INI CET Orthopaedics Syllabus

Orthopaedics syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Orthopaedics in INI CET, not a summary of it.

1. 1

   General Orthopaedics

   3 topics

   • Introduction to Orthopaedics
     • History, scope, and importance in medical practice
   • Basic Principles of Orthopaedic Examination
     • History taking
     • Physical examination
     • Assessment of musculoskeletal function
   • Imaging Modalities in Orthopaedics
     • X-ray
     • CT scan
     • MRI
     • Ultrasound
     • Nuclear medicine imaging
2. 2

   Trauma and Fractures

   4 topics

   • Classification of fractures
     • Open vs. closed fractures
     • Displaced vs. nondisplaced fractures
     • Complete vs. incomplete fractures
   • Principles of fracture management
     • Closed reduction
     • Open reduction
     • Internal fixation
     • External fixation
     • Plaster immobilization
   • Complications of fractures
     • Delayed union
     • Nonunion
     • Malunion
     • Compartment syndrome
     • Infection
   • Fracture healing
     • Phases of fracture healing
     • Factors influencing healing
     • Principles of fracture fixation
3. 3

   Orthopaedic Disorders of the Upper Limb

   3 topics

   • Shoulder disorders
     • Rotator cuff injuries
     • Shoulder dislocation
     • Adhesive capsulitis
     • Shoulder impingement syndrome
   • Elbow disorders
     • Tennis elbow
     • Golfer's elbow
     • Elbow instability
   • Hand and wrist disorders
     • Carpal tunnel syndrome
     • Trigger finger
     • Dupuytren's contracture
     • De Quervain's tenosynovitis
4. 4

   Orthopaedic Disorders of the Lower Limb

   3 topics

   • Hip disorders
     • Osteoarthritis
     • avascular necrosis of the hip
     • hip fractures
     • hip dysplasia
   • Knee disorders
     • Osteoarthritis
     • meniscal injuries
     • ligamentous injuries (ACL, PCL)
     • patellofemoral syndrome
   • Ankle and foot disorders
     • Ankle sprain
     • Achilles tendon rupture
     • plantar fasciitis
     • hallux valgus (bunion)
5. 5

   Pediatric Orthopaedics

   3 topics

   • Developmental dysplasia of the hip (DDH)
     • Screening
     • Diagnosis
     • Management of DDH in infants and children
   • Congenital talipes equinovarus (clubfoot)
     • Classification
     • Ponseti method
     • Surgical correction
   • Developmental disorders of the spine
     • Scoliosis
     • Kyphosis
     • Congenital vertebral anomalies
6. 6

   Orthopaedic Oncology

   3 topics

   • Primary Bone Tumors
     • Osteosarcoma
     • Chondrosarcoma
     • Ewing's Sarcoma
     • Giant Cell Tumor
   • Metastatic Bone Disease
     • Pathophysiology
     • Clinical Presentation
     • Management of Bone Metastases
   • Soft Tissue Tumors
     • Lipoma
     • Fibroma
     • Synovial Sarcoma
     • Malignant Fibrous Histiocytoma
7. 7

   Sports Medicine

   3 topics

   • Sports-related injuries
     • Muscle strains
     • Ligament sprains
     • Tendonitis
     • Stress fractures
   • Overuse injuries
     • Runner's knee
     • Shin splints
     • Tennis elbow
     • Stress fractures
   • Rehabilitation and return to play
     • Physiotherapy
     • Strengthening exercises
     • Gradual progression of activities
8. 8

   Orthopaedic Rehabilitation and Physiotherapy

   3 topics

   • Principles of orthopaedic rehabilitation
     • Range of motion exercises
     • Strengthening exercises
     • Proprioceptive training
   • Modalities in orthopaedic physiotherapy
     • Heat therapy
     • Cold therapy
     • Ultrasound therapy
     • Electrical stimulation
     • Traction
   • Postoperative rehabilitation
     • Rehabilitation protocols following orthopaedic surgeries
     • Joint replacement
     • Ligament reconstruction
     • Fracture fixation
9. 9

