100+ Free Arab Board Orthopedic Surgery Clinical Practice Questions

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Sample Arab Board Orthopedic Surgery Clinical Practice Questions

Try these sample questions to test your Arab Board Orthopedic Surgery Clinical exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 32-year-old male presents after a motorcycle collision with an open Gustilo-Anderson Type IIIB midshaft tibial fracture. The wound measures 12 cm with extensive periosteal stripping and heavy contamination. What is the most appropriate initial management sequence regarding systemic antibiotics and soft tissue coverage?

A.First-generation cephalosporin alone; delayed soft tissue coverage beyond 3 weeks

B.First-generation cephalosporin plus aminoglycoside immediately; definitive soft tissue coverage within 7 days

C.Oral fluoroquinolone monotherapy; primary wound closure under tension in the emergency department

D.Topical antibiotic irrigation only; delayed primary closure without vascularized soft tissue transfer

Explanation: Gustilo-Anderson Type IIIB open fractures require immediate intravenous coverage against gram-positive and gram-negative organisms using a first-generation cephalosporin plus an aminoglycoside (or piperacillin-tazobactam). British Orthopaedic Association and Orthopaedic Trauma Association (BOA/OTA) guidelines recommend radical debridement and definitive soft tissue reconstruction within 7 days to dramatically lower deep infection and nonunion rates.

2A 45-year-old male is brought to the trauma bay following a high-speed motor vehicle collision. An anteroposterior pelvic radiograph reveals symphysis pubis diastasis of 4.5 cm with disruption of the anterior sacroiliac ligaments (Young-Burgess APC-II / Open Book). The patient is hemodynamically unstable with a blood pressure of 82/46 mmHg. What is the most critical initial mechanical intervention?

A.Emergent placement of an open retroperitoneal packing via laparotomy

B.Application of a pelvic binder centered precisely over the greater trochanters

C.Immediate traction pin placement in the distal femur

D.Application of a pelvic binder high around the iliac crests and abdomen

Explanation: In an unstable open-book pelvic ring injury (APC-II/III), applying a commercial pelvic binder centered directly over the greater trochanters reduces pelvic volume, stabilizes bone fragments, and promotes retroperitoneal tamponade. Binders placed around the iliac crests or soft abdomen fail to generate adequate compressive forces across the pelvic brim and may compromise abdominal access.

3A 28-year-old male with a closed midshaft tibia fracture treated in a cast develops progressive, unremitting leg pain out of proportion to the injury. On physical examination, passive stretch of the great toe elicits excruciating pain. The anterior compartment pressure is measured at 48 mmHg, and his diastolic blood pressure is 72 mmHg (delta pressure 24 mmHg). What is the definitive treatment?

A.Elevation of the limb above the heart and administration of intravenous mannitol

B.Immediate two-incision four-compartment fasciotomy of the leg

C.Single lateral incision fasciotomy releasing only the anterior compartment

D.Repeat compartment pressure measurement in 12 hours while maintaining cast immobilization

Explanation: A delta pressure (diastolic blood pressure minus compartment pressure) of 30 mmHg or less confirms acute compartment syndrome and is an absolute indication for emergency decompression. A two-incision, four-compartment fasciotomy (anterolateral and posteromedial incisions) fully decompresses the anterior, lateral, superficial posterior, and deep posterior compartments.

4A 74-year-old active, cognitively intact female falls at home and sustains a displaced subcapital femoral neck fracture (Garden Stage IV). She ambulated independently prior to the fall. What is the evidence-based management of choice?

A.Closed reduction and percutaneous fixation with three cannulated screws

B.Total hip arthroplasty (cemented stem)

C.Unipolar hemiarthroplasty with non-cemented press-fit stem

D.Bed rest and derotation boot for 6 weeks

Explanation: In active, independent elderly patients with displaced intracapsular femoral neck fractures (Garden III/IV), total hip arthroplasty (THA) provides superior functional outcomes, lower reoperation rates, and better pain relief compared to hemiarthroplasty or internal fixation. Modern registry guidelines favor a cemented femoral component to eliminate the risk of periprosthetic fractures.

