Orthopedic Surgery Knowledge and Skills - Written Exam
The written exam rewards a structured, mechanism-first knowledge base rather than rote recall. Build your review around these core concept clusters: fracture biology and healing (primary vs secondary healing, the roles of stability and blood supply, timing of union), classification systems used to drive treatment (e.g., Salter–Harris for physeal injuries, Garden for femoral neck, Gustilo–Anderson for open fractures, Neer for proximal humerus), biomechanics and implant principles (load-bearing vs load-sharing constructs, lag screws, plating, intramedullary nailing, tension-band constructs), and regional anatomy with its danger zones (radial nerve at the humeral shaft, common peroneal nerve at the fibular neck, axillary nerve at the surgical neck).
Common traps: questions that conflate descriptive classifications with treatment-directing ones; options that confuse compartment syndrome's early signs (pain with passive stretch, pain out of proportion) with late findings (pulselessness, paralysis); and distractors that ignore the patient's skeletal maturity. Read each stem for age, open/closed status, and neurovascular findings before choosing.
Worked rule of thumb
For open fractures, grade by the Gustilo–Anderson system: Grade I is a clean wound under 1 cm; Grade II is 1–10 cm without extensive soft-tissue damage; Grade III is over 10 cm or with extensive soft-tissue injury, and IIIA/IIIB/IIIC subdivide by coverage and vascular injury. If a stem describes a farm injury with a 12 cm wound and exposed periosteum, that is at least Grade IIIB and mandates urgent debridement and antibiotics - not just irrigation in the ED.