   Orthopaedic Surgery Techniques

   3 topics

   • Arthroscopic Surgery
     • Indications
     • Techniques
     • Complications of arthroscopic procedures in various joints
   • Joint Replacement Surgery
     • Total Hip Arthroplasty (THA)
     • Total Knee Arthroplasty (TKA)
     • Total Shoulder Arthroplasty (TSA)
   • Spinal Surgery
     • Decompression Procedures
     • Spinal Fusion
     • Instrumentation Techniques in the Management of Spinal Disorders
10. 10

    Orthopaedic Research and Evidence-Based Practice

    2 topics

    • Basics of orthopaedic research
      • Study design
      • Data collection
      • Statistical analysis
      • Interpretation of research findings
    • Evidence-based orthopaedics
      • Critical appraisal of research literature
      • Application of evidence-based guidelines
      • Practice-based learning

Orthopaedics flashcards for INI CET

22 of 50 cards from the Orthopaedics deck — real questions with worked answers.

1. What does orthopaedics deal with, and what is the origin of the term?

   Orthopaedics is the branch of surgery concerned with the diagnosis and treatment of disorders of the musculoskeletal system (bones, joints, ligaments, tendons, muscles, nerves). The term derives from Greek 'orthos' (straight) and 'paidion' (child), originally referring to correction of childhood deformities.

2. What does the 'look, feel, move' sequence describe in orthopaedic examination?

   It is the standard order of musculoskeletal examination: Look (inspection for swelling, deformity, scars, muscle wasting), Feel (palpation for tenderness, warmth, crepitus), and Move (active, passive, and resisted range of motion). It is often followed by special tests and a neurovascular assessment.

3. What does a positive Trendelenburg test indicate?

   When the patient stands on one leg, the pelvis on the unsupported (opposite) side drops instead of rising. A positive test indicates weakness or insufficiency of the hip abductors (gluteus medius/minimus) or instability of the supporting hip joint on the standing side.

4. Which imaging modality is the first-line investigation for suspected fractures, and what is the minimum rule for views?

   Plain X-ray (radiograph) is first-line. The 'rule of twos' applies: at least two views (typically anteroposterior and lateral), including the two joints proximal and distal to the injury, and where relevant two limbs (comparison) and two occasions (repeat imaging).

5. When is MRI the preferred imaging modality in orthopaedics?

   MRI is preferred for soft-tissue and marrow pathology: ligament and meniscal tears, tendon injuries, cartilage assessment, occult/stress fractures, avascular necrosis, infection (osteomyelitis), spinal cord/disc disease, and soft-tissue or marrow tumours. It gives excellent soft-tissue contrast without ionising radiation.

6. What is the main advantage of CT over plain X-ray in fracture assessment?

   CT provides detailed cross-sectional and 3D bony anatomy, making it superior for complex/intra-articular fractures (e.g., tibial plateau, calcaneus, pelvis/acetabulum), surgical planning, and detecting occult fractures not seen on plain films.

7. Describe the Salter-Harris classification of physeal (growth plate) fractures.

   Type I: through the physis only (Slipped). Type II: through physis and metaphysis (Above). Type III: through physis and epiphysis (Lower/below). Type IV: through metaphysis, physis, and epiphysis (Through). Type V: crush injury of the physis. Mnemonic 'SALTR'. Higher types carry greater risk of growth disturbance.

8. Differentiate a simple (closed) fracture from a compound (open) fracture.

   A closed fracture has intact overlying skin with no communication between the fracture and the external environment. An open (compound) fracture has a wound connecting the fracture site to the outside, raising the risk of contamination and infection.

9. What does the Gustilo-Anderson classification grade, and what distinguishes the types?

   It classifies open fractures by soft-tissue injury. Type I: clean wound <1 cm. Type II: wound 1-10 cm without extensive soft-tissue damage. Type III: wound >10 cm or high-energy/contaminated, subdivided into IIIA (adequate soft-tissue coverage), IIIB (extensive soft-tissue loss needing flap coverage), and IIIC (associated arterial injury requiring repair).