5A 78-year-old male sustains an unstable intertrochanteric femur fracture with reverse obliquity (AO/OTA 31-A3). What is the optimal surgical implant to achieve stable biomechanical fixation?

A.Standard dynamic hip screw (DHS) with a two-hole side plate

B.Cephalomedullary intramedullary nail with a helical blade or lag screw

C.Dual non-locking reconstruction plates placed anteriorly and laterally

D.Cannulated cancellous screw fixation in an inverted triangle configuration

Explanation: Reverse obliquity and subtrochanteric intertrochanteric fractures (AO 31-A3) present an unstable fracture line that runs from medial to lateral distally. A sliding hip screw (DHS) is contraindicated because the compression screw causes lateral displacement of the distal shaft fragment, whereas a cephalomedullary nail acts as an intramedullary buttress resisting medialization and medial wall collapse.

6A 42-year-old male sustains a high-energy Schatzker Type VI bicondylar tibial plateau fracture with significant articular comminution, severe soft tissue swelling, and fracture blisters. What is the most appropriate initial management strategy?

A.Immediate extensive open reduction and internal fixation with dual plating through a midline incision

B.Knee-spanning external fixator placement with delayed definitive open reduction and internal fixation after soft tissue wrinkles appear

C.Immediate single lateral locking plate application through an extended anterolateral approach

D.Cylinder cast immobilization without surgical stabilization for 8 weeks

Explanation: High-energy bicondylar tibial plateau fractures (Schatzker V/VI) with severe soft tissue compromise should be managed with a staged protocol. Immediate spanning external fixation restores length and alignment while allowing soft tissue edema and blisters to resolve (demonstrated by positive skin wrinkling), after which safe definitive open reduction and dual buttress/locking plate fixation can be performed.

7A 35-year-old construction worker falls 4 meters, sustaining a closed Rüedi-Algöwer Type III distal tibial pilon fracture. CT demonstrates multiple displaced intra-articular fragments and severe metaphyseal comminution. The ankle is tensely swollen. What is the standard staged surgical approach?

A.Immediate primary open reduction, articular reconstruction, and definitive anterolateral plating on day 0

B.Temporary spanning delta-frame external fixation with fibular length restoration, followed by delayed definitive ORIF at 10 to 14 days

C.Closed reduction and immediate application of a non-weight-bearing short leg cast

D.Primary ankle arthrodesis using a retrograde tibiotalocalcaneal nail within 24 hours

Explanation: High-energy pilon fractures require staged management to protect the vulnerable distal tibial soft tissue envelope. The initial step is closed reduction and application of a spanning external fixator (spanning the ankle from tibia to calcaneus/talus) with or without open reduction and plating of the fibula to restore length, followed by definitive CT-guided intra-articular reconstruction once soft tissues have completely settled.

8A 50-year-old female sustains a closed, isolated midshaft humeral fracture following a simple fall. On examination, she has a complete radial nerve palsy with wrist and finger drop and dorsal first web-space numbness. What is the most appropriate initial management?

A.Emergent surgical exploration of the radial nerve and open reduction and plating

B.Functional Sarmiento brace immobilization, wrist cock-up splint, and clinical observation

C.Urgent open exploration with sural nerve graft interposition

D.Immediate closed reduction and retrograde flexible intramedullary nailing

Explanation: Primary radial nerve palsy following a closed humeral shaft fracture is a neuropraxia in 85-90% of cases. Conservative management with functional bracing (Sarmiento) and splinting yields spontaneous nerve recovery within 3 to 4 months. Surgical exploration is reserved for open fractures, secondary palsies developing after reduction, or failure of recovery confirmed on EMG at 3-4 months.

