DNB Orthopaedics December 2018

ORTHOPAEDICS PAPER I

PART A

1.    Define growth plate. Describe the zones of growth plate with diagram. Discuss the clinical significance of these zones?

2.     Describe the types of fracture healing. Describe the stages of secondary fracture healing. Enumerate the factors affecting the fracture healing.

3.    Describe the investigations and their uses in musculoskeletal system.

a)    DEXA Scan

b)    Bone Scan

c)     Ultrasonography

4.    Define allograft. Describe the types of allograft. Give salient features of each type.

5.    Pathology, clinical features and management of primary hyperparathyroidism.

PART B

6.    Etiopathology , clinical features, radiographic findings and management of scurvy.

7.    Describe strength duration curve. Describe the changes in the curve after nerve injury and following regeneration.

8.    Describe necrotizing fasciitis in following subheads:

a)    Definition

b)    Pathology

c)     Management

9.    Define neuropathic joint. Discuss the causes ,clinical features and treatment.

10.           Discuss anti-tubercular treatment in osteo-articular TB in terms of drugs, doses, regimen and duration of anti-tubercular treatment.

 ORTHOPAEDICS PAPER II  

PART A

1.Define  muscular torticollis .describe  causes ,investigations and treatment .

2.Define recurrent anterior dislocation of shoulder . discuss the pathological anatomy ,investigations and broad principles of treatment .

3.Types  ,causes ,clinical features ,diagnosis and treatment of radial nerve paralysis .

4.Clinical features ,diagnosis and treatment of De Quervains tenovaginitis.

5.proximal femoral osteotomies and the indications of each type .

PART B

6. Classify femoral bone stock deficiency in total hip arthroplasty. Describe the broad principles of management

7. Describe the clinical features of giant cell tumour(GCT). Describe the treatment options in a young patient with GCT upper end of tibia without a pathological fracture

8. Enumerate the sequelae of septic hip in infancy. List the types and indications of each type of reconstruction

9. Describe peri-prosthetic fracture of upper end of femur. Describe the treatment of each type.

10. Define slipped capital femoral epiphysis. Describe its clinical features, diagnosis and treatment in brief.

 ORTHOPAEDICS PAPER III

PART A

1.    Classify ankle fractures. Describe in brief the investigations and treatment of each type.

2.    Describe tension band principle with a diagram. Describe its applications in orthopaedics.

3.    Classify femoral neck fracture in children. Describe its treatment and complications in brief.

4.    Classify cervical spine injuries. Describe diagnosis and treatment of a patient with c5/c6 dislocation(in brief).

5.    Describe the pathophysiological changes in response to intramedullary reaming of long bones. Describe the reamed vs non reamed nails in a patient with polytrauma.

PART B

6.    Describe in brief the mechanism of injury , classification, treatment and complications of calcaneal fractures.

7.    Classify proximal humerus fractures. Describe in brief treatment and complications of proximal humerus fractures.

8.    Describe the classification and broad principles of management of open fractures of tibia.

9.    Define distraction osteogenesis. Describe its clinical applications in orthopaedics practice.

10.Pathoanatomy, investigations and principles of treatment of habitual dislocation of patella.

ORTHOPAEDICS   PAPER 4      

PART A

1.    Define  Surgical   site  infection SSI. Describe the current   WHO guidelines for prevention of SSI

2.    Describe the biomechanics   of ankle joint.  Describe the  current status of total ankle arthroplasty  .

3.    Define drug resistant bone and joint tuberculosis .describe the case identification  , and broad principles of treatment

4.    Define femoro- acetabular  impingement .describe the investigation, types  and their management .

5.    Describe in brief , the principles of limb savage surgery in musculoskeletal tumors .what are the patients not suitable for this procedure?

Part B

6. Define  and enumerate the bearing surfaces in hip arthroplasty  .Describe  each types with their pros and cons .

7. Enumerate  the  bone graft substitutes and describe in brief the advantages and disadvantages of each type .

8. Define evidence based  orthopaedics and how it can be applied in clinical practice .list the hierarchy of evidence (various types of studies)

9. what is spontaneous osteonecrosis of the knee (SPONK)describe the clinical features and principles of treatment .

10. Describe the current concepts of the mechanism of osteolysis after arthroplasty .what is the role of bone grafting in such patients without performing a revision arthroplasty ?

DNB Orthopaedics June 2018

Paper 1


1. a) Stages of fracture healing.


b) Describe various patterns of fracture healing after intramedullary nailing, locked plates and dynamic compression.


2. a) What is gout?


b) Difference between gout and pseudo gout.


c) Management of gout in middle aged woman


3. a) Write the extensor mechanism of finger with its diagram.


b) Describe brief development of proximal end femur.


c) Blood supply of femoral head.


4. a) Describe calcium metabolism.


b) Skeletal and radiological changes in hyperparathyroidism.


c) Principles and indications of Teriparatide in osteoporosis.


5. a) What is Complex Regional Pain Syndrome(CRPS)?


b) Describe its types and stages.


c) Diagnostic criteria and management of CRPS.






