Cambridge University Press

978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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Postgraduate Orthopaedics:
MCQs and EMQs for the FRCS
(Tr & Orth)

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Cambridge University Press
978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
Frontmatter
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Cambridge University Press
978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
Frontmatter
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Postgraduate
Orthopaedics: MCQs
and EMQs for the FRCS
(Tr & Orth)

Edited by
Kesavan Sri-Ram, BSc, MRCS (Eng), FRCS (Tr & Orth)
Senior Arthroplasty Fellow, Royal National Orthopaedic Hospital and Wycombe Hospital, UK

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Cambridge University Press
978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
Frontmatter
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CAMBRIDGE UNIVERSITY PRESS

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# Cambridge University Press 2012

This publication is in copyright. Subject to statutory exception

and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without
the written permission of Cambridge University Press.

First published 2012

Printed in the United Kingdom at the University Press, Cambridge

A catalogue record for this publication is available from the British Library

Library of Congress Cataloging-in-Publication Data

Postgraduate orthopaedics : MCQS and EMQS for the FRCS (Tr & Orth) /
edited by Kesavan Sri-Ram.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-521-18471-7 (Paperback)
I. Sri-Ram, Kesavan.
[DNLM: 1. Orthopedic Procedures–Examination Questions. WE 18.2]
LC classification not assigned
6170 .9076–dc23
2011029387

ISBN 978-0-521-18471-7 Paperback

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websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this book to provide accurate and
up-to-date information which is in accord with accepted standards and
practice at the time of publication. Although case histories are drawn from
actual cases, every effort has been made to disguise the identities of the
individuals involved. Nevertheless, the authors, editors and publishers can
make no warranties that the information contained herein is totally free
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therefore disclaim all liability for direct or consequential damages
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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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For Sharmili

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Edited by Kesavan Sri-Ram
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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
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Contents
List of contributors page viii
Foreword Mr Barry Ferris x
Preface xi
Acknowledgements xii

1 Introduction 1 7 Foot and ankle 119

Kesavan Sri-Ram Kesavan Sri-Ram and Andrew
Robinson
2 Hand and wrist 4 Questions 119
Maxim Horwitz and Elliot Answers 132
Sorene
Questions 4 8 Pathology 144
Answers 17 Danyal H. Nawabi and Tim W.R. Briggs
Questions 144
3 Shoulder and elbow 25
Answers 158
Deborah S. Higgs and Simon
Lambert 9 Paediatric orthopaedics 172
Questions 25 Russell Hawkins and Deborah M.
Answers 38 Eastwood
Questions 172
4 Spine 47
Answers 184
Zaher Dannawi and Rajiv A. Bajekal
Questions 47 10 Trauma 198
Answers 60 Paul Whittingham-Jones, Kesavan
Sri-Ram and Dennis Edwards
5 Hip and pelvis 71 Questions 198
Nashat Siddiqui and Phil Kerr Answers 211
Questions 71
Answers 83 11 Basic science 223
Ben Rudge and John A. Skinner
6 Knee 93 Questions 223
Kesavan Sri-Ram and Answers 235
Howard Ware
Questions 93
Answers 106 Index 246

