Orthopedics

miniOSCE
Yazan Alawneh
Note: I’m not sure about the answers,
they are based on the past year questions mainly
 Injury Nerves at risk Clinical signs
Shoulder Dislocation Axillary Loss of deltoid contraction
I
Numbness over regimental badge
Humerus (arm) Radial Wrist drop
Fracture Numbness over the back of hand
Supracondylar Elbow Median (Anterior Loss of thumb and index flexion
Fracture E
Interosseous nerve) Inability to make the OK sign
Elbow Medial Condyle o
Ulnar Nerve Claw Hand

Forearm Fracture
I
Radial (Posterior Fingers and thumb drop (at knuckles)
Interosseous nerve)
Radial (Posterior
I
Deviated wrist extension
Fingers and thumb drop (at knuckles)
Monteggia fracture
and dislocation Interosseous nerve) Deviated wrist extension
Hip Dislocation Sciatic Foot drop
s 3 Numbness over the back of foot
Knee Dislocation Common peroneal Foot drop

33
nerve
I Numbness over the back of foot

Radial above an wristdrop

 rewarm yerdrop

Injury Artery Affected

1st Rib Fracture Subclavian Artery
Shoulder Dislocation Axillary Artery
Humeral Supracondylar Fracture Brachial Artery
Elbow Dislocation Brachial Artery
Pelvic Fracture Presacral and the internal iliac
Femoral Shaft Femoral Artery
Femoral Supracondylar Fracture Popliteal artery!
(based on dr. Kefah, Saeed)
Knee Dislocation Popliteal Artery
Proximal Tibial Fracture Popliteal or Its Branches
SHOULDER
Cs Tt Etsy
 Supraspinatous Initiate abduction Suprascapular nerve
Infraspinatous External rotation Suprascapular nerve
Teres minor
Subscapularis
O
External rotation
Internal rotation
Axillary nerve
Subscapular nerve
33 3 3

abou tin

internal rotation Destruct rotation

 • What is your Dx ?
- Winged scapula
• The affected nerve is ?
- Long thoracic nerve
5
Springle Shoulder
Klippel Feil
Anterior Shoulder Dislocation

O O
Anterior Shoulder Dislocation
Acromioclavicular Dislocation

cure

y
a cranium
 Hill-Sach Sign
O Cause: recurrent dislocation
É

z
g
 00
Bankart Lesion

CT scan: damage to
glenoid labrum

Cause:
recurrent dislocation
 Light Bulb sign
Posterior Dislocation
If
 ARM
(Humerus)
 Popeye sign
Biceps Tendon Rupture
Erbs palsy
“causes paralysis of Waiter Tip Position
the abductors and so
external rotators of the
shoulder and the
forearm supinator's,
The arm is held to
I
the side, internally
rotated & pronated”
 Describe the
displacement:

-Anterolateral
translation
(100%)

-Posteromedial
angulation

-Lengthening of the
limb

0
-No rotation.
 Describe the
displacement:

mid shaft fracture of the

humerus with
- shortening about 2 cm
- lateral translation and
14
- medial angulation
- without rotation
I
 What is your diagnosis?

Pathological facture
Due to tumor mostly

What is the most common

nerve to be injured
in humeral shaft fractures:

To
Radial nerve

Mnemonic: ARM:
Proximal (Shoulder dislocation) – A – Axillary nerve
Shaft – R – Radial nerve

s
Distal (Supracondylar) – M – Median nerve
 Dx:
- Humeral shaft fracture

- Spiral

- Most common
complication:
Radial nerve injury
 Describe the
displacement:

Lengthening
Is
ELBOW
 What is the diagnosis
of this condition?
Cubitus varus (vara)

What is the cause of

this condition?
- malunion of supracondylar fracture
I
/ supracondylar fracture of the distal
humerus

Dios
 What is the diagnosis?
Cubitus valgus
What is the cause?
0
Non union of lateral condyle
Most Common complication:
Ulnar nerve

É
Name the deformity
can happen as a
result of non-union
e
of this fracture?

8
Cupitus Valgus O
Tavern
lateral
epigney rays Erin
To
What Is the name of this test ? & for what ?
Tennis elbow test , lateral epicondylitis
B
 E
O
 Diagnosis:
Humeral Supracondylar
Fracture

What is the most

commonly injured
structure: O
Median nerve
Brachial artery

Where is the
dislocation:
Posterior
- What is the Fracture ? - Where is the displacement?
Supra-Condylar fracture Posterior Displacement
3
Supracondylar fracture
3
 Posterior Elbow Dislocation

Terrible triad

the combination of fractures of the radial head

and ulnar coronoid process and
dislocation of the elbow joint
Posterior Elbow Dislocation
Bicondylar fracture
 What is this?
Lateral condylar fracture of the elbow
treated by Percutaneous Pinning
with K-WiresIt
 What is the fracture?
Medial Epicondylar Fracture
Cause? Avulsion of the flexors
E

Q
É

IYad medial
 O

Medial
Epichondylar
fracture
 Lateral
Condyle
Fracture

a
What is the fracture ?
Olecranon fracture

É
FOREARM
 What is your Dx?
Radius

Galeazzi fracture
3
“ fracture of distal radius
with dislocation of distal

P
radioulnar joint ”

disot
 - What is the Fracture?
Monteggia fracture (Ulnar fracture with
proximal radio-ulnar joint dislocation)
at
- Treated/Managed by ORIF

Éj
 O

Id 3
BEEFY
in
 - What is the Fracture ?
Colles Fracture (fracture of the distal forearm in which the
broken end of the radius is bent backwards (dorsally))
E
- What Deformity does it cause ? Dinner fork deformity

O
 - What is the Fracture ?
Smiths Fracture (reversed
Colle’s) “fracture of the distal

I
forearm in which the broken end of the
radius is bent forwards (ventrally)”
- What Deformity does it
o
cause ?
Garden Spade deformity
33
 Describe
the fracture:
- Dx?
Ulnar Fracture

- Type ?
Segmental
or
- Displacement?
Y
Translation +
Angulation +
shortening
 Green-Stick
Fracture
In both Ulna and
I

Radius
 Dx? Barton fracture
Barton fractures extend through the dorsal aspect to the articular surface but not to the
volar aspect. Therefore, it is similar to a Colles fracture. There is usually associated dorsal
subluxation/dislocation of the radiocarpal joint
 I
k

inward
two
are
ol
son
u dorsal
WRIST, HAND
AND FINGERS
 Nerve Palsies
Ulnar Median Radial
Pointing finger

Claw Hand Wrist Drop

Ape Hand
Mnemonic: DR.CUMA
Drop
Radial
Claw
Ulna
Median
Ape
 Snuff
Box
Boundaries

3 p
 É
c

to
 Radial
Club Hand
Dx? Syndactyly
Dx? Polydactyly
RA RA

OA OA
RA
GOUT
 Dx?

