Questions, operative experience and evidence-led discussion.
Discuss DNB Orthopaedics previous-year questions, preparation strategies, high-yield topics, answer-writing approaches and recent examination trends. Keep shared material educational and free of patient-identifying information.
Which humerus fractures would you nail and which would you plate?
What fixation method for syndesmotic injuries? When to remove the screw if you use one? When to WBAT? When do you fix?
With modern functional rehabilitation protocols showing good outcomes, what patients with acute Achilles rupture are you still recommending surgery for? Does tendon gap on ultrasound in plantar flexion influence your decision?
A patient has a large L4–5/L5–S1 disc extrusion on MRI but pain is improving, power is preserved and there are no red flags. How much weight do you give the MRI appearance itself? Apart from neurological deficit, what makes you recommend earlier surgery?
For patients with severe bilateral knee OA requesting both knees to be replaced together, what are your selection criteria? Which comorbidities or age cutoffs make you strongly prefer staged procedures?
We occasionally finish a fixation where reduction or implant position is acceptable but not what we ideally wanted. The construct is stable and revising it would require significant additional surgical trauma. What findings make you reopen and revise immediately, and what imperfections are you willing to accept? Interested in examples from actual practice.
MRI shows a full-thickness supraspinatus tear with mild retraction in an otherwise active 65-year-old. Pain is significant but strength is reasonably preserved. How long would you trial physiotherapy/injection before offering repair, and which MRI features make you operate earlier?
For an adult with a displaced midshaft clavicle fracture with >2 cm shortening but no skin threat or neurovascular issue, are you routinely offering fixation? In your experience, which patients genuinely benefit enough from surgery to justify the implant-related complications?
This age group often creates a difficult decision. For a physiologically young, active patient with a displaced intracapsular neck of femur fracture, what factors push you towards fixation versus THA? Is chronological age still a useful cutoff in your practice?
The patient had normal radial nerve function initially but develops a complete radial nerve palsy after manipulation/reduction of a closed humeral shaft fracture. Would you observe with serial examinations/EMG or proceed to early exploration? Does the fracture pattern alter your decision?
Patient presents months after TKA with persistent pain. Plain radiographs look satisfactory and there is no obvious instability on initial examination. What is your step-by-step investigation sequence before labeling it unexplained pain? When do you obtain CT, aspiration or nuclear imaging?
We know remodeling depends heavily on age and fracture level, but what limits do you actually use clinically? For an 8–10-year-old with a midshaft radius/ulna fracture, how much residual angulation and rotation would make you re-manipulate?
For routine unstable intertrochanteric fractures without subtrochanteric extension, do you generally prefer a short or long cephalomedullary nail? What specific fracture or patient factors make you choose a long nail?
After closed reduction of an extra-articular Colles fracture, radial height and inclination are acceptable but the lateral X-ray shows neutral tilt rather than volar tilt. In a middle-aged patient, would you accept this or attempt another reduction? At what point does repeated manipulation cause more harm than benefit?
