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Postgraduate Orthopaedics: the Candidate's Guide to the FRCS (Tr

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Postgraduate Orthopaedics: the Candidate's Guide to the FRCS (Tr This page intentionally left blank Postgraduate Orthopaedics Postgraduate Orthopaedics The Candidate’s Guide to the FRCS (Tr & Orth) Examination Edited by Paul A. Banaszkiewicz FRCS (Glas) FRCS (Ed) FRCS (Eng) FRCS (Tr & Orth) Cert Clin Ed Consultant Orthopaedic surgeon Queen Elizabeth Hospital and North East Surgery Centre Gateshead, UK Associate Editors Deiary F. Kader FRCS (Tr & Orth) MFSEM (UK) Consultant Orthopaedic Surgeon Queen Elizabeth Hospital and North East Surgical Centre Gateshead, UK Visiting Professor, Sports Science Northumbria University Newcastle upon Tyne, UK Nicola Maffulli MD MS PhD FRCS (Orth) Professor of Trauma and Orthopaedic Surgery Keele University School of Medicine Stoke on Trent Staffordshire, UK CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521674638 © Cambridge University Press 2009 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2008 ISBN-13 978-0-511-46531-4 eBook (NetLibrary) ISBN-13 978-0-521-67463-8 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this publication 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 from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. Contents List of contributors vii Foreword by Mr Peter Gibson ix Preface xi Glossary xiii Section 1 The FRCS (Tr & Orth) examination 1 1. General guidance 3 Paul A. Banaszkiewicz and Simon Barker Section 2 The written paper 7 2. Written paper guidance 9 Paul A. Banaszkiewicz Section 3 The clinicals 11 3. The short cases 13 Paul A. Banaszkiewicz 4. Short case list 15 Paul A. Banaszkiewicz 5. The long cases 17 Paul A. Banaszkiewicz 6. Long case list 19 Paul A. Banaszkiewicz 7. Hand and wrist clinical cases 20 Paul A. Banaszkiewicz and John W. K. Harrison 8. Shoulder and elbow clinical cases 51 Paul A. Banaszkiewicz v vi Contents 9. Spine clinical cases 64 Section 7 The trauma oral 401 Paul A. Banaszkiewicz 23. Trauma oral topics 403 10. Hip clinical cases 71 Abayomi Animashawun and Paul A. Banaszkiewicz Paul A. Banaszkiewicz 11. Knee clinical cases 105 Section 8 The basic science oral 459 Deiary F. Kader and Leo Pinczewski 24. Basic science oral core topics 461 12. Foot and ankle clinical cases 110 Simon Barker and Paul A. Banaszkiewicz Paul A. Banaszkiewicz 13. Paediatric clinical cases 126 Paul A. Banaszkiewicz Section 9 Miscellaneous topics 567 25. Candidates’ accounts of the Section 4 Adult elective examination 569 orthopaedics oral 133 Paul A. Banaszkiewicz and Niall Munro 14. General oral guidance 135 26. Examination failure 587 Paul A. Banaszkiewicz Paul A. Banaszkiewicz 15. Shoulder and elbow oral core topics 138 Niall Munro Index 591 16. Hip oral core topics 155 Paul A. Banaszkiewicz 17. Knee oral core topics 194 Deiary F. Kader and Leo Pinczewski 18. Foot and ankle oral core topics 215 Paul A. Banaszkiewicz 19. Spine oral core topics 237 Niall Craig Section 5 The hand oral 271 20. Syllabus and general guidance 273 Paul A. Banaszkiewicz 21. Hand oral core topics 276 Paul A. Banaszkiewicz and John W. K. Harrison Section 6 The paediatric oral 357 22. Paediatric oral topics 359 Joseph Alsousou and Paul A. Banaszkiewicz Contributors Mr. Abayomi Animashawun BSc (Hons) MRCS (Ed) Queen Elizabeth Hospital Gateshead, UK Mr. Joseph Alsousou LMSSA (Lon) MRCS (Ed) Queen Elizabeth Hospital Gateshead, UK Mr. Simon Barker BSc (Hons) MD FRCS (Tr & Orth) Royal Aberdeen Children’s Hospital Aberdeen, UK Mr. Paul A. Banaszkiewicz FRCS (Glas) FRCS (Ed) FRCS (Eng) FRCS (Tr & Orth) Cert Clin Ed Queen Elizabeth Hospital Gateshead, UK Mr. Niall Craig FRCS (Ed) FRCS (Tr & Orth) Aberdeen Royal Infirmary Aberdeen, UK Mr. John W. K. Harrison MSc FRCSEd (Tr & Orth) MFSEM (UK) Queen Elizabeth Hospital Gateshead, UK Mr. Deiary F. Kader FRCS (Tr & Orth) MFSEM (UK) Queen Elizabeth Hospital Gateshead, UK Visiting Professor, Sport Science Northumbria University Newcastle upon Tyne, UK vii viii List of Contributors Mr. Niall Munro MD FRCS (Tr & Orth) Golden Jubilee Hospital Glasgow, UK Mr. Leo Pinczewski MBBS FRACS