TB of wrist joint
Memorize the
hand bones!!
 What is the
name of the
bone pointed
with the red
Arrow?

Capitate
 Dx?

Distal interphalangeal
joint dislocation
• What is the muscle responsible for this movement ?
Lumbricals

• Supplied by which nerve ?

by Ulnar nerve
 Trigger finger
is a condition that causes pain, stiffness, and a
sensation of locking or catching when you bend and
straighten your finger. The condition is also known as
“stenosing tenosynovitis.” The ring finger and thumb are
most often affected by trigger finger
What is the salter
harris type of this
fracture ?
Type 3
O
mnemonic:
Type 1 – Straight across
Type 2 - Above
Type 3 – Lower/below
Type 4 – Two or through
Type 5 – ERrasure of
I
growth plate or cRush
• What is this sign? Froment's Sign
• For which nerve? Ulnar nerve
Dx? Dupuytrens Contracture
 Dx?
Kienbock’s disease (AVN of the
lunate – lunate density)

O
Kienbocks
Cut injury at forearm result in this picture
which most likely nerve injury?

Median nerve injury

Pointing Index Sign

 Dx?
Mallet finger
(Extensor Tendon
Avulsion)
Boutonniere deformity

Swan neck Boutonniere deformity

00
 • Dx?
Scaphoid
fracture

• Complication:
AVN
 Scaphoid blood supply:
- Dorsal carpal branch (branch of radial)
- Superficial palmar arch (branch of volar radial)
 Dorsal intercalated
segmental instability
(DISI)
*widening of scapho-lunate interval*
(Terry-Thomas Sign)
 Dx? Rolando fracture
(comminuted fracture of the base of the 1st phalanges)
 Dx? Bennets fracture
(Bennett fracture is a fracture of the base of the first metacarpal bone which
extends into the carpometacarpal (CMC) joint)
 3

Boxer’s
Fracture

* break in the neck of the

5th metacarpal mostly *
5
Dx? Madelung’s Disease
HIP
The hip abductor muscles include the

E
- gluteus medius,
- gluteus minimus, and
- tensor fascia lata (TFL)
Nerve supply: Superior gluteal nerve
(branch of the sacral plexus)
 The hip
adductors
muscles include:
- adductor
longus, and
brevis, and
magnus
- gracillis
- obturator
externus
Nerve supply:
Obturator nerve
(branch of lumber plexus)
 The Femoral Head blood supply:
- extracapsular arterial ring (LCFA, MCFA)
- ascending cervical branches
- artery to ligamentum teres:
obturator artery or MCFA
 Dx? Bilateral Protrusion Acetabuli
Causes: Paget, RA, Osteomalacia, Trauma
 Dx? Bilateral Protrusion Acetabuli
Causes: Paget, RA, Osteomalacia, Trauma
Dx? Hip Dislocation
(Left Hip, Posterior Dislocation)
Left Femoral head dislocation
Posteriorly
What is nerve that is commonly injured
according to the pic ? Sciatic nerve
Dx? Right Acetabular Dysplasia
Dx? Acetabular Dysplasia
Dx? Hip Subluxation
Dx? DDH of the Left Hip
(Developmental Dysplasia of the Hip)

Acetabular
Perkins line
Angle
Hilgenreiner line 40
25

Shenton line

Memorize the lines!!

 DDH

Note: the best sign on x-ray is the acetabular index

 DDH
Left
Sided

Right
Sided
 Coxa Vara

Coxa Valga
 Dx?
Bilateral Slipped
Capital Epiphysis
SCFE
 Dx?

Right
Slipped
Capital
Femoral
I

Epiphysis
Lateral Compression
Dx? Perthes Disease
(AVN of the femur head)
Dx? Perthes Disease
(AVN of the femur head)
 Dx?
Avulsion fracture
of the ischial
tuborisity

Contraction of
which muscle
can cause this
fracture?
Hamstring
muscles
 Dx?
Displaced Intra-capsular fracture
 Dx?
Right Femur Inter-
trochanteric fracture
(Type 2)

Displaced
slightly comminuted
Lesser trochanter fracture
Varus

Most common
Complication?
Malunion,
Bleeding,
Soft tissue injury
 Dx? Right inter-trochanteric fracture
Most common complication? Malunion, failure of fixation
 Dx?
Inter-
trochanteric
fracture

Most common
Complication?

Malunion
Dx? Avulsion IAIS Fracture
 Dx?
Femur neck
fracture

Treatment?
ORIF

Complication?
- Non union
- AVN
 Dx?
Femur neck
fracture

Complication?
- Non union
- AVN
Combined Fracture
 Dx?
Fractures of the
pelvic ring (open
book injury)

what is the
direction of the
force causing
this?
Anteroposterior
w
compression +
lateral rotation
 Dx?
Open book
Fracture

Force
Direction?
Anteroposterior
Compression

Complications?
Bleeding,
Soft tissue injury
 Dx? Open book fracture
What does it indicate ? AP compression
Total Hip Replacement
FEMUR (THIGH)
 Name the site and
the pattern of this
fracture:

Left femoral shaft

fracture Segmental or
SegmentalÉE comminuted
(comminuted alone is wrong)
What is the name
of this fracture?
femoral shaft
fracture

What structure is
commonly
injured with this
fracture?
femoral artery
 Dx? Supracondylar femur fracture
Displacement? Translation, Angulation
What vessel at risk? Popliteal artery
 Describe the
displacement?

Lateral
se

translation and
shortening
 Dx?

malunion
KNEE
 Name the Test? Lachman test
Ftl
The Purpose of the Test? To Examine the ACL
 Dx?

Generalized
Joint Laxity
 Dx?

Genu
Recurvatum
 Dx? Dx?
Genu Valgum Genu Varus
“Knock-Knee” “Bow-legged”

is
Dx? Tibial Plateau Fracture

g
Dx? Tibial Plateau Fracture
 Dx?

Lateral O
patellar
dislocation
 Dx?
Osgood-
Schlatter
Disease
(OSD)
(apophysitis of the tibial tubercle)
 Dx?

Loose body
in the knee
 Dx?

Osteochondritis
dissecans
(OCD or OD)
 Dx?

