital Torticollis

PAPER III

1. Classify distal radius fractures. Describe radiological indices of wrist. Discuss the treatment principles of extra-articular distal radius fractures.

2. Classify infected nonunion. Discuss the treatment of infected nonunion of tibia.

3. Discuss the diagnosis and management of Anterior cruciate Ligament (ACL) lnjury.

4. Discuss the differences between :-

a. Machine screw and ASIF screw

b. DCP, LCDCP, Locking plate

c. Static compression and Dynamic compression

5. Classify proximal tibial fractures. Outline the management of type lV, V, and Vl fractures.

6. a. Fracture head of femur

b. Classification of Calcaneal fracture

7. Discuss the management of osteoporotic spinal fractures.

8. Describe the blood supply of talus. classify "Talar neck fractures". Discuss treatment and list complications.

9. Describe the structure of physis. Classify physeal injury. Outline the treatment of physeal injury and enumerate the compiications.

10. Define and classify Montegia fracture dislocation. Discuss the treatment principles of neglected Montegia fracture dislocation in a 10 years old child.

PAPER IV

1. Describe the extensor mechanism of knee and the factors that predispose to recurrent dislocation of patella.

2. Draw a cross section of peripheral nerve and label the structures. Describe Sunderland's classification of nerve injury.

3. a. Plaster Cast Syndrome

b. Bone morphogenic protein

4. Describe Stress, Strain, and Young's Modulus of Elasticity in relation to Orthopedic implants.

5. Describe 'free vascularized bone transplant. Discuss the principles of technique and applications in Orthopaedic practice.

6. Discuss the role of parathyroid glands in calcium metabolism.

7. Discuss the principles of application of Functional Cast Bracing in ' the management of diaphyseal fractures of long bones.

8. Discuss ceramics as bearing surface in Total Hip Arthroplasty.

9. a. Biodegradable lmplants

b. Principles and applications of lnterlocking Nailing

10. a. Unicameral Bone Cyst

b. Parosteal Osteosarcoma

Has the IOACON lost its charm?

Has the IOACON lost its charm?

After attending the last three IOACONs(Annual Meeting of the Indian Orthopaedic Association) in succession, I found that there is a gradual decline in the no of delegates attending the prestigious meeting of the Indian Orthopaedic Association. The past presidents, including Prof Johari had made serious amendments, so that IOACON still remains the most popular meeting among Indian Orthopaedic Surgeons. Prof Rajasekharan in 2010 put forward a questionnaire to everyone to suggest changes at IOACON and he has tried to implement many of them. Some of the biggest issues of IOACON 2010 at Jaipur were that most of the people were not present in the halls, even when highly respected international faculty delivered their lectures. This became such a serious issue that even local newspapers ran full page news covering photographs with empty halls and many orthopaedic surgeons standing in queue for gift vouchers and bags at various pharma stalls.

The faculty selection has been a considerable debate over the years at the most prestigious conference. It has been a common practice that state chapters recommend the faculty and forward it to the national executive. This leads to considerable bias. Prof Rajasekharan suggested a feedback system where all delegates are required to provide feedback for faculty talks, so that those with higher points were given preference at the next IOACON. Though this has been proposed at the last conference, it has still not been implemented.

The significant decline in the number of foreign faculty and delegates is also a serious issue. There has been a significant decline in foreign faculty. While most associations, have a tie up with the AAOS, the tie up of IOA and the AAOS looks weak. In National Meetings of other associations, there is a separate session or even one day dedicated for the AAOS Instructional Course Lectures and most of them are overbooked. It is time that the IOA invites the AAOS and provide them a session or a hall for the prestigious ICLs. I am sure that this step will bring back some of the lost zeal of IOACON. The lack of involvement of AAOS in the IOACONs led Alkem pharmaceuticals to conduct the AAOS India Trauma Conclave in 4 cities, which was again overbooked and a huge success for Alkem laboratories.

The only session where he had the best of foreign faculty was the ACE Trauma symposium, the brainchild of Prof Mohit Bhandari and Dr Parag Sancheti. We saw some the world’s best faculty, Prof Joel Matta, Prof Thomas Einhorn, Dr Vinod Dasa from USA, Dr Mohit Bhandari, Dr Brad Pretisor, Dr Femi Ayeni from Canada, Dr Susan Liew from Australia, Dr Karthik Hariharan from UK. The greatest part of the meeting was that all the talks delivered were based on Current Best Evidence and a great emphasis was placed on Evidence Based Orthopaedics. The halls ran full until the last talk at 6pm in the evening. Next year, we are going to have ACE Trauma, ACE Spine, ACE Joint Reconstruction, ACE Sports Medicine, so that emphasis is placed on current best evidence.

This drawback of IOACON has led to success of speciality meetings. For eg, there were more than 7 joint replacement major meetings last year like the ROC, JRSOA, IAA, Current concepts in arthroplasty, ISHK and MIOT meetings. Others like IASCON conduct live arthroscopy workshops with experts in the respective fields. The foot and ankle meeting by Dr Selene G Parekh from Duke University also is very popular because of the fairly good no of international faculty. In Spine, the ASSICON and the Ganga Hospital Courses run packed.

I remember in 2003(Chennai), 2004(Agra), 2005(Mumbai), at least the main hall was usually full. But since 2009, the no of delegates in the main hall has also decreased. Will the new leadership with Prof Rajasekharan, Dr SKS Marya, change the scenario of our prestigious meeting?

The other major issue was the website, which has been revamped to provide a new website. The current one looks very impressive but nowhere can we compare it with the largest educational resource, the AAOS website. I am sure that Prof Rajasekharan would have visited the AAOS web a no of times. It is time that we do a bit of introspection.

I would still recommend the IOACON for the younger generation of orthopaedic surgeons and postgraduates, because it is a good platform for trainees and junior surgeons to present papers and posters in big halls(although there is no audience). They can overcome stage fear and they can gain some practice sessions

Dr Hitesh Gopalan U

Editor, Orthopaedic Principles

Expert Advisory Panel, Ortho-Evidence, India