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Osce Orthopedic Year 4

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MBBS UiTM 6th batch

OSCE ORTHOPEDIC year 4

2nd rotation 2011/2012

OSCE 1

Picture : gangrene of the 1st and 2nd toe with trophic changes of the foot.

1. What abnormalities that u see in the picture? 2marks


2. What is your diagnosis? 1marks
3. How would u classify the conditions above? 2marks
Wargener’s classification grade 4
4. How would u treat this condition? 2marks
Local and systemic approach
5. What are your advices so that this condition won’t occur in the future? 3marks

OSCE 2

1. Which nerve roots are involved in this condition? 2 marks


C5, C6 +/- C7 nerve roots
2. Name of the group of muscle in the shoulder that affected in this condition? 2 marks
3. Which dermatomal distributions are affected in the hand? 2marks
4. Briefly describe Horner’s syndrome and its 4 sign. 3marks
Miosis, enophtalmos, anhydrosis and ptosis
5. Name the counter injury in this condition. 1mark
Klumpke’s palsy

OSCE 3
MBBS UiTM 6th batch

1. What is the name of this type of immobilization? 1marks


External fixator
2. What are the indications? 3marks
3. What are the advantages of this immobilization? 3marks
4. What are the complications? 3marks

OSCE 4

A 12 years old girl present with swelling and pain over the right knee.

1. What are the radiological abnormalities that can be seen? 4marks


2. What is your diagnosis? 2marks
MBBS UiTM 6th batch

Osteosarcoma of distal right femur


3. What are the differential diagnoses that show similar radiological changes? 2marks
Osteomyelitis
Previous callus formation
4. Name (1) definitive investigation that will confirm your diagnosis? 2marks
Histophatology study

OSCE 5

A 14 years old obese boy comes to ED complaint of painful hip with deformity of the left hip
for the past 2month.

1. What is your diagnosis? 2marks


Slipped upper femoral epiphysis(SUFE) of the left hip.
2. What is Trethowen’s sign? 2marks
In an anteroposterior (AP) view of the hip joint, a line (Klein’s line) drawn along the
superior surface of the neck should pass through the femoral head. In slipped femoral
epiphysis, the line is above the femoral head and known as a positive Trethowan sign.
3. Give 2 factors that can cause this problem? 2marks
4. How do you manage this condition? 2marks
5. What are the complications, if this condition is not treated? 2marks

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