OA of the knee

Typical changes seen in OA:

- Joint space narrowing
- Sclerosis

E
- Cyst formation
- Osteophytes
RA OA
LEG
 Dx?
Transverse
fracture of the
tibia and fibula
s
Description: g
- Transverse
- Shortening
- 100% Anteromedial Translation
- Posterolateral Angulation
(about 20 degree)
- No Rotation
 Dx?
Comminuted mid
shaft fracture of
tibia with fibular
fracture
 Dx?
Hypertrophied
nonunion fracture
of the tibia
I
Causes?
movement,
wrong reduction
Inadequate immobilization
Inadequate stabilization
 Dx?

Atrophic
non-union

Causes?
vascular causes
(e.g.impaired blood
supply) or metabolic
causes (DM or
smoking)
7
ANKLE & FOOT
D

Es
 Dx? Congenital Talipes
Equinovarus (Club-foot)
I
TTT:
Conservative (poonseti) serial casting

Description:
plantar flexion supination medial
rotation, except the body of talus
so
 Dx?

Pes Cavus
 Dx?
Pes Planus
Valgus
E
flat foot
 Dx?
Congenital Convex Pes Vulgus
 Dx?
Hallucus Valgus
I
Memorize
The Foot
Bones!
Name The Bone?
Navicular Bone
 Dx?

Sever
Disease
(Apophysitis of
calcaneus)
 Dx? Osteochondritis
I
Dissecans in the ankle
 Dx? Köhler Disease
“navicular bone osteochondritis”
 Dx?
Bimalleolar
Ankle Fracture

00
 Dx?

Pilon
Fracture
Salter 2 Salter 4

Salter 3
 Dx?
Avulsion of the
5 Metatarsis
th
5 bone
 Dx?
Calcaneus
Fracture
 Dx?
Talus
Fracture
AVN
O
 Jones Fracture
“caused by a twisting injury in the peroneal brevis and peroneal
longus tendons, this leads to avulsion of the bone in the lateral side”
March Fracture
“a type of stress fracture that is
caused by repeated minor trauma
to the area, it can be mistaken with
malignancy on X-ray”

q
March Fracture

O
Lisfranc Fracture
“injury to the metatarsal bones at the
level of the tarsus, it is named
after Lisfranc who was napoleon’s
personal doctor. We also Lisfranc joint
& tendon.
Treatment is anatomical reduction
2
OTHERS
 • What is most common pathogen to cause
o
osteomyelitis in sickle cell patients? Salmonella
Scoliosis
Non Union - Treated by a Nail
 45 years old, sustained humerus fracture 9 months ago, this is the x-ray now
A- what is the diagnosis of this complication?
Non-atrophic Non-union
B- what is the cause of this condition?
They have given rise to the acronym CASS:
Contact – Was there sufficient contact between the fragments?
Alignment – Was the fracture adequately aligned, to reduce shear?
Stability – Was the fracture held with sufficient stability?
Stimulation – Was it sufficiently ‘stimulated’? (e.g. by encouraging weight bearing).
There are, of course, also biological and patient related reasons that may lead to non-
union: Poor soft tissues (from either the injury or surgery), Local infection associated
drug abuse, anti-inflammatory or, immunosuppressant meds, Non-compliance
Good Luck!!
..‫دعواتكم‬
 b
b in vatted
ulnarnery Eoin
extensor waste
y
 D

D
outfit
Pig
I
 T
ostemalasia
 I 3
To test carpal
median N tunnel syndrome
TS cured ian N
 3

I I
s
É
O

fauna
head
is
gone
33
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Ncurogcnic Vascular aaudlcatlon

5P1 0'\11nal-d1, 1.1I thigh

Claudlcatlon
D ista l - Pn.1"'11n.il \,a ll J)dlll
3
p,1111

Standing l 'au..,cs ,\ n1pto1n,

Stair climbing S\n1ptn1n, Jc, 0lup late "'' 111 pto111~ dc:velop ,ol' ll~ t
1

1hnl k tlc,cd) ('>1t :11a hl back.)

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Stationary ( ,111,~, ..,, n1p101n-.
bicycle (back

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'\i0r1nal \bnl)I 1n:d K

ss 8126 .zo,~
 FEMORAL
COMPONENT

• POLYETHYLENIE
CrO,MPONENT

TIBilAL
COMPOINENT
 . .· a:,ulcnnin
de b, nl y
,I
•
Ortho

1- non union fracture x ray

Identify it ? Two risk factors ?

2- Ortolani test for DOH

Identity it ? If +ve: whrs next ?

3- type 2 salter harris fracture x ray

Identify which type ? Name a complication

4 - Flexion on 4th DIP joint of hand

Name the muscle ? Innervation ?

5- Foot anatomy

Name the bones ? Against which muscle we palpate the clorsalis peds ?

6- TKR intr-op picture

Identify structures ?

7- In-toeing gait

Most common cause ?

8- Osteoarthorsis in both knees x ray

Identify the disease ? Wht deformity it causes ? Management ?

9- Cast on leg with sever pain and paresthisea

Identify the most worrying diagnosis ? Management ?

10- hip fracture in elderly with comorbidity what's management ?

Risk of mortality if left untreated?

 Organization of Cartilage within
Epiphyseal Plate of Growing Long Bone
,. l
Resting zone - small, Inactive cartilage cells

© Proliferation zone
I
Chondroblasts quickly divide and push the
1plphy1i1 away from the dlaphysis, lengthening
the bone.

® Hypertrophic zone
Older chondrocytes enlarge and signal the
surrounding matrix to calcify.

F
@ Calcification zone
Matrix becomes calcified; chondrocytes die,
leaving behind trabeculae-1haped calcified cartilage.
THI S IS NOT YET BONE!
Calcified canllage
spicule

Osseous tissue--
@) Ossification zone
Osteocfasls digest theEEcalcified cartilage, and
osteoblasts replace It with actual bone tissue In the
shape of the ca lcifled canllage - resultl ng In bone
trabeculae.
 Tinn-r FlfffllY'

C
1i11iii .d lfNilli• fil tliiidlM .

..