North Sydney Orthopaedic and Sports Medicine Centre Sydney, NSW Australia Foreword The aim of this book is to allow candidates to orien- tate themselves towards the intercollegiate special- ity examination in orthopaedics leading to the FRCS (Tr & Orth) award. It affords guidance on the appro- priate examination skills and approaches, which hopefully will lead to success in this examination. The FRCS (Tr & Orth) continues to evolve with significant changes in both the written part of the exam, which must now be successfully completed prior to entry into the clinical, and to the oral. This book has been written by those who have recently successfully completed the examina- tion. It is written from the candidate’s point of view and experience in the way the examination is conducted. While no single book can be a substitute for wide clinical experience and knowledge of the orthopae- dic literature, I believe that this text will be of value to candidates preparing to sit the examination. There is no doubt that presentation in the examina- tion setting is important in ensuring success. Peter Gibson Consultant Orthopaedic Surgeon Head of Training North East of Scotland Rotation Ex Examiner for the FRCS (Tr & Orth) ix Preface This book has been written specifically for can- didates preparing for the Intercollegiate Board Examination in Trauma and Orthopaedic Surgery. It is an attempt to guide the orthopaedic trainee better in his or her preparation before they are thrown into the lion’s den. It is not intended to replace or be a substitute for the numerous orthopaedic textbooks available. I make no claim for the originality of the material contained within this text. The core mate- rial originated from notes made whilst preparing for the FRCS Orth examination from a wide variety of differing sources. We are not trying to re-invent the wheel! The curriculum for this examination is vast and therefore we have asked a variety of colleagues to contribute to various sections. Our aim was to put forth differing views and opinions regarding the key essentials for success in this examination and to give as broad a prospective as possible to candi- dates preparing to sit the examination. There is no doubt that the FRCS Orth is a stressful experience even for the most well prepared candidate. There is nothing more frustrating than a good candi- date with good knowledge failing the examination because of lack of orientation and technique in the examination. We have broken the book down into various sections to make revision easier. The first section covers the written paper. We give general advice about preparation. The “clinicals” – long and short cases – are crucial because if this aspect is failed, doing well in the orals does not allow redemption. In this section we cover a series of the most likely xi xii Preface orthopaedic long and short cases that regularly know the subject well but fail to appreciate how the appear in the exam. questions are going to “run” during an oral. The general orthopaedics and pathology oral The next four sections cover the remaining covers a great breadth of orthopaedics, with a large orals; namely, Basic science, Trauma, Hands and number of subjects dealt with. To simplify matters Paediatrics. we have broken the oral down into five core subspe- In the candidates’ accounts of the exam section cialties; namely, shoulder/elbow, hip, knee, foot/ we have give several candidates’ blow-by-blow ankle and spine. Within each core subspecialty we accounts of their whole examination performance. have dealt with various topics by way of a series of This gives candidates a prospective of the whole key points that guide the candidate through impor- picture of their potential examination. tant details of the subject. At the end of each topic we We hope that this is an enjoyable book to read and have tried to re-emphasize important aspects of the provides you with sound guidance in your prepara- subject by giving specific examples of how in reality tion for the examination, in which we wish you every questions tend to be asked. We have called this sec- success. Finally, Paul Banaszkiewicz
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