6. a) Anatomy of the arches of the foot.


b) What is posterior tibial tendon dysfunction?


c) Write stages and management of posterior tibial tendon dysfunction.






7. a) Histological zone of growth plate.


b)Classification of physeal injury in children.


c) Management of physeal injury in children.






8. a)What is limb length discrepancy?


b)Classification of limb length discrepancy.


c)Management of limb length discrepancy due to congenital pseudoarthrosis of tibia in children.






9. a)Define entrapment syndrome.


b)Enumerate various entrapment syndromes.


c)Clinical features and management of carpal tunnel syndrome.






10. Etiopathogenesis ,diagnosis and management of gas gangrene in lower extremity.






PAPER –2


Write short notes on:


1.a)Sequelae of osteomyelitis in paediatric patients.


b)Describe management of each sequela.


2. a)Classification of acetabular fracture.


b) Describe necessary radiological views for diagnosis of acetabular fracture.


c) Surgical management of posterior column acetabular fracture.


3. a)Enumerate causes of painless limp.


b) What is perthes disease?


c) Classification and management of perthes disease


4 .a)Types of tourniquets used in orthopaedic surgery.


b) Principles of usage of tourniquet.


c) Complications of tourniquet in orthopaedic surgery and its management.


5. a)Types of proximal tibial osteotomies in children &adults.


b) Indicatioins and contraindications of high tibial osteotomy for O.A Knee.


c) Technique of high tibial osteotomy


6. a)Enumerate various deformities of rheumatoid hand .


b)Management of deformities of rheumatoid hand






7. a)Classify periprosthetic fracture around total hip arthroplasty.


b)Management of periprosthetic fracture around hip






8. a)Define claudication. b)Difference between vascular and neurological claudication


c)Management of 60 year old woman with lumbar canal stenosis.


9. a)Clinical,radiological features and management of giant cell tumour.


b)How to prevent &manage recurrence of giant cell tumour?


10. a)What is dynamization?


b) Describe its role in orthoipaedics using various implants.









Paper 3


1.a)Describe Hoffa’s fracture.


b)Mechanism of injury in Hoffa’s fracture.


c)Diagnosis and management of HOFFA’S FRACTURE.


2. a)Classify thoracolumbar spinal injuries.


b)Management of patient with D12 burst fracture.


3. a)What is Lisfranc joint?


b)Classify Lisfranc joint injury.


c)Management of Lisfranc injury with complications.


4. a)What is unstable trochanteric fracture?


b)Briefly discuss the various methods of treatment of unstable trochanteric fracture.


5. a)Anatomy of posterolateral corner 9f knee joint(PLC).


b) Clinical test for diagnosis of PLC injury.


c) Management of PLC injury.


6. a)Classify Monteggia fractures.


b) Management of Monteggia fracture in children


c) Management of a 3 month old anterior neglected Monteggia fracture dislocation in a 6 year old child


7. a)What is Hagman’s fracture?


b) Mechanism of injury ,classification and management of Hagman’s fracture.


8. a)Surgical anatomy of lower end of radius.


b)Classify lower end of radius fractures


c)Describe management of comminuted fracture of lower end of radius


9.a) Classify nerve injury.


b)Causes of radial nerve palsy in adult


c) Management of Holstein Lewis fracture.


10.a) Indications of amputation.


b)Surgical principles of amputation in children.


c)Levels of various foot amputations,their indication & disadvantages.






Paper 4






1.a)What is free vascularised bone graft?


b)Role of free vascularised bone graft,allograft and bone substitutes in orthopaedics.


2.a)What is biodegradable implants?


b)Describe various biodegradable implants used in orthopaedics.


c)Advantages and disadvantages of biodegradable implants.


3.a)Indications and contraindications of Tibiocalcaneal(TCC) Nail.


b)Advantages and of Tibiocalcaneal Nail over other methods of ankle arthrodesis.


4.a)Classification of cartilage injury.


b)Describe investigation and management of cartilage injuries of knee joint.


5.a)Define non-union.


b)Classification of non-union.


c)Recent advances in management of gap non-union of fracture tibia.


6.a)Anatomy of rotator cuff of shoulder joint.


b)Indications ,contraindications and biomechanics of reverse shoulder arthroplasty


7.a)Recent advances in medical and surgical management of osteoporotic vertebral fracture.


b)Minimal invasive spine surgery in orthopaedics.


8.a)Unicompartmental knee arthroplasty indications.


b)Advantages &disadvantages of unicompartemental knee arthroplasty.


c)Complications of unicompartemental knee arthroplasty


9.a)Radiation hazards in orthopaedics.


b)Preventive measures for radiation hazards in orthopaedics.


10.a)Recent advances in various imaging modalities in orthopaedics.

DNB Ortho December 2016 Papers

1. a) Physiology of calcium metabolism.

b) Role of PTH in calcium metabolism.

c) Tabulate the biochemical differences between renal tubular

and glomerular rickets.

2. a) Ganga score.

b) Vacuum assisted closure of wounds.