.......
r ~ ......, ...... ,, ~ a
Mdii llilJIWWMNI ANI M,MH p - I
 Ffex°Lan fradure uf the
,~rUliJ5 t5T1111ilh's I rilcturr.>

[\l~oo ir..-chJrt: of l1h.-_..

radius lColl~ rracture,
.... Zain JO 3G 11:29 PM @ V 24% t 0•
o. i shepard crock deformity

O ibrous Dysplasia
• Ground glass appearance typical
Shepherds crook deformity of proximal femur
• Variable appearance with expansion of cortex

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Xray bone-tumor
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polktk ""9'" function ;uw,11
1ump1ofurtdus function to nng
is lluor d!gitorum profundus
f"1<~on to lfldot "'d tong) and p,nky}

Oper::itive Techniq ues in Orthopaedic Pediatric S urgery. 20 I J

9 8126120 19
 DORSAL t
Colles fracture

Smith fracture

Barton fracture •

Barton fracture ~
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s
Common sites of Or th op ae di c disease
·;: Gout MP joint of big toe.
* Pse udogout Knee
1
* Rh eurnatoid arthritis joi nt
* Diabetic Charcot joint Tarsa ls j oin ts
1* Senile osteopo rosis
* Acute Osteomyelitis end of fern ur
* Brodies Abscess end of Tibia.
* Anky/os ing spondylitis Sacra ilia c joint
J JI Os teochondritis dessi
cans Kn ee
L
* Dis c
_ _ _ _ __
L4- LS
ORTHOPEDICS ARCHIVE
Orthopedics Mini OSCE

1-11-2020
Prepared by Ashraf Nasraween
 Q1
What Muscle cause this •
fracture:
Gastrocnemius .1
Hamstring .2
Sartorius .3
Quadriceps .4
 Q2
According to the •
picture, Lachman test
procedure( flexion 30
degrees and pulling the
tibia anteriorly )

To test ACL injury

 Q3
Which of the following •
is wrong about this
fracture:

Rotational deformity of
the index finger
 Q4
The deformity shown in •
this picture:
Mallet finger •
 Q5
Which of the following •
is incorrect about
osteoarthrosis:
Gouty tophi •
 Q6
Most important factor •
to detect the method of
Rx:
Intact Extensor •
mechanism
 Q7
The examined muscle •
subscapularis •
 Q8
The injured nerve •
Musculocutaneous •
nerve
 Q9
This method is for •
treatment:
Pes cavus .1
Pes planus .2
Club foot .3
Infantile flat foot .4
 Q10
Describe the following •
lesion:
Eccentric metaphysical •
well defined mostly
benign o o
 Q11 femoralphysis
Disorder of proximal
slippage of epiphysis relative
to
hypertrophic Zone
The diagnosis • femoral neck in
weakness in perichondral ring
SCFE •
gradual progressive onset
groin kneethigh pain
Obese male Adolescent O
Shearingfores
Slight external
they walk in
limited internal rotation
rotation
O
AVN
In E
situ fixation Klein Line
Trethowan's sign
 Q12
Distal fracture in Pediatric Skeleton
A
Type of salter Harris •
Type 2 •

j
Growth

b I b Igf
Notthrough growthplate growth Piaget

Below
downward
straight upward
through
 Q13
Treatment: •

Closed reduction with

wires

3 ‫اﻟﺟواب ﻣن اﻟدﻛﺗور‬
 Q14 DDA II
Dysplasia
w

The red line is: •

it Perkin line •

D Test Harmful
Barlow e Adduction
of Hip light pressure on
not
knee popping iftagged
Relocated Barrow
o
Ortolani Test
Abduction which will bed
Galeazzi Alli's sign flexing
both knees t Looking for
lengthdiscripency index on ASIS Middleon GT
line should be below
Bilateral Klinsic sign umbilicus
 Q15
This sign is: •
Harrison sulcus •
 Q16
Patient presented with •
Bradycardia and
hypotension:
Neurogenic shock •
 Q17
tenderness crepetation
Patient presented with •
2501 ofvertebra Stable
conservative tx
low back pain, type of
fracture:

wedge
507
Mechanism
Compression •

Flexion
Associated with osteoporosis
 Q18 Scoliosis
The most prognostic • CobbsangleIII mix
Sed tojudge ossification factor mild 1030 mod 30 45
ofspinal vertebra sage
Ossification of iliac •
apophysis
coliosis curve oftenProgresses most
during
enod ofrapid skeletal
maturity is
reached
level of calcification
E

Right thoracic curve is me

idiopathic scoliosis curve

 Q19
What is the name of •
this classification?
Risser’s zone •
ndined measure of skeletal 2,50s
7si moi too

Maturity
251 prepuberty
grade 1
beforeduring growthspurt
grade 2 501
grade 3 751 slowing of growth
grade 4 1001 End of growth
 Q2) Picture of club foot (direct
CongenitalTalipes question)
Equinovams
Management Adduction of
3
CAVE forefoot
connection should Short
o
be by 3months
Achillustendon
conservatively
f stayed 73months O vans
f Clinical
surgery 3 DX

23 months conserative
3 mouths surgery
Q4) Giant cell tumor and
ee
chondroblastoma
 Hallux valgus. Bunion
Lateral deviation and rotation of Hallux
first metatarsal Hea
Prominence of medial side of

Always describewhats Tight shoes

distal
IEEx I

overcrowding of lateral toes

Q5)picture of Buckle fracture. Not so
obvious. T
Toms Fracture

Usually distal radius

cast
Children have softer more flexible bone

Tension side remains solid

6

co
Q7) According to Salter-Harris classification, what type of
fracture is this?

A: Type 4
Q8)What is the name of this line?
Shenton’s line. •

DDH
 Q15)Mcmurray test
• Flextion, internal rotation, valgus stress and
then extention 3
IF
Test Meniscus injury
 Q16)Type of fracture.
• Galeazzi (fracture of radius and dislocation of
ulna)
Tien

I
Q17)Picture of pelvic dislocation and
blood at meautus, you suspect injury
of ?
• Urethra.
 Q18)Garden’s classification of femur
neck fracture?
• Type 3 (not sure)

EE
Q19)Long qsof old man 65 years with 2
years history of pain in the hip not
responding to analgesia and
interfering with his daily life (he has
osteoarthritis)
Management? Total hip replacement. •
 mainly degenerative 740 yo

Ruptured Achilles tendon

above tendon 5am
gap
3
Simonds Test

Tx Surgery
 Management ?
History ,physical examination and
follow up xray
 WHICH NERVE AFECTED IN THIS
INJURY ?
Lateral ligament
ankle jerk injury compression
intact I
numb dorsum
of foot
o At fibula neck

Common peroneal nerve

weak ankle dorsiflexsion x foot eversion
3 foot inversion
ankle plantarflexsion t
 B

Active resisted extention of wrist

examination for ?

Tennis elbow
Z
What is the attachment of the
structure examined?
Medial border of lateral femoral
condyle Lachman's
Test
75 year old patient with right hip fracture
Your management

Hip replacement
 Where is the abnormality ?
Secondy tibial tuberosity ossification
center
o goods
outfit
Not feature of the disease ?
Widening of joint space

c
Which nerve affected ?
Posterior interosseous nerve
What is the deformity ?
Coxa vara
3

I
in which layer the pathology occurs ?
Hypertrophic layer SCFE
to

O
Plastic deformation

7 i
What is the deformity ?
Angulation
What is the name of this pathology?