9A 24-year-old male sustains a Hawkins Type II talar neck fracture (subluxation of the subtalar joint with an intact tibiotalar joint). What is the primary surgical objective and typical approach to minimize the risk of avascular necrosis (AVN)?

A.Closed reduction and percutaneous pinning without visual assessment of the joint

B.Anatomic open reduction via dual (anteromedial and anterolateral) approaches with rigid screw fixation

C.Complete talectomy and primary tibiocalcaneal arthrodesis

D.Prolonged immobilization in an equinus cast for 16 weeks

Explanation: Hawkins Type II talar neck fractures carry an avascular necrosis risk of 20-50%. Anatomic reduction is mandatory to restore the delicate vascular supply entering via the canalis tarsi, sinus tarsi, and deltoid branches. Dual anteromedial and anterolateral incisions allow visualization of the entire talar neck and articular surfaces, enabling stable countersunk interfragmentary screw fixation.

10A 30-year-old male arrives in the emergency department after a head-on collision where his knee struck the dashboard. His right hip is held in flexion, adduction, and internal rotation. A plain radiograph confirms a posterior hip dislocation without obvious acetabular rim fracture. What is the most critical time-sensitive management step?

A.Immediate urgent closed reduction under deep sedation/anesthesia within 6 hours, followed by post-reduction CT

B.Delayed reduction after completing elective 24-hour MRI of the femoral head

C.Immediate open reduction via posterior Kocher-Langenbeck approach without trying closed reduction

D.Application of 10 kg skin traction and watchful waiting for 48 hours

Explanation: Traumatic posterior hip dislocation is an orthopedic emergency requiring urgent closed reduction within 6 hours to minimize the risk of femoral head avascular necrosis (AVN) and sciatic nerve neuropraxia. After successful reduction, a pelvic CT scan is mandatory to evaluate for non-concentric reduction, intra-articular osteochondral fragments, or subtle acetabular wall fractures.

About the Arab Board Orthopedic Surgery Clinical Exam

The Arab Board Orthopedic Surgery Final Clinical and Oral Examination is the definitive exit qualification administered by the Scientific Council of Orthopedic Surgery under the Arab Board of Health Specializations (ABHS). This rigorous clinical examination assesses senior orthopedic surgery residents and fellows across member countries in clinical physical examination, diagnostic imaging interpretation (radiographs, CT, MRI), surgical decision-making, intraoperative complication management, and viva voce defense of operative strategies. This practice module provides an English-language MCQ study adaptation designed to hone your diagnostic reflexes and surgical management algorithms for the clinical exit exam.

Assessment

The exit clinical and oral examination features patient bedside clinical examination (short and long cases), OSCE-style stations, radiograph and MRI interpretation tables, and structured oral viva voce examining operative indications, surgical technique, and complication management.

Time Limit

Approximately 2 to 3 hours

Passing Score

A passing score of approximately 60% across clinical stations and viva components is required by the ABHS Scientific Council of Orthopedic Surgery.

Exam Fee

Set by ABHS and national councils; candidates should consult their national board coordinator for country-specific testing and administrative fees. (Arab Board of Health Specializations (ABHS) - Scientific Council of Orthopedic Surgery)

Arab Board Orthopedic Surgery Clinical Exam Content Outline

22%

Adult Trauma and Fracture Fixation

ATLS protocols, damage control orthopedics, pelvic ring injuries, open fracture classifications and antibiotic protocols, acute compartment syndrome, periarticular fractures (tibial plateau, pilon, calcaneus), and nonunion.

17%

Adult Reconstruction and Arthroplasty

Primary and revision total hip and knee replacement, safe zones, periprosthetic infection management (DAIR vs two-stage), periprosthetic fractures (Vancouver classification), and femoroacetabular impingement.

15%

Spine Surgery and Pathology

Cervical spondylotic myelopathy, lumbar spinal stenosis, cauda equina syndrome, thoracolumbar burst fractures (TLICS), spinal tuberculosis (Pott disease), epidural abscess, and adolescent idiopathic scoliosis.