vii

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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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Contributors
Mr Rajiv A. Bajekal, MS (Orth), ChM
(Orth), FRCS (Orth)
Consultant Orthopaedic Surgeon, Barnet
Hospital, London
Professor Tim W.R. Briggs, MD (Res),
MCh (Orth), FRCS
Professor of Orthopaedic Surgery and
Orthopaedic Oncology, Royal National
Orthopaedic Hospital, Stanmore
Mr Zaher Dannawi, FRCS (Tr & Orth)
Spinal Fellow, Royal National Orthopaedic
Hospital, Stanmore
Miss Deborah M. Eastwood FRCS
Consultant Orthopaedic Surgeon, Royal
National Orthopaedic Hospital, Stanmore
Mr Dennis Edwards, FRCS (Orth)
Consultant Orthopaedic Surgeon, Cambridge
University NHS Trust, Cambridge
Mr Russell Hawkins, FRCS (Tr & Orth)
Specialist Registrar in Trauma and Ortho-
paedic Surgery, Royal National Orthopaedic
Hospital, Stanmore
Miss Deborah S. Higgs, MBBS, FRCS (Tr &
Orth)
Consultant Shoulder and Elbow Surgeon,
Royal National Orthopaedic Hospital,
Stanmore
Mr Maxim Horwitz, FRCS (Tr & Orth)
Locum Consultant Orthopaedic and Hand
Surgeon, St Mary’s Hospital, Imperial
College Healthcare NHS Trust, London
Mr Phil Kerr, FRCS
Consultant Orthopaedic Surgeon, Lister
Hospital, Stevenage
viii
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Mr Simon Lambert, BSc, FRCS, FRCS Ed
(Orth)
Consultant Shoulder and Elbow Surgeon,
Royal National Orthopaedic Hospital,
Stanmore
Mr Danyal H. Nawabi, BM, MA, MRCS
(Eng), FRCS (Tr & Orth)
Specialist Registrar in Trauma and Ortho-
paedic Surgery, Royal National Orthopaedic
Hospital, Stanmore
Mr Andrew ‘Fred’ Robinson, BSc, FRCS
(Orth)
Consultant Foot and Ankle Surgeon, Cam-
bridge University NHS Trust, Cambridge
Mr Ben Rudge, FRCS (Tr & Orth)
Specialist Registrar in Trauma and Ortho-
paedic Surgery, Whittington Hospital,
London
Mr Nashat Ahmad Siddiqui, FRCS (Tr &
Orth)
Specialist Registrar in Trauma and Ortho-
paedic Surgery, Royal Free Hospital, London
Mr John A. Skinner, FRCS (Orth)
Consultant Orthopaedic Surgeon, Royal
National Orthopaedic Hospital, Stanmore
Mr Elliot Sorene, MBBS, FRCS (Tr & Orth),
EDHS
Consultant Orthopaedic and Hand Sur-
geon, University College London Hospital,
London
Mr Kesavan Sri-Ram, BSc, MRCS (Eng),
FRCS (Tr & Orth)
Senior Arthroplasty Fellow, Wycombe
Hospital, Wycombe and Royal National
Orthopaedic Hospital, Stanmore
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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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List of contributors

Mr Howard Ware, FRCS (Orth) Mr Paul Whittingham-Jones, FRCS (Tr &

Consultant Orthopaedic Surgeon, Wellington Orth)
Knee Surgery Unit, London and Chase Farm Specialist Registrar in Trauma and Ortho-
Hospital, Enfield paedic Surgery, Royal National Orthopaedic
Hospital, Stanmore

ix

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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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Foreword
The biggest hurdle for the modern orthopaedic trainee is passing the FRCS (Tr & Orth) exit
examination. Practice is necessary when preparing for any examination, and the written
component of the FRCS (Tr & Orth) is no exception. However, this does need to be focused.
So why another book? These MCQs and EMQs are divided according to subspecialty so
the questions can easily be used as part of a revision plan.
Detailed explanations are given in the answers making this a revision guide by topic as
well as practice with the question-and-answer format.
Written by surgeons with recent examination experience, this book features both styles
of exam questions and covers the topics in the FRCS (Tr & Orth) syllabus.

Mr Barry Ferris MS FRCS

Consultant Orthopaedic Surgeon
Barnet Hospital, London

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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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Preface
Examinations are always a nuisance, especially as you enter more mature years. Studying
becomes less natural and more tedious. Thankfully, the FRCS (Tr & Orth) examination is
just about orthopaedics, and so some of the knowledge required would hopefully be second
nature. However, MCQ and EMQ examinations always tend to ask about less obvious
topics, which do not always feature in routine practice, and this is no different with the
FRCS (Tr & Orth).
When many of the authors were preparing for their examination, there was a distinct
shortage of practice questions. The vast majority related to American examinations, and
our experience was that these are very different to the questions in the British examination.
The aim of this book, therefore, is to provide the candidate with a feel of the standard of
questions in the examination. Divided into subspecialty chapters, the book contains both
MCQs and EMQs in the same format as the FRCS (Tr & Orth), with many of the topics
encountered in the actual examination by the authors. Each chapter is complete with
explanations to provide the required knowledge and selected references for further reading.
Although a great deal of work is required to pass this examination, it is hoped that this
book provides not only knowledge, but also some reassurance that the process will go
smoothly.

Kesavan Sri-Ram

xi

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978-0-521-18471-7 - Postgraduate Orthopaedics: MCQs and EMQs for the FRCS (Tr & Orth)
Edited by Kesavan Sri-Ram
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Acknowledgements
I’m very grateful for all the authors who have found time in busy schedules to write the
chapters and keep to the deadlines (ish!). Many of the authors were part of my ‘study
group’, and were instrumental in me getting through the FRCS. I am also grateful for the
training experiences with every consultant I have had the privilege to work for and be
trained by; these, without exception, have been excellent.
I would like to thank Nick and Joanna at Cambridge University Press for all their help
during the entire process of composing this book, right from the initial proposal through to
the final editing.
My appreciation for the support from friends and family, especially my parents, goes
without saying, but my biggest thank you is to my wife, Sharmili, and girls, Alisha, Riya and
Shrina, who allowed me enough time in my ‘office’ to put this book together.

xii

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