A: Club foot
 What pathology can you see in this image?

ACL LMT
Acute
AU MMT
Chronic
contact trauma
Needs
surgery
in pediatrics

Painswelling butafter several hrs

A: Meniscal tear (double PCL sign)
Chronic complaint Locking click
 This patient had a high fever and elevated ESR, and on doing
synovial fluid analysis, had a WBC count of 140000. What is the
best next step of management?
Septic Arthritis

Staph Aureus
Hematologic or
from
osteomycitis

as
A: Arthrotomy (NOT ANTIBIOTICS FOR 6 WEEKS)
 How would you describe this lesion?

A: Eccentric, well-defined, metaphyseal lesion, no disruption to the cortex, mostly benign

so Is
20 year old male patient complaining of knee pain, what
disease could have caused the appearance shown here?

A: Osgood Schlatter disease

All of the following are risk factors for this condition
EXCEPT:

A: Genu vaRUS (genu valgus is the risk factor)

What is the appropriate management for this patient?

A: Tension wire banding (this is an olecranon fx)

What type of fracture is this and what is the appropriate
management?

A: Supracondylar fracture, type 2, closed reduction and fixation

According to Salter-Harris classification, what type of
fracture is this?

O
A: Type 4
What is shown in the picture?

Rickets
Osteomalacia

A: Rachitic Rosary
The sign shown in the red circle indicates what?

A: ACL tear (Segond fracture, pathognomic)

What type of fracture is shown in this image?

A: Compression fracture
What type of fracture is shown in this image?

A: Talus neck fracture

What is the most obvious deformity in this x-ray?

DO
A: Translation
 Severe pain
957 Anterior Dislocation limited Motion
What is the management for this patient?

Axillary Nerve injury sensation

Deltoid weakness Impaired Abduction

Ulnar Abduction
Test vascular Adduction
Radial Ulnar Radial Extensionof
Capillary Refill MCP

Median oksign

A: Closed reduction under anesthesia

Respiratory Depress
1

x
3
5
6

?????
7
8
01
11
13

speed Test
Test
Yergansons
14
16

Epiphysis
17

Answer from doctor

18

Answer from doctor

19

Answer from doctor

20

Answer from doctor

 DDx Brodie's Abscess
Q1 : subacuteosteomyelitis

25 male patient come •

to your clinic suffer
from pain :
•
1- your Dx :
•
2- mention two
features of pain:

2am Usually resolves spontaneously

after 3years butpatientdoesnt
they produce pg wait this long
Removed radiofrequency usually
 at

Q2 :

Your dx : •

Dx lipoma
sarcoma
Posterior interosseus neuroma
Hamarto ma
 Q3:

Patient come to •
clinic after 9 M
from surgery
suffering from pain
.
your Dx: •
 Q4:
Pt come with low •
back pain

Your Dx :
 Q5:

YOUR Dx : •
 Q6:
1- Your dx: •

2- TTT •
 Q7:

1- What your dx : •

2- what possible •
causes :
 Trabicularbone becomes fibwu
Tumor due to Gs protein mutation
Q8: withwovenbonegivingappearance
of Ground Glass Appear
T

1- Your dx: •

2- What associated •
hormonal
abnormality Shepherd's
McCune Albright Syndrome crook
deformity
coxa
8401 monostotic vans
201 polyostotic

Tx Small observe
Large camelagetgrafting
 1 I 0

Q9:
patient came to ER With knee •
pain 1 day duration and the TM
was 39 A cute
Aspiration from joint show •

Write two possible causes

Blood
 Q10

3
O
1 semi membrane

2 4
rectus femoris
station 1
 station 2
1.after knee surgery •
pt came with this
condition,whats
your diagnosis?
Drop foot
2.name of injured •
nerve ?
common peroneal
nerve
 station 3

Gait cycle
1.stance phase
2.swing phase
 station 4

Name of lined
structure?
1.Coracoacromial
2.Latissimus dorsi
3.Rhomboid major
 station 5

1. your diagnosis?
syndactyly (fused
finger)
 Station 8
1.name of this sign? •
2.whats the injured •
lig.? L
1.sag sign

2.PCL
 Station 9
history of falling
down from 2nd floor
1.diagnosis?

2.mech. of Fracture?
 Ans.station 9
1.tibial plateau fracture
2.if lateral condyl fx
>>>valgus falling down
medial condyl fx >>>varus
both condyle fx
>>>straight legs
so in this case mech. of fx
is valgus
 Station 10
a case of index pain after
repetitive fx
1. diagnosis?
2.management?

1.chondroma
2.follow up but if
repetitve fx>>curettage
and graft so in this case
the ans. is curettage
 A 14yrs old child with hip pain
Dx? Risk factors?
Obesity
Hormonal
FHX
Medication
steroid
 Hx of falling down on outstretched
Midd acicular hand
fracture Diagnosis?
conservative
Lateral43 INSTABLE
9
figureofeight brace
StaticStabilizingFactors sacc
Acromioclavicular ligament
Coracoclavicular ligament
Capsule
Dynamic Stabilizing
factors DDT
Deltoid
Hx of falling on elbow
Diagnosis?
A 45yrs old male had a distal femur fx
since 9 months and underwent an
open reduction internal fixation
Diagnosis •
Risk factors •
Name the labeled muscles

Tibialis anterior •
Poplitues •
Extensor hallucis longus •
Extensor digitorum longus •

a
 Name the following deformity
at PIP
hammar toe
Flexsion
Extension at DIP
What type of Salter Harris is this
fracture 2

Type 2 •
 A child with this x-ray
What is the most probable DX?
Non-ossiying fibroma •
 A 64 yrs old osteoporotic women after
falling down
Proximal femur Dx? Proximal femur shaft fx •
frater
Transverse with Lateral translation Management •
Open reduction internal fixation •
soon
OR IF
 Hx of trauma

Femur shaft frachine Dx? •

Mid shaft femur fx •
Intra medullary nail
Management •
Closed reduction Surgery •
Internal fixation
1- Old age, your diagnosis?
Dupuytren's contracture
History of twisting injury inflammation warmth
redness
Dx ankle sprain Swelling
Throbbing pain
Most commonly injured ligament : ATFL
Anteriortalo Fibular ligament
grade I
mild damage
no instability

rade 2
artial fear loose

rude3
complete tear bruising
instability

X Ottawa ankle rule to decide if it needs

4- Elbow pain exacerbated by hand
movement and resisted wrist extension
Dx : lateral epicondylitis tenniselbot
Affected tendon : ECRB Extensor Carpi Radial
Brevis

