1. OSCE Answers Orthopedics

2. MBChB v OSCHE 15 NOVEMBER 2016 Guidelines 1.You must hand in your case books before the OSCHE – No case book no OSCHE. 2.There are 14 questions in this OSCHE, you have 3 minutes per question. 3.This OSCHE contributes 50% of the final In-block mark. 4.You need to pass Orthopaedics in order to sit for the General Surgery exam at the end of the year. GOOD LUCK!

3. QUESTION 1 List 10 indications for Open Reduction & Internal Fixation of a fracture -Malunion -Delayed union -Non-union -Soft tissue interposition -No position in fracture 10 marks

4. QUESTION 2 (a). What is the diagnosis? Shoulder Dislocation (b). Classify this injury. Anterior (c). List 3 methods you can use to treat this condition. -Hippocratic -Kocher -Stension -Traction-counter traction (d). Name 2 complications you can get with this condition -Recurrent Dislocation -Axillary Nerve Damage -Rotator Cuff Injury

5. QUESTION 3 (a). What is the diagnosis? -Developmental Dysplasia of the hip (b). Name 3 lines that you draw to help you make this diagnosis. -Hilgen Renus -Perking’s line -Shanton’s line

6. QUESTION 4 (a). What is the diagnosis? -C4/C5 Supluxation (b). List 5 lines you draw to assist in making this diagnosis. -Anterior Soft Tissue line -Anterior Vertebral body line -Posterior Vertebral body line -Line of Convergence -Spinal Laminar line

7. QUESTION 5 (a). What is the diagnosis? -Bilateral Club’s Foot (Talipes Equinovarus) (b). Name 4 deformities that you get in this disorder. -Cavus -Adduction -Varus -Equinus -Atrophy of the affected limb

8. QUESTION 6 (a). What is the diagnosis? -Osteosarcoma (b). List 5 radiological features of this disorder. -Sunburst Effect -Periosteal reaction -Codma’s triangle -Osteolytic Lesions -Osteocblastic lesions (c). Name 2 treatment modalities of this disorder. -Analgesia and neoadjuvant therapy -Wide Resection

9. QUESTION 7 (a). What is the name of this test? Thoma’s test (b). What is it used for? -Hip flexion Contracture -Psoas Syndrome -Anterior Capsular Restrictions -Lateral Capsular restrictions

10. QUESTION 8 (a). What is the diagnosis? -Osteoarthritis (b). Give 4 radiological features of this disorder. -Decreased Joint space -Subchondrial cyst -Subchondrial Sclerosis -Osteophytes formation -Remodelling (c). Name 1 conservative and 1 surgical treatment modality in the treatment -Conserv: Analgesia; Deloading Brace and Walking Aid+ Physiotherapy and Intra-articular steroidal injections -Surgical: Athroscopic Debridement; Osteotomy; Athrodesis; Athroplasty

11. QUESTION 9 (a). What is compartment syndrome? - Reduced capillary perfusion to a nerve/muscle caused by swelling within the osteofascial compartment due to muscle swelling and rise in compartment pressure (b). Name 4 major clinical symptoms and signs of this disorder. -Pain out of proportion to injury -Pain on passive stretching -Pain not responding to analgesics -Pain -Paraesthesia -Pallor -Paralysis -Pulselessness

12. QUESTION 10 (a). What is the name of this test? -Allen’s Test (b). What is it used for? -To check arterial blood flow/ perfusion to the hand (Ulnar and radial aa.)

13. QUESTION 11 (a). What is the diagnosis? -Osteogenesis Imperfecta (b). List 6 radiological features of this disease. -Osteopenia -Multiple fracture of different stages of healing -Acetebular pitrusis -Coxa Vara -Popcorn Calcification -Zebra Stripe Sign

14. QUESTION 12 Name the most likely nerve that can be injured in the following injuries: (a). Surgical neck of the humerus fractu -Axillary Nerve (b). Midshaft humerus fracture -Radial Nerve (c). Supracondylar humerus fracture -Ulnar Nerve (d). Posterior hip dislocation -Sciatic Nerve (e). Fibula head/neck fracture -Common Peroneal nerve

15. QUESTION 13 (a). What is the diagnosis? Colle’s Fructure (b). Who gets this type of injury? -Those who fall on an outstretched hand (c). List 6 displacements you get with type of a fracture. -Length -Angulation -Rotation -Apposition -Translocation

16. QUESTION 14 (a).What is the diagnosis? Tibial and Fibula Fructures (b).List all the displacements in this fracture. -- Length shortening - No Angulation - No Rotation - No Apposition - No DESTRUCTION

17. THANK YOU!!