100+ Free Arab Board Orthopedic Surgery Final Practice Questions

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Sample Arab Board Orthopedic Surgery Final Practice Questions

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

1A 74-year-old active, independent community ambulator sustains a displaced Garden Type IV femoral neck fracture after a low-energy fall. Which surgical intervention is the most appropriate management according to evidence-based orthopedic guidelines?

A.Total hip arthroplasty (THA)

B.Unipolar hemiarthroplasty

C.Closed reduction and percutaneous cannulated screw fixation

D.Dynamic hip screw (DHS) fixation

Explanation: In active, cognitively intact elderly patients who are independent community ambulators, total hip arthroplasty (THA) is the preferred treatment for displaced femoral neck fractures (Garden III/IV). High-quality randomized trials have demonstrated that THA provides superior functional outcomes, reduced pain, and lower reoperation rates compared to hemiarthroplasty or internal fixation in this active demographic.

2A 32-year-old male sustains an open Gustilo-Anderson Type IIIB tibial shaft fracture in a motorcycle collision. What is the most appropriate initial intravenous antibiotic regimen and timing of administration?

A.First-generation cephalosporin alone started within 12 hours of admission

B.First-generation cephalosporin combined with an aminoglycoside (or third-generation cephalosporin) started immediately within 1-3 hours

C.Vancomycin alone started after operative debridement cultures are obtained

D.Oral fluoroquinolone started once the patient is hemodynamically stabilized

Explanation: For high-grade open fractures (Gustilo-Anderson Type III), standard guidelines mandate broad-spectrum coverage for both Gram-positive organisms (e.g., Cefazolin) and Gram-negative bacilli (e.g., Gentamicin or Ceftriaxone). Antibiotic administration within the first 1-3 hours of injury is the single most critical factor in reducing the risk of deep infection and osteomyelitis.

3In the Young-Burgess classification of pelvic ring injuries, an Anteroposterior Compression Type II (APC-II) injury is characterized by which anatomical ligamentous disruption pattern?

A.Disruption of the pubic symphysis diastasis (< 2.5 cm) with intact sacrospinous and sacrotuberous ligaments

B.Disruption of the pubic symphysis (> 2.5 cm), sacrospinous, sacrotuberous, and anterior sacroiliac ligaments, with intact posterior sacroiliac ligaments

C.Complete disruption of both anterior and posterior sacroiliac ligamentous complexes resulting in vertical instability

D.Impaction of the anterior sacrum with intact anterior sacroiliac ligaments

Explanation: APC-II pelvic ring injuries result from severe external rotation forces causing symphyseal diastasis greater than 2.5 cm, complete disruption of the sacrospinous and sacrotuberous ligaments, and tearing of the anterior sacroiliac ligaments. The posterior sacroiliac ligaments remain intact, creating rotational instability (open-book pelvis) while preserving vertical stability.

4A 28-year-old male is admitted with a closed tibial shaft fracture. Six hours after splinting, he develops severe, unrelenting pain out of proportion to the injury, aggravated by passive toe extension. Intracompartmental pressure testing is performed. Which pressure measurement confirms the diagnosis of acute compartment syndrome?

A.Compartment pressure of 15 mmHg with a diastolic blood pressure of 85 mmHg

B.Delta pressure (diastolic blood pressure minus compartment pressure) of 22 mmHg

C.Delta pressure (systolic blood pressure minus compartment pressure) of 45 mmHg

D.Compartment pressure equal to the central venous pressure

Explanation: Acute compartment syndrome is diagnosed when the intracompartmental pressure rises to within 30 mmHg of the patient's diastolic blood pressure (delta pressure <= 30 mmHg) or exceeds an absolute threshold of 30 mmHg in symptomatic patients. A delta pressure of 22 mmHg indicates critically compromised capillary perfusion requiring urgent emergency four-compartment fasciotomy.