Localized pain
due to
repetative
strain injury
5- Winged scapula
affected nerve : Long thoracic nerve
affected muscle : Serratus anterior
6- dx : Giant cell tumor
treatment : Curettage and grafting
7- Varus stress test
Lateral collateral ligament
8- Identify H line
Tx: pavlic harness
9- dx : Subtrochantaric fracture
Tx : surgery (open reduction and internal
fixation)
10- Identify the marked muscles
5th months old baby come for DDH screen : Hilgenneiner
1- what is your DDx ? H line
2- what is the name of line that is indicated by thin arrow ?
3- what is your management ? Pelvic Harness
‫ﻣش ﻧﻔس اﻟﺻورة ﺑﺎﻟﺿﺑط ﺑس ﻟﻠﺗوﺿﯾﺢ‬
what is the name of these bone ?
1- Cuboid
2- Navicular bone
1- what is the name of this deformity ?
Claw hand
2- what is the nerve affected ?
Ulnar nerve
What is the name of theses structure ?
1- patella
2- patellar tendon
3- posterior cruciate ligment
Child feverish 39.5
1- the most common emergent DDx ?
Septic hip
2- your management ?
Surgery
1-What is the most common benign DDx ?
Non-ossifying fibroma ( NOF )
2- what is your management ?
Conservative
1- what is this deformity ?
Scoliosis
2- what is the name of this test ?
Bending forward test ( Adams test )
Case of RTA :
1- what is your DDx ?
Open Frx
2- what is your management in ER ?
4 As ( anti-biotic , anti-tetanus , analgesia ,
adequate irrigation )
 8

1- your DDx ?
osteoarthritis
2- mention 4 findings ?
1- Loss of joint space 2- osteophyte 3- subchondral
sclerosis 4 subchondral cyst 5- bone fusion
This pt. is presented to ER :
1- mention 4 structure may be injured ( 2
tendons , 1 artery , 1 nerve )
2- what is the medico-legal importance ?
1- palmaris longus , Flexor carpi radialis
tendons
Median nerve
Ulnar artery , radial artery

2- suicidal attempt
‫اﻻﺟﺎﺑﺎت ﻣش ﻣﺗﺎﻛد ﻏﯾر ﻣن اﻟﻠﻲ ﺑﺎﻻﺣﻣر ﻓﻲ ھذا اﻟﺳؤال‬
Q1
14 year old male presented with left hip pain:
What is the diagnosis:

-Mention two risk factor:

Slipped capital femoral epiphysis
SCFE
-Risk factors:
1-hormonal imbalance
((Growth hormone>> gonadal hormone due to
hypogonadism))
2-obesity
 Q2
-What is the lesion that
will form at the
glenoid labrum……avulsion

Bankart lesion
dislocation
Complication of shoulder
anterior inferior glenohumeral
incompetent
ligament 100 risk of recurrence
 DDx Disc prolapse
Muscle spasm
Q3
-The name of this
condition….
Retrolittesis
L5-S1 spondylolisthesis
Pain worse with extension
Defect in pars interarticularis

Types
1 Dysplastic congenital
stress fracture
2
Lytic women 740
3 Degenerative
Q4
-Herniation of which disc will cause this
test to be
negative:

C5-C6

**Note: biceps reflex is controlled by C5

Herniation of C5-C6 intervertebral disc
would affect C5
(Any disc herniation affects the upper
segment except for far lateral lumbar
disc herniation affects the lower segmen
Q5
-This test is ....
valgus stress test

-And the ligament

examined is....
Medial collateral ligament
 in Abduction
9 10 are posterior present
Q6 emergency AUN

-What is the most common

affected nerve?
Siatic Nerve
-If This patient was
hemodynamically stable
What is the next step
management of this patient?
Reduction under
Anaesthesia
Do X next
 ay

Q7
-This fracture is.....
Intertrochanteric fracture

-management of this
fracture is ......
Management: open
reduction internal fixation
Q8
-The diagnosis of this test if it was
positive……
De quervain disease
Tenosynovitis
-Which extensor compartment of
the wrist is affected…..
1st extensor compartment of the
wirst (extensor pollicis brevis,
abductor pollicis longus)
Q9
-This area is supplied by ....
ulnar
Q10
-This fracture is named.....
Lateral condylar fracture of the humerus

-Mention one complication of this fracture......

non-union
-Scaphoid fracture

-complications:
AVN
Carpal tunnel
Osteoarthrosis
• Humerus shaft fracture
• movement will be lost at the wrist
• extension

Radial Nerve
• Rickets Bowing
• mention two investigations:
Vitamin D
level PTH
level KFT
• Picture for anterior drawer test and Lachman
• what is the examined ligament; ACL
• Femur head fragmentation;
• DX; perthes dis
• Prognostic factor ; age

O
Lesion in epiphysis with histological slide show •
giant cells
DX; Giant cell tumor •
• Picture of proximal femur fx;
• DX; subtrochanteric fx
• Mention one muscle lead to the deformity;
Iliopsoas muscle
• Picture of spine scoliosis;
• Mention 2 prognostic factors;
1. Cobbs angle
2. Rissers staging
What your Dx
What you Dx
Identify these muscles :
Triceps
Deltoid

Biceps

Brachialis
 Mention the muscle attached to these
points

Sartorius

f
tinea Aspera
Hip
rotator Hamstring
muscles
patient suffer from left hip and thigh
pain ,Your Dx

o
o
Identify these tendons :
1-decripe what you see
2- - Dx
This fracture is..... The management of
this fracture is ......
This test is .... And the ligament
examined is..
‫اﺟﺖ ﺻﻮرة ﻛﺘﯿﺮ ﺷﺒﯿﮭﺔ ﺑﮭﺎي ﺧﺎﺻﺔ اﻟﺼﻮرة اﻟﻠﻲ‬
This fracture is named..... ‫ع اﻟﺸﻤﺎل‬
Mention one complication of this
fracture
 -mention two radiological features
‫وﻛﺎﻧﻮ ﻛﺎن ﺣﺎﻛﻲ اﻧﮭﺎ‬found in this x ray
osteosarcoma -.- - answer : sun burst
appearance , codman's triangle .
 -perthes disease - mention one poor
prognostic factor : older age ,gage sign
on X-ray
 - hallux valgus - mention one risk
factor : wearing high-heeled shoes.
Genetic
- To examine what nerve ? Anterior
interosseous nerve - In which fx it
could be injured

medicine
X
 Reduction
- what is this lesion ? Bankart lesion under
- what is the best management ? ?! ?! Anesthesia
patient presented with shoulder dislocation 4 time
what's the management
surgery(open reduction,internal fixation)
where is the insertion of the muscle
doing this movement ?
- lesser tubercle
- what is the action of this muscle ?
- internal rotation with adduction
‫ﺻﻮرة ل ‪adem bending forward test‬‬
‫_ﺷﻮ اﺳﻢ اﻟﺘﺴﺖ _ﺷﻮ اﺳﻢ اﻟﺰاوﯾﺔ اﻟﻠﻲ‬
‫ﺑﻨﺴﺘﺨﺪﻣﮭﺎ ﺑﺎﻟﺘﺸﺨﯿﺺ‬
‫‪scoliosis‬‬