3. Pathophysiology, clinical features and management of septic

arthritis of hip in a neonate.

4. a) Use of Plaster of Paris in orthopaedics and precautions in

applying hip spica.

b) Principles of functional cast bracing.

5. a) Types of bone grafts

b) Principles of bone banking.

6. a) Define osteoporosis. How will you assess for osteoporosis?

b) Principles of management of fragility (osteoporotic)

fractures of long bones.

7. a) Histology of growth plate.

b) Factors causing growth disturbance.

c) Principles of guided growth modulation.

8. a) Radiological features for the diagnosis of tuberculosis of

spine.

b) Radiological features of scurvy and rickets.

9. a) Blood supply of femoral head in various age groups.

b) Role of Virchow’s triad in the pathogenesis of DVT.

10. a) Clinical features of chronic painful mid portion tendinopathy

of Achilles tendon.

b) Role of plantaris tendon in the pathogenesis of this

condition; with special emphasis on anatomy of plantaris

tendon

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Part 2

1. a) Clinical and radiological features of developmental

dyplasia of hip.

b) Types of pelvic osteotomies for acetabular dysplasia.

2. a) Classify torticollis.

b) Management of torticollis.

c) Sprengel shoulder deformity.

3. a) Intrinsic plus hand.

b) Ulnar paradox.

4. a) Patho-anatomy and Pirani scoring in congenital talipes

equino varus.

b) Steps of Ponsetti manipulation and serial cast application.

5. a) Define Perthes’ disease

b) Aetiological factors, classification systems and head-at-risk

signs of Perthes’ disease.

6. a) Staging of bone tumours.

b) Principles, indications and contraindications of limb

salvage surgery.

7. a) Outline the technical steps to achieve desired degree of

version of acetabular & femoral components during THR.

b) What is combined angle of anteversion?

c) How will you modify your version in a case of fixed lumbar

lordosis or flat back?

8. a) Pathology and clinical features of acute hematogenous

osteomyelitis in long bone.

b) Management of chronic osteomyelitis of long bone.

9. a) Pathogenesis and diagnosis of Bankart’s lesion.

b) Anterolateral decompression in tuberculosis of spine.

10. a) Aetiopathogeneis of hand to knee gait.

b) Biomechanical features of floor reaction orthosis.

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Part 3

1. a) ATLS guidelines in polytrauma management.

b) Early Total Care (ETC ) in polytrauma and its indications.

2. a) Classify nerve injuries.

b) How will you manage a 1½ year old child with median

nerve injury in the middle of the arm?

3. a) Indications & techniques of hip arthroscopy.

b) Can you manage an incongruent reduction after a reduced

hip dislocation because of loose body with hip

arthroscopy?

c) What is an absolute contraindication to manage such a

case with conventional hip arthroscopy?

4. A 5 years old child starts developing a progressive valgus

deformity of tibia after an insignificant trauma to the knee.

What is the possible cause and pathogenesis of such a

deformity? How will you treat this condition?

5. a) Classify distal femoral fractures.

b) Management algorithm for such fractures.

6. a) Management of Volar Barton’s fracture.

b) Pathological anatomy and management of trans-scaphoid

perilunate dislocation.

7. a) Classify injuries of thoraco-lumbar spine.

b) Outline management of each type.

8. a) Classify fractures around the elbow in a six year old child.

b) Myositis ossificans – Diagnosis and management.

9. a) Management of postoperative knee stiffness.

b) Anatomy of posterolateral corner of knee & various

patterns of injuries in this area.

10. a) Masquelet technique: indication and steps in an infected

nonunion.

b) Evolution of different generations of cementing techniques

in arthroplasty.

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Part 4

1. a) Bearing surfaces in total hip replacement.

b) Investigation and management of dislocation of hip after

total hip arthroplasty.

2. a) Principles of reverse shoulder replacement. Enumerate its

indications.

b) Radial head prosthesis - Design & technique of

implantation.

3. a) Endoscopic spinal surgery - technique.

b) What is sacral nutation & its role in chronic low backache.

4. a) Salient features of tensile elastic nailing & technique of

implantation.

b) Low molecular weight heparin – Indications & monitoring

during treatment.

5. a) Clinical features of transient migratory osteoporosis of hip

(TMO).

b) Tabulate the differences between osteonecrosis and

transient migratory osteoporosis of hip.

c) Enumerate the steps of managing TMO.

6. a) Management of degenerative arthritis of knee in the young

patients.

b) Visco supplementation for knee arthritis.

7. a) Enumerate the causes of painful stiff knee after total knee

replacement.

b) How will you investigate and manage such a case?

8. a) Arthroscopic management of osteochondral lesion of knee.

b) Etiology of osteochondritis dessicans.

9. a) Modified Stoppa’s approach for acetabulum fractures.

b) Classification of brachial plexus injury.

10. a) Define drug resistant tuberculosis.

b) How do you suspect drug resistance in spinal

tuberculosis?

c) How will you investigate and manage a case of suspected

drug resistant tuberculosis?