Past FRACS Orthopaedic Exams
Royal Australasian College of Surgeons
Part 2 Examination for Fellowship
Orthopaedic Surgery
MONDAY, 1 MAY, 2000
SECOND PAPER - 2 hours
ALL questions must be answered - Question 3 (1 hour) is worth double the marks of Question 4 & 5 (1/2 hour each)
Question (1 Hour)
A 35 year old man presents with an unstable vertical shear fracture of the pelvis after falling 10 m from a viewing platform. He has no other associated musculoskeletal injuries. He is in a shocked state.
You, as the Orthopaedic Surgeon on duty, are discussing the treatment with the patient, who is a lawyer and his General Practitioner wife on the day of injury.
- Outline the early and late complications of this injury. 30%
- Discuss the advantages and disadvantages of (external and (internal fixation with particular reference to their effects on complications. 60%
- Discuss the important consent issues. 10%
Question 4. (½ hour)
A premenarchal 12 year old girl presents, following a tripping accident, with acute onset of severe pain in the left hip on weight bearing. There has been a history of vague ipsilateral knee and thigh pain for 3 months
- List the differential diagnoses. 10%
- Discuss in short note form:
- Clinical assessment and investigation. 30%
- Your treatment plan, which includes informed consent and possible complications of the most likely diagnosis. 30%
- The current controversies in the management of the most likely diagnosis. 30%
Question 5. (½ hour)
A 65 year old female with widespread joint involvement from sero positive rheumatoid arthritis of ten years duration presents with a six month history of increasing difficulty walking because of a painful and deformed right knee
- Briefly list the likely clinical findings related to the knee. 20%
You and your patient agree that total knee replacement is the best treatment option.
- Itemise your preoperative (30%),
- operative (30%),
- postoperative (20%) assessment and management in order to minimise the problems and possible complications related to the rheumatoid disease
