MBBS 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 MBBS, 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 MBBS

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

1. What is the definition of orthopaedics as a surgical specialty?

   The branch of surgery concerned with the diagnosis, treatment, and prevention of disorders of the musculoskeletal system — bones, joints, muscles, ligaments, tendons, and nerves.

2. In orthopaedic clinical assessment, what does the standard 'look, feel, move' sequence of examination refer to?

   Inspection (look) for swelling, deformity, scars, and muscle wasting; palpation (feel) for tenderness, warmth, and crepitus; and assessment of movement (move) including active and passive range of motion.

3. What is the difference between active and passive range of motion in joint examination?

   Active ROM is the movement a patient performs using their own muscles; passive ROM is the movement the examiner produces while the patient relaxes. A passive ROM greater than active suggests muscle/tendon weakness or pain inhibition.

4. What is the gold-standard imaging rule for plain radiographs of a suspected fracture (the 'rule of twos')?

   Take at least two views (e.g., AP and lateral) at 90° to each other, include two joints (above and below), at two times if needed, and consider both limbs for comparison in children.

5. Which imaging modality is the investigation of choice for soft tissue, ligaments, cartilage, marrow oedema, and early osteomyelitis?

   Magnetic resonance imaging (MRI).

6. Which imaging modality best demonstrates complex fracture configurations and cortical bone detail, particularly for intra-articular and spinal fractures?

   Computed tomography (CT).

7. What is a bone scintigraphy (bone scan) using technetium-99m most useful for detecting?

   Increased bone turnover — stress fractures, metastases, osteomyelitis, and Paget's disease — shown as 'hot spots' of increased radiotracer uptake.

8. Define a 'simple' (closed) fracture versus a 'compound' (open) fracture.

   A closed fracture does not communicate with the external environment; an open (compound) fracture has a break in the overlying skin so the fracture communicates with the outside, carrying a high infection risk.

9. What are the main descriptive categories of fracture pattern by configuration?

   Transverse, oblique, spiral, comminuted (>2 fragments), segmental, greenstick (incomplete, paediatric), and impacted.

10. What does the Salter-Harris classification describe, and how is its mnemonic structured?

    It classifies physeal (growth plate) fractures in children. Mnemonic SALTR: I = Slipped (through physis), II = Above (metaphysis, most common), III = Lower (epiphysis), IV = Through (epiphysis + metaphysis), V = Ruptured/crush (worst prognosis).

11. What does the Gustilo-Anderson classification grade, and what distinguishes its three main types?

    It grades open fractures. Type I: wound <1 cm, clean. Type II: wound 1–10 cm, moderate soft tissue damage. Type III: wound >10 cm or severe soft tissue/contamination — IIIA (adequate coverage), IIIB (needs flap coverage), IIIC (arterial injury requiring repair).

12. What are the four key principles ('4 Rs') of fracture management?

    Resuscitation (treat the patient first, ATLS), Reduction (restore alignment), Restriction/Retention (immobilise/hold reduction), and Rehabilitation (restore function).

13. What is the difference between closed and open reduction of a fracture?

    Closed reduction restores alignment by manipulation without surgical exposure; open reduction involves surgically exposing the fracture to achieve direct reduction, usually combined with internal fixation (ORIF).

14. State the components of the Garden classification of intracapsular femoral neck fractures.

    Garden I: incomplete/impacted in valgus. Garden II: complete, undisplaced. Garden III: complete, partially displaced. Garden IV: complete, fully displaced. (I–II undisplaced; III–IV displaced, higher avascular necrosis risk).

15. What is meant by relative versus absolute stability in fracture fixation?

    Absolute stability (compression, e.g., lag screw/compression plate) produces no interfragmentary motion and primary (direct) bone healing. Relative stability (e.g., intramedullary nail, bridging plate) permits controlled micromotion and secondary healing via callus.

16. What is compartment syndrome and what is its characteristic early clinical sign?

    A surgical emergency where raised pressure within a fascial compartment compromises perfusion. The earliest and most reliable sign is pain out of proportion to the injury, worsened by passive stretch of the muscles in the compartment.

17. At what compartment pressures (and delta pressure) is fasciotomy indicated in compartment syndrome?

    Fasciotomy is indicated when the delta pressure ($\Delta P = \text{diastolic BP} - \text{compartment pressure}$) is less than $30\,\text{mmHg}$, or absolute compartment pressure is sustained above $30\text{–}40\,\text{mmHg}$.

18. List the early local, late local, and systemic complications of fractures.

    Early local: vascular/nerve injury, compartment syndrome, infection. Late local: malunion, nonunion, delayed union, avascular necrosis, joint stiffness, post-traumatic OA, complex regional pain syndrome. Systemic: fat embolism, DVT/PE, ARDS, hypovolaemic shock.

19. What is the difference between delayed union, nonunion, and malunion?

    Delayed union: healing slower than expected but still progressing. Nonunion: failure of healing with no progression (atrophic or hypertrophic). Malunion: healing in a non-anatomical position (angulation, rotation, or shortening).

20. What are the classic clinical features of fat embolism syndrome and its typical onset?

    Onset 24–72 hours after long-bone fracture; the triad is respiratory distress (hypoxia), neurological changes (confusion), and a petechial rash (axilla, conjunctiva, chest).

21. Describe the four overlapping stages of secondary fracture healing.

    1) Haematoma/inflammation (0–48 h). 2) Soft callus formation (fibrocartilage, weeks 1–3). 3) Hard callus formation (woven bone via endochondral ossification). 4) Remodelling (woven bone replaced by lamellar bone along stress lines, per Wolff's law).

22. What is Wolff's law in the context of bone healing and adaptation?

    Bone remodels and adapts to the mechanical loads placed upon it — bone is laid down where stress is high and resorbed where stress is low, optimising the trabecular structure along lines of force.

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