5A 24-year-old polytrauma patient with bilateral closed femur fractures, a severe pulmonary contusion, and an ISS of 38 arrives in the trauma bay. Laboratory analysis demonstrates an arterial pH of 7.20, serum lactate of 4.5 mmol/L, base deficit of -8 mmol/L, and body temperature of 34.8°C. What is the recommended orthopedic strategy for the femur fractures?

A.Immediate bilateral reamed intramedullary nailing (Early Total Care)

B.Temporary spanning external fixation with delayed definitive intramedullary nailing (Damage Control Orthopedics)

C.Bilateral open reduction and locked plate fixation under prolonged general anesthesia

D.Bilateral skeletal traction on a Bohler-Braun frame until fracture union

Explanation: This patient is in the 'in extremis' or borderline category displaying the lethal triad of hypothermia (< 35°C), severe metabolic acidosis (base deficit < -6 mmol/L, lactate > 2.5 mmol/L), and coagulopathy. Damage Control Orthopedics (DCO) using rapid temporary spanning external fixation minimizes surgical duration and physiological second-hit insult until resuscitation parameters normalize.

6When evaluating plain radiographs for an acetabular fracture using Judet views, which anatomical structures are profiled on the 45-degree obturator oblique view?

A.Posterior column and anterior wall

B.Anterior column and posterior wall

C.Iliac wing and posterior column only

D.Sacroiliac joint and quadrilateral plate only

Explanation: In the Judet 45-degree obturator oblique radiograph, the pelvic brim (anterior column) and the posterior wall of the acetabulum are clearly profiled. Conversely, the iliac oblique view profiles the posterior column and the anterior wall of the acetabulum.

7A 35-year-old male sustains a Hoffa fracture (AO 33-B3) of the distal femur following a motor vehicle collision. Which condylar location and surgical fixation strategy are most characteristic of this injury?

A.Medial condyle coronal fracture; treated non-operatively in a long-leg cast

B.Lateral condyle coronal fracture; treated with open reduction and countersunk AP/PA lag screws with buttress plating

C.Intercondylar notch avulsion; treated with isolated suture anchor fixation

D.Sagittal split of both condyles; treated with a retrograde intramedullary nail

Explanation: Hoffa fractures are unicondylar coronal-plane shear fractures of the distal femoral condyle, most commonly involving the lateral femoral condyle (due to physiological valgus alignment). Because they are inherently unstable intra-articular injuries subject to significant shear forces in flexion, open reduction and rigid internal fixation with countersunk lag screws (anteroposterior or posteroanterior) and posterior buttress plating is standard.

8A 29-year-old skydiver sustains a Hawkins Type III talar neck fracture. What is the defining anatomical characteristic and expected rate of osteonecrosis (avascular necrosis) associated with this injury?

A.Non-displaced talar neck fracture; 0-5% risk of avascular necrosis

B.Talar neck fracture with subtalar dislocation; 20-40% risk of avascular necrosis

C.Talar neck fracture with subtalar and tibiotalar dislocation; 80-100% risk of avascular necrosis

D.Talar neck fracture with subtalar, tibiotalar, and talonavicular dislocation; 10-15% risk of avascular necrosis

Explanation: Hawkins Type III talar neck fractures involve displacement of the talar neck accompanied by dislocation of both the subtalar and tibiotalar (ankle) joints. Because all primary extraosseous vascular inflows (deltoid branches, tarsal canal artery, and sinus tarsi vessels) are disrupted, the risk of osteonecrosis of the talar body approaches 80-100%.

9In the Schatzker classification of tibial plateau fractures, a Schatzker Type IV injury is defined by which fracture pattern and associated high-risk clinical concern?

A.Pure cleavage split of the lateral tibial plateau; risk of lateral meniscus tear

B.Depression and split of the lateral plateau; low neurovascular risk

C.Isolated medial tibial plateau fracture; high risk of popliteal artery and peroneal nerve injury

D.Bicondylar plateau fracture with diaphyseal-metaphyseal dissociation; low risk of compartment syndrome

Explanation: Schatzker Type IV represents an isolated fracture of the medial tibial plateau (split or split-depression). Because the medial plateau requires substantial high-energy force (axial load with varus strain) to fracture, this injury is frequently associated with knee subluxation/dislocation, cruciate and posterolateral corner tears, and a high risk of popliteal artery occlusion or peroneal nerve palsy.

