Post-grad UKM Batch 2016-2019

LIST OF TOPICS FOR CBO PART II (UKM)

 General Orthopaedic  Paeds

 General Trauma  Foot & Ankle
 Peri-operative  Sports
 Surgical Approach  Hand & Microsurgery
 Spine  Oncology
 Arthroplasty

General Orthopaedic

1. Osteomyelitis (acute & chronic)

2. Septic arthritis – definition, classification, clinical presentation, how to confirm diagnosis (gold standard Ix – joint
aspiration  what investigation samples to sent for?), principles of management, duration of IV antibiotics,
complications, etc
3. Osteoarthritis – classification (xray/ scope), principles of management,
4. HA injection – how it works, physiology at molecular level
5. Rheumatoid arthritis – latest criteria to diagnose, principles of management, holistic/ multidisplinary management, types
of pharmacology available – DMARDs, cytotoxic drugs, etc
6. Osteoporosis – definition, primary vs secondary, treatment modalities, etc
7. Ricket’s
8. Bone graft (synthetic/BMP/DBM etc) – adv vs disadv of each
9. PRP – how it works, controversial issues
10. Compartment syndrome
11. FES
12. Hypovolaemic shock e.g. major amputation
13. Spinal/ Neurogenic shock
14. Metabolic response to trauma (Ebb/Flow, Anabolic/Catabolic)
15. Principle of CMR & sedation technique (sedative first or analgesic first?)
16. Patella tendon bearing cast – how to apply, principle
17. Ankle-foot orthoses (AFO) – types, adv vs disadv, indication
18. Splinting – Thomas/ Bohler Braun/ Pavlic harness
19. Implant material & the differences
20. PVNS

General Trauma

21. Moralle lavalle – definition, associated common injury, choices of treatment

22. Bimalleolar fracture – Lauge Hansen classification
23. Syndesmotic injury – classification, how to clinical detect, radiological signs, how to assess stability, how to fix (dorsiflex
vs neutral), cortices to
24. Clavicle fracture – when to fix, complications
25. Humeral shaft fracture – Holstein lewis, plate vs nail, etc
26. Neck of femur fracture – classification (Garden’s based on trabeculae lines), principles of management (ORIF vs
arthroplasty, hemi vs total)
27. Open fracture – definition, classification, principles of management (at scene  ED  operation room  ward care 
home care), principles of antibiotic ( BAPRAS), complications, options of closure if skin defect
28. Aseptic non-union – definition, principles of management
29. Septic non-union – definition, principles of management
30. Malunion – definition, principles of management
31. Joint arthrodesis – indications, techniques (degree to fuse the joint)
32. ATLS – definition of polytrauma, principles of management, ETC vs DCO (Early Total Care vs Damage Control
Orthopaedic), given example e.g. how do you manage polytrauma patient with pelvic fracture in hypovolaemic shock?
 Post-grad UKM Batch 2016-2019

33. Major amputation – classification, to safe or not to safe, scoring systems, complications (hypovolaemic shock, crush
syndrome, rhabdomyolisis, acute kidney injury secondary to myoglobinuria – pathophysiology), principles of
management

Peri-Operative

34. Principle of consent

35. Safe live Safe surgery – definition, objectives, how to apply
36. How to reduce risk of infection – pre,intra & post op, ward condition, operative room condition, etc
37. How to reduce bleeding intra-operative – hypotensive surgery, tourniquet, hemostasis using diarthermy or ligation, etc
38. Usage of antibiotics – prophylactic/ therapeutic, half-life prior to surgery, choices of antibiotic for each surgery, post-
operative principle of antibiotic e.g closed fracture fixation vs open fracture
39. Tourniquet – principle, complications
40. Diarthermy – uni vs bipolar, complications, etc
41. How do you prepare RA patient for THR/ TKR?
42. Post-operative DVT prophylaxis – choices, adv vs disadv, mechanical vs pharmacological, etc
43. Post-operative fever – mneumonics, classification, principle of management
44. Bone cement implantation syndrome – clinical presentation, how to prevent, management

Surgical Approach (from cephalic to caudal)