10. What are the four general principles ('Rs') of fracture management?

    Resuscitation (treat the patient first, ATLS), Reduction (restore alignment - closed or open), Retention/Restriction (hold reduction with cast, traction, or fixation), and Rehabilitation (restore function). Reduce, hold, and rehabilitate are the core surgical aims.

11. What is the difference between absolute and relative stability in fracture fixation?

    Absolute stability eliminates motion at the fracture (e.g., lag screw/compression plate) and heals by primary (direct) bone healing with no callus. Relative stability permits controlled micromotion (e.g., intramedullary nail, bridging plate, external fixator) and heals by secondary healing with callus.

12. Define malunion, delayed union, and nonunion.

    Malunion: fracture heals in an unacceptable position (angulation, rotation, shortening). Delayed union: healing takes longer than expected for that bone/site but is still progressing. Nonunion: healing has stopped and the fracture will not unite without intervention (subtypes: hypertrophic vs atrophic).

13. What is compartment syndrome, and what is the classic clinical hallmark?

    A surgical emergency in which raised pressure within a closed osteofascial compartment compromises perfusion, causing tissue ischaemia. The classic hallmark is pain out of proportion to the injury, worsened by passive stretch of the muscles. The definitive treatment is urgent fasciotomy.

14. Which fracture is most associated with avascular necrosis, and why?

    Femoral neck (intracapsular) fracture, because the femoral head's blood supply (mainly the medial femoral circumflex artery via the retinacular vessels) is disrupted. Other classic sites are the scaphoid (proximal pole) and talus (body).

15. List the stages of secondary (indirect) fracture healing.

    1) Haematoma/inflammation (clot and inflammatory cells). 2) Soft (fibrocartilaginous) callus formation. 3) Hard (bony) callus formation by endochondral and intramembranous ossification. 4) Remodelling (Wolff's law reshapes bone to mechanical demands).

16. What is primary (direct) bone healing and when does it occur?

    Direct cortical healing without callus, occurring under absolute stability with anatomic reduction and rigid fixation. It proceeds via cutting cones (osteoclasts followed by osteoblasts forming new Haversian systems) across the fracture; called contact healing when gap is minimal and gap healing for small gaps.

17. List patient and local factors that impair fracture healing.

    Patient factors: smoking, diabetes, malnutrition, old age, NSAID/steroid use, vitamin D deficiency. Local factors: inadequate immobilisation/excessive motion, poor blood supply, infection, soft-tissue interposition, large fracture gap/bone loss, and intra-articular location.

18. What is the most common direction of shoulder (glenohumeral) dislocation, and which nerve is at risk?

    Anterior dislocation is by far the most common (~95%). The axillary nerve is most at risk, tested by sensation over the 'regimental badge' area of the lateral shoulder and deltoid function.

19. Describe the typical pain pattern of subacromial impingement / rotator cuff disease.

    Pain over the lateral shoulder, worse with overhead activity and at night, with a painful arc of abduction typically between 60 and 120 degrees. Caused by impingement of the supraspinatus tendon/subacromial bursa under the coracoacromial arch.

20. What is adhesive capsulitis (frozen shoulder) and its hallmark examination finding?

    A condition of progressive shoulder stiffness and pain from inflammation and fibrosis of the glenohumeral capsule. The hallmark is global loss of both active AND passive range of motion, especially external rotation. It is associated with diabetes and typically passes through freezing, frozen, and thawing phases.

21. Differentiate lateral epicondylitis from medial epicondylitis.

    Lateral epicondylitis ('tennis elbow') is tendinopathy of the common wrist extensor origin (ECRB), with pain on resisted wrist extension. Medial epicondylitis ('golfer's elbow') affects the common flexor-pronator origin, with pain on resisted wrist flexion/pronation.

22. What is carpal tunnel syndrome and which nerve and digits are affected?

    Compression of the median nerve beneath the flexor retinaculum at the wrist, causing pain and paraesthesia in the thumb, index, middle, and radial half of the ring finger, often worse at night, with thenar wasting in chronic cases. Tinel's and Phalen's tests are positive.

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