‫‪Cobbs angle‬‬
Ortho mini osce
Groups A
Ihsan batch
Groups A1-A4
Q1) Deteremine the site
and the pattern of this
fracture ?

Ans : comminuted mid

shaft fracture of tibia with
fibular Fracture
Q2 ) Describe this fracture ? ( not
exactly the same pic )

Ans : mid shaft fracture of the

humerus with shortening about
2 cm with lateral translation and
medial angulation
Q3) What is the diagnosis ?

Ans : Bilateral protrusio

acetabuli
Q4) What is the name of
this condition?

Ans : calcaneal
apophysitis ( sever
disease )
Q5)
1) What is the type of this
Frcture ?
Ans : avulsion fracture of
ischial tuborisity

2) The violent contraction of

Which muscle can cause this
fracture?

Ans : Hamstring muscles

Q6) Name the deformity
can happen as a result of
non-union of this fracture?

Ans : cupitus valgus

Q7) Name the deformity ?

Ans : cupitus varus

Q8) what is the diagnosis
of this condition?

Ans : Talipes equinovarus

(club-foot)

Club foot alone is wrong

Q9)
1) what is name of line A
and line B? A
A: Perkin’s line
B: Hilgenreiner line

2) what is the diagnosis of

B
this patient in right and
left hips?
Developmental dysplasia
of the hip (DDH)
( you should write the full name , DDH alone is
wrong )
Q10) Name the deformity ?

Ans : polydactyly
Q11
1) What is the name of this
fracture?
Ans : supracondylar fracture
of femur

2) what structure is
commonly injured with this
fracture

Ans : femoral artery

Q12:
What is nerve that is
commonly injured
according to the pic ?

Ans : Sciatic nerve

Q13) Name the deformity ?

Ans : mallet finger

Q14) What is the name of
this fracture ?

Ans : galleazzi fracture

Q15) What is the name
of this fracture?

Ans : Tibial plateau fractures

Groups A5-A8
 The Exam were 19 Qs I tried to remember
what I could..

The 1st two Questions:

1: Determine the site and the pattern of this
fracture?

2: Describe This Fracture

..
 Dx?
Hypertrophied
nonunion fracture
of the tibia

Causes?
movement,
wrong reduction
Inadequate immobilization
Inadequate stabilization
 Dx?
Femur neck
fracture

Complication?
- Non union
- AVN
DDx? Swan neck
 What is the
name of the
bone pointed
with the red
Arrow?

Capitate
Dx? Syndactyly
 Dx? Supracondylar femur fracture
Displacement? Translation, Angulation
What vessel at risk? Popliteal artery
- What is the Fracture?
Monteggia fracture
Name the deformity
can happen as a
result of non-union
of this fracture?

Cupitus Valgus
Dx: Anterior Shoulder Dislocation
Nerve at risk: Axillary
What is this sign: Claw Hand
Nerve Affected: Ulnar Nerve
What is the DDx in both Hips?
And Name The Lines:
Left: DDH / Right: Normal
(Developmental Dysplasia of the Hip)

Acetabular
Perkins line
Angle
Hilgenreiner line 40
25

Shenton line
 Dx?
Avulsion fracture
of the ischial
tuborisity

Contraction of
which muscle can
cause this
fracture?
Hamstring
muscles
 Dx? Bilateral Protrusion Acetabuli
Causes: Paget, RA, Osteomalacia, Trauma
 Dx? Congenital Talipes
Equinovarus (Club-foot)
 Dx?

Sever Disease
(Apophysitis of
calcaneus)
 Dx?
Osgood-
Schlatter
Disease (OSD)
(apophysitis of the tibial tubercle)
 Dx?
Genu Valgum
“Knock-Knee”
O rth o p e d i c s P a st P a p e rs
G R O UPS B – IHSA N B AT C H
G ro u ps B1-B4
N a m e th e sit e a n d
th e p a tt e rn o f this
fr a c tur e

l e ft f e m or a l sh a ft fr a c tur e
S e g m e nt a l or S e g m e nt a l
c o m min ut e d
( c o m min ut e d a lo n e is
wro n g )
d e s c ri b e th e
fr a c tur e a n d
d isp l a c e m e nt
-Tr a nsv e rs e
fr a c tur e o f th e
ti b i a a n d fi b ul a
-Sh ort e nin g ,
100% l a t e r a l
tr a nsl a tio n,
a nt e rior
a n g ul a tio n, n o
ro t a tio n
W h a t is
th e n a m e
o f this
c o n d itio n ?
SYN D A C TYLY
D e s c ri b e th e
d isp l a c e m e nt in this
fr a c tur e
- 100% l a t e r a l tr a nsl a tio n
- l e n g th e nin g
- Post e ro m e d i a l
a n g ul a tio n
A- W h a t is th e n a m e o f
this fr a c tur e ?
-f e m or a l sh a ft fr a c tur e

B- w h a t stru c tur e is
c o m m o nly injur e d with
this fr a c tur e ?
-f e m or a l a rt e ry
W h a t is th e n a m e o f this
fr a c tur e ?
-Ti b i a l p l a t e a u fr a c tur e s
W h a t is th e d i a g n osis?

Bil a t e r a l pro trusio

a c e t a b uli
W h a t is th e n a m e o f this c o n d itio n?