45. How to apply skull traction – what is weight e.g if C5 fracture, safe area, tension applied
46. How to apply Halovest – principle, safe area, indication etc.
47. Anterior approach of spine e.g ACDF 1 level c5/c6
48. How to do posterior fixation & stabilization of lumbar fracture eg. L2 burst fracture – indications, instruments, level of
fixations, complications
49. How to do discectomy? – open vs micro (better open),position (advantages), structures etc
50. Deltopectoral approach for proximal humerus fracture
51. Deltopectoral approach for hemiarthroplasty
52. Deltopectoral approach for open shoulder dislocation – ways to stabilize shoulder if unstable after open reduction
53. Shoulder arthroscopy – portals available, indications & limitations, complications
54. Distal humerus approach – triceps lift/ Bryan Morrey/ Chevron’s osteotomy
55. Kocher’s approach for radial head/ neck fixation – safe area for radial head fixation
56. Henry’s approach for plating radius/ulna
57. Distal end radius fixation – approach, cut/not cut pronator quadratus, tri-column theory,
58. Suzuki frame – how to do, principle, advantage
59. How to do carpal tunnel release
60. How to do trigger finger release
61. How to apply pelvic external fixator – standard/ supraacetabulum
62. Lateral approach of the hip
63. Posterior approach of the hip
64. How to do hip hemi-arthroplasty – step by step
65. How to do DHS – principle (controlled collapse), barrel length (if 85mm or shorter screw, use short barrel) etc
66. How to do ILN femur – how to know malrotation, antegrade vs retrograde, technique for closed reduction
67. How to do TKA – step by step, instruments, bone cut steps, soft tissue release steps, steps to get equal flexion & extension
gap
68. Knee arthroscopy – portals available, complications
69. How to do ILN tibia – entry point
70. How to fix pilon fracture – approach, follow Ruedi-Allgower principles,
71. How to fix Lisfranc injury – K-wire vs screws, etc
72. Ray Amputation – fingers vs toe, middle toes vs 1st/5th toe, step by step, instruments e.g. saw vs bone cutter
73. How to do BKA
74. How to do AKA
75. Principle of lag screw – different screw & drill size for radius ulna/ humerus/ tibia/ femur
76. Principle of compression plating – tension band principle, pre-bend plate, etc, working length
77. Principle of locking plate – fixed angle device, working length, MIPO to reserve periosteum, etc
 Post-grad UKM Batch 2016-2019

78. Principle of TBW – convert tension force to compression force, how to do the 8-figure (tightened together), etc
79. Principle of K-wiring – diverge vs converge, small to large fragment, etc
80. How to do iliac bone graft – techniques, instruments, complications,
81. How to do gastroc flap
82. How to do SSG vs Full thickness graft
83. How to do cannulated screw neck of femur?, how to reduce, how to know reduction acceptable

Spine

84. Compression fracture – Dennis three column theory, principles of management

85. Burst fracture – classification (Gaines), stable vs unstable, principle of management
86. Fracture-dislocation
87. Chance fracture – bony vs soft tissue
88. CSM (Cervical Spondylostic Myelopathy) – clinical presentation, special tests, xray/ MRI changes (cord occupation ratio,
etc), scoring (JOA/ Ranawat/ Nurick), principles of management
89. Other causes of cervical myelopathy – OPLL (classification, etc), infection, trauma etc
90. Spinal stenosis
91. PID
92. DDD
93. Scoliosis
94. AS (Ankylosing spondylitis)
95. DISH (Disseminated Idiopathic Skeletal Hyperostosis)
96. Usage of steroid in spinal cord injury – NASCIS I, II, & III,
97. Spinal cord injury – classification (complete vs incomplete, ASIA A B C D E), time frame for fixation, holistic approach,
multi-disciplinary management
98. Non-union spine fracture – presentation, classification, scoring to fix or not (TLICS), choices of surgery (vertebroplasty,
kyphoplasty, PIF, etc)
99. Metastatic spine tumor – classification, scoring to fix or not to fix, principles of management
100.Spine pyogenic infection – spondylodiscitis
101.TB spine

Arthroplasty

102.TKA – principle, choices of implant/ components (PS vs CR, CCK, mobile vs non mobile bearing, hinge vs non hinge)
etc, complications,
103.THR – principle, choices of implant/ components (PS vs CR, CCK, mobile vs non mobile bearing, hinge vs non hinge)
etc, complications
104.Bipolar vs Unipolar hemiarthroplasty
105.Prosthetic joint infection (PJI) – classification, principle of management
106.Bone cement – history of the beginning, evolution of techniques (1st, 2nd, 3rd generation), phases/ working time, different
types (adv vs disadv), complications, etc
107.Usage of tranxenamic acid in arthroplasty
108.Knee OA
109.Knee RA
110.AVN of the hip

