Questions, operative experience and evidence-led discussion.
Textbooks give displacement and articular step-off cutoffs, but how strictly do you use them? If the extensor mechanism is intact but there is a 3–4 mm gap or articular incongruity, would you operate? Does fracture pattern matter more to you than the measured gap?
For an isolated Weber B fracture with a congruent mortise and no medial clear-space widening, are you allowing immediate weight bearing in a boot? Do you routinely obtain stress or weight-bearing radiographs before deciding that it is stable?
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?
Suppose the helical blade is central on AP but slightly anterior on lateral, with good reduction and a TAD below 25 mm. Would you accept the construct or revise the blade position? How much importance do you give to Cleveland zone versus TAD/calTAD?
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?
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?
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?
In an extra-articular distal radius fracture in a 55–65-year-old active patient, suppose reduction restores length and inclination reasonably well but leaves around 5–10° of dorsal tilt. Would you accept this, woudl attempt reduction again and cast, or consider fixation? How much do age, occupation and dominant hand influence your threshold?
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.