Se v e r d is e a s e
A- w h a t is th e d i a g n osis o f this
fr a c tur e ?
-Int e rtro c h a nt e ri c
fr a c tur e s(TYPE 2
Disp l a c e d
Slig htly c o m min ut e d
L e ss e r tro c h a nt e r fr a c tur e
V a rus)
B- w h a t a r e m ost c o m m o n
c o m p li c a tio n ?
-m a lu nio n
 12

W h a t is th e
d i a g n osis o f this
C o n d itio n ?
-Hi p d islo c a tio n
A- w h a t is th e d i a g n osis
o f this c o n d itio n ?
C a b itus v a rus

B- w h a t is th e c a us e o f
this c o n d itio n ?
-m a lu nio n o f
su pr a c o n d yl a r fr a c tur e
A- w h a t is n a m e o f lin e A
a n d lin e B?
-A : P e rkin ’s lin e
-B: Hilg e nr e in e r lin e
25 40

B – w h a t is th e d i a g n osis B
o f this p a ti e nt in rig ht
a n d l e ft hi ps? A
D e v e lo p m e nt a l
d ysp l a si a o f th e hi p
(D D H)
w h a t is th e d i a g n osis
o f this c o n d itio n ?
-T a lip e s e q uin o v a rus
( c lu b-f o o t)
A- Wh a t is th e ty p e o f
this fr a c tur e ?
16
-Fr a c tur e s o f th e p e lvi c
rin g (o p e n b o o k injury)

B- w h a t is th e d ir e c tio n
o f th e f or c e c a usin g
this fr a c tur e ?
-A nt e ro p ost e rior
c o m pr e ssio n with
l a t e r a l ro t a tio n
G ro u ps B5-B8
Bo utini e r e d e f ormity
A v ulsio n fr a c tur e of ASIS, S a rt orius m us c l e
Tib i a l a n d fib ul a r fr a c tur e
Post e rior hip d islo c a tio n a n d s c i a ti c n e rv e injury
Sh o ul d d islo c a tio n a xill a ry n e rv e injury
F e m or a l su pr a c o n d yl a r fr a c tur e a n d p o p lit e a l a rt e ry injury
G e li a zi fr a c tur e
Poly d a c tyly
D D H a n d m e ntio n th e n a m e s of lin e s
M e d i a n n e rv e injury
Bil a t e r a l pro trusio a c e t a b uli a n d c a us e s
G e n u v a l g us + c a us e
C o n g e nit a l t a lip e s q uin o v a rus
A tro p hi c n o n u nio n + c a us e
F e m ur n e c k fr a c tur e + c o m p li c a tio n
Students Exam
 ①
deformity' on
Qs
*

the right elbow

¥÷÷÷÷÷÷a¥
.

1
Cubit as Varus
*

• Name this deformity. fabius Varus

• What is the most likely cause of this deformity?
fracture
fracture Caused by Malani on supra condylar
-
Old →

distal part of humerus fracture ped

mmfgdftefaflladi.us
-

C) 2nd
elbow fracture peds Supracondaylar fracture ( M →
fracture
-

=
 plate "" "

.m*ia .iq/iswide
Qs een:* re .÷:*
2 a pelvis X-ray
This
for a 7 y/o boy with
hip pain and limping

/
of 5 months. He has a
a hx of sickle cell

/
disease.Tobias ants
-
a'

1. What is the
AVN on

diagnosis. the left

side

2. Mention 2 osrefttocrnanter head fragmented

possible future *
subluxation of femur
head

complications. outside acetabulum

PIeremnadteyrebdureggegnairation.IE:1?nmogstfFh'Toros .iq#hicAuNofremurhead--PdeYstehag3I-.
's
1-

37 acetabulum wont grow normally 5- Pelvic tilt

 fingers What
puff
→
ulnar 2 to exam
fpp →
interosseous
on

1st z FDP ant .

immobilize finger

Qs
same

:D
the

3 -
in
::÷÷
H
fundus
flexor digitorum pro

it hats a common muscle

belly

superficialis
1. Which tendon is tested by this exam? flexor digitorum
2. What is the nerve supply to the tendon muscle? median nerve
 causes
⑤ in toeing
:

Qs I -
internal tibial
torsion

2. Femoral rotations

4
anteversion
high femoral
3. rotation foot
metatarsus
adductors ,

d
patella →
A component of
facing clubfoot
inward
①walking intoning '

A- patella facing
forward →
W position
deformity below
-

jntoeing - patella →
tibial foot

• A 7 y/o child presented by her mother for the posture

patella inwards
shown in the picture. z
-

above
deformity
femur
patella

• What is the name of the posture and the most likely

femoral rotation high femoral anteversion
cause? I internal rotation hip up
on
to 90

- w posture
Qs
5
dislocated reduction maneuver

• Name this physical examination test? ortolan i

• If the exam is positive in a 1-month-old baby, what is

the diagnosis? DDH
• What is the next diagnostic step to confirm the
diagnosis? US before the age of 3 months
 Qs
6
Figure 1

• The player in the picture developed a RIGHT knee

injury during the game. Contact injury valgus
, stress

• What is the most likely injured structure?

medial collateral ligament
 's line
hilgeureiner line

f f
""
in

Qs
6 is an xray
• This
for a 4 month
old child.
• Mention: 9

A
– The Red line. "
-

– The Blue line.e

– If the angle
marked is 35
on both sides
what is the www..no "

diagnosis and bracing ( Pavlik harness)

the
management? ace tabular dysplasia ,
 B

C
A

• Name this deformity. high arch

,
idaeusus pronation valgus
-
-

neuromuscular disorders
• Mention one cause. marie tooth
.
Charcot
Ms
cerebral palsy
-

Qs
.
 7 fathead
Qs &shoulder
towards the
weak side

8 this gait. trendeknburg gait

• Name if
normal
• Where is the pathology
side (Rt or LT)? Right ←
• Which muscles are weak
? abductor muscles
gluteus medius
minimus
gluteus
 Qs

t
9
• 21-year-old male patient
presented to clinic as a
case of chronic LBP of 2
years increased in the last
ant slippage
2 months. forward
.

• What is the diagnosis?spondylolidhesis

• Which grade ? 2 ( less than
than
25more

) b- o

O
be .
• Mention 3 types.
traumatic
-
iatrogenic
-

degenerative g
dysplastic forward
-
'

-
d
gthmic CME)
05151 # Lu -
LD

pathological
 Q 10

* Colle 's
radial angulation
fracture
•

volar types
dorsal ←
.

← -
-
- .

→
← → ulnar

Horsa
radial

exartiacnar
• 56 y/o female came to ER 2 hours after FD with severe g
distal radial fracture the
right on
) side ,

pain in the RT wrist. metaphysics comminuted

, fracture Cmulti fragmented
shortening
no rotational abnormality
,
no

• Give full description for this fracture.angulation slight radial

dorsal
→

translation
no ,

• What are the principles of management? reduction immobilization ,

rehabilitation
RE
24
O