Paeds

111.Supracondylar humerus fracture – classification, management

112.DDH – history, clinical signs/ test, pathology (structures that blocked the reduction), ultrasound vs xrays, principles of
management based on age of presentation
113.Child with ‘clicking hip’
114.Pavlik harness – how to apply, indication, principles, complication, etc
115.SUFE
116.Perthe’s disease
117.PFFD
 Post-grad UKM Batch 2016-2019

118.Blount’s disease – classification (Langerskoid), principles of management

119.Genu varum – causes, differential diagnosis
120.Genu valgus – causes, differential diagnosis
121. CPT (Congenital Pseudoarthrosis of Tibia)
122. Fibular hemimilia
123. CTEV – how to apply Ponsetti cast, etc
124. Septic arthritis in children – Kocher’s criteria, clinical, management etc
125. Cerebral palsy – types, management
126. Spina bifida
127. Osteogenesis imperfect
128. Torticollis – causes, treatment choices

Foot & Ankle

129. DFU – classifications (Wagner/ Texas/ King), principle of mx, holistic approach
130. Charcoat arthropathy
131. Chronic ankle pain following trauma – diff dx, plan of management
132. Peroneal tendon injury – clinical presentation, mechanism of injury, principle of management
133. Lateral ligament rupture – principle of management, surgery (Brostrom Gould)
134. Talus fracture – classification, principle of management, choices of approach
135. Stress/ Jones/ Pseudojones fracture – definition, management
136. Ankle fusion – indication, types, choices of implant (adv vs. disadv), complications, etc
137. Total ankle replacement – indications, pre-requisite, choices of implant, complications, etc
138. Flatfoot
139. ATFL injury
140. Haglund’s disease
141. Hallux valgus

Sports

142.Shoulder impingement syndrome – types, presentation, principles of management

143.Rotator cuff injury – tendinopathy  simple tear  massive tear  rotator cuff arthropathy, principles of management
(acute vs chronic, young vs old) etc
144.Instability – acute vs chronic, traumatic vs habitual, radiological changes (anterior vs posterior dislocation, CT/ MRI
changes), principles of management, post-op rehab
145.ACL injury – principles of management – early of late surgery, BPTB vs harmstring graft, traditional vs accelerated
rehab, complications of recon
146.Patella dislocation/ instability – bony vs soft tissue stabilizers, MPFL recon (layers 1, 2, 3), post-op rehab
147.Anterior knee pain – causes (Patella chondromalacia, etc), investigations, principles of management
148.PLC injury – structures of PLC, mechanism, clinical presentation & test, management
149.Segon’s fracture

Hand & Microsurgery

150.Brachial plexus injury – all from A to Z

151.Carpal tunnel syndrome
152.Trigger finger
153.Flexor tendon injury – zones, principles of management
154.Extensor tendon injury – zones, principles of management
155.Pre-requisite tendon transfer
156.Principles of replantation
157.Re-perfusion technique
158.Dupuytren contracture
159.Carpo-metacarpal OA
 Post-grad UKM Batch 2016-2019

160.Tennis elbow
161.Glomus tumor

Oncology

162.Principle of biopsy
163.Types of biopsy – adv & disadv
164.Osteosarcoma
165.Giant cell tumor (GCT) – extended curettage & options, phenol vs liquid nitrogen, cement vs bone graft to fill-up cavity,
approach to distal radius GCT, what to do if subchondral fractured during curettage, etc
166.Chondrosarcoma
167.Ewing’s sarcoma
168.Multiple myeloma
169.Schwannoma
170.Secondary metastasis – classification, scoring system for prophylactic fixation, principles of management, etc

Others (addition after exam…few topics that we added during study group…not being listed in the ‘Study Group List’

171.How these medications worked?

 Paracetamol
 NSAIDs
 COX-2 inhibitor
 Tramadol
 Opiods (Pethidine)
 Colchicine
 Allopurinol
172.Distraction osteogenesis
173.Principles of correctional deformity (Rules of osteotomy)
174.Principles of chemotherapy in soft tissue sarcoma
175.Mri, PD, T1,T2, Stir, how proton get aligned in our body,
176.bone scan,- what is bone scan, type and function, how metabolise, how uptake
177.pet scan
178.clinical research, how u conduct study
179.