15%

Pediatric Orthopedics

Developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), Legg-Calve-Perthes disease, clubfoot (Ponseti method), supracondylar humerus fractures, and Salter-Harris physeal fractures.

13%

Sports Medicine and Arthroscopy

ACL and multiligament knee injuries, meniscal tears and repair techniques, shoulder anterior instability (Bankart vs Latarjet), rotator cuff tears, SLAP lesions, and osteochondral defect management.

Hand and Upper Extremity

Scaphoid fractures and nonunion, perilunate dislocations, flexor tendon zones and rehabilitation, distal radius fracture plating, carpal tunnel release, trigger finger, and Dupuytren contracture.

Musculoskeletal Oncology

Osteosarcoma, Ewing sarcoma, giant cell tumor of bone, osteoid osteoma, metastatic bone disease (Mirels score), and biopsy principles.

Foot and Ankle Surgery

Hallux valgus deformity correction, Charcot neuroarthropathy, Lisfranc injury identification and screw fixation, and posterior tibial tendon dysfunction (PTTD).

How to Pass the Arab Board Orthopedic Surgery Clinical Exam

What You Need to Know

Passing score: A passing score of approximately 60% across clinical stations and viva components is required by the ABHS Scientific Council of Orthopedic Surgery.
Assessment: The exit clinical and oral examination features patient bedside clinical examination (short and long cases), OSCE-style stations, radiograph and MRI interpretation tables, and structured oral viva voce examining operative indications, surgical technique, and complication management.
Time limit: Approximately 2 to 3 hours
Exam fee: Set by ABHS and national councils; candidates should consult their national board coordinator for country-specific testing and administrative fees.

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Arab Board Orthopedic Surgery Clinical Study Tips from Top Performers

1Master systematic physical examination algorithms for the shoulder, knee, hip, spine, hand, and foot/ankle, verbalizing each maneuver clearly and identifying pathognomonic clinical signs.

2Review standard radiological classification systems (e.g., Gustilo-Anderson, Garden, Vancouver, Schatzker, TLICS, Salter-Harris, Hawkins, Sanders, Mirels) and be prepared to state clear management protocols based on each grade.

3Practice articulating step-by-step surgical indications, operative approaches, landmarks, structures at risk, and complication salvage strategies out loud under timed conditions to excel in the structured viva voce.

Frequently Asked Questions

What is the format of the Arab Board Orthopedic Surgery Final Clinical and Oral Exam?

The examination consists of structured clinical stations with real or standardized patients (short and long clinical cases), imaging interpretation tables (interpreting radiographs, CT, and MRI scans), and structured oral viva voce tables where senior examiners assess surgical indications, operative approaches, implant choices, and complication management.

What is the passing score for the ABHS Orthopedics Clinical Examination?

A passing standard of approximately 60% across all clinical stations and oral viva components is typically required by the ABHS Scientific Council of Orthopedic Surgery. Candidates must demonstrate competent clinical judgment and surgical safety across all subspecialties.

Which subspecialties are tested most heavily on the orthopedic clinical exit exam?

Adult trauma and complex fracture fixation, joint arthroplasty (primary and revision THA/TKA), pediatric orthopedics (DDH, SCFE, clubfoot, trauma), and spine pathology represent the majority of examination cases, along with sports medicine, hand surgery, foot/ankle, and musculoskeletal oncology.

How does this practice bank help prepare for an oral and clinical examination?

While the official ABHS examination is conducted clinically and orally, this practice bank translates high-yield clinical scenarios, physical examination findings, radiological signs, and surgical decision-making algorithms into structured scenario-based MCQs. This rapid-retrieval format reinforces the exact evidence-based criteria and protocols tested by examiners during bedside evaluations and oral viva sessions.

100+ Free Arab Board Orthopedic Surgery Clinical Practice Questions

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