10A 22-year-old male sustains a closed Holstein-Lewis fracture (distal third spiral fracture of the humeral shaft) and presents with complete wrist drop and numbness in the first dorsal web space. What is the initial recommended management strategy for the radial nerve deficit?

A.Immediate open surgical exploration of the radial nerve within 6 hours

B.Closed reduction, functional bracing or coaptation splinting, and expectant clinical observation

C.Percutaneous pinning with immediate nerve transfer surgery

D.Urgent tendon transfers to restore wrist and finger extension

Explanation: Radial nerve palsy associated with closed humeral shaft fractures (including the distal-third spiral Holstein-Lewis fracture) represents a neuropraxia or axonotmesis in over 85-90% of cases. The standard of care is closed reduction, functional bracing (or locked intramedullary nailing/plate fixation if surgical criteria are met), and observation with serial electrodiagnostic studies if recovery is not apparent by 3-4 months.

About the Arab Board Orthopedic Surgery Final Exam

The Arab Board Orthopedic Surgery Final Written Examination is the mandatory exit assessment required for senior orthopedic surgical trainees seeking board certification across Arab League member nations. The exam evaluates advanced clinical and operative competencies in adult trauma, joint reconstruction, spine surgery, pediatric orthopedics, sports medicine, orthopedic oncology, hand surgery, and foot and ankle disorders.

Assessment

A comprehensive single-best-answer written examination assessing advanced clinical decision-making across all orthopedic subspecialties.

Time Limit

Approximately 3 hours

Passing Score

Approximately 60% (as established by the ABHS Scientific Council of Orthopedic Surgery)

Exam Fee

Set by ABHS and national councils (Arab Board of Health Specializations (ABHS))

Arab Board Orthopedic Surgery Final Exam Content Outline

20%

Adult Trauma and Fracture Management

Pelvic and acetabular trauma, polytrauma resuscitation, open fractures, compartment syndrome, lower and upper extremity fractures, nonunions, and complications.

15%

Adult Reconstruction and Arthroplasty

Primary and revision total hip and knee arthroplasty, shoulder arthroplasty, osteonecrosis, periprosthetic joint infection, and periprosthetic fractures.

14%

Pediatric Orthopedics

DDH, Perthes disease, SCFE, clubfoot, physeal injuries, neuromuscular conditions, limb deformity, and pediatric infections.

12%

Spine Disorders and Trauma

Cervical and thoracolumbar trauma, adult and adolescent spinal deformity, degenerative spine disease, spondylolisthesis, and spine infections.

12%

Sports Medicine and Arthroscopy

Ligamentous knee injuries, meniscal pathology, shoulder instability, rotator cuff tears, femoroacetabular impingement, and articular cartilage restoration.

10%

Hand and Upper Extremity Surgery

Distal radius fractures, scaphoid trauma, flexor tendon repairs, compressive neuropathies, brachial plexus injuries, and Dupuytren contracture.

Foot and Ankle Surgery

Ankle and hindfoot fractures, syndesmotic injuries, Lisfranc trauma, Achilles tendon rupture, hallux valgus, flatfoot deformity, and Charcot neuroarthropathy.

Orthopedic Oncology and Pathology

Primary malignant bone tumors, benign bone lesions, metastatic disease, biopsy principles, and staging systems.

How to Pass the Arab Board Orthopedic Surgery Final Exam

What You Need to Know

Passing score: Approximately 60% (as established by the ABHS Scientific Council of Orthopedic Surgery)
Assessment: A comprehensive single-best-answer written examination assessing advanced clinical decision-making across all orthopedic subspecialties.
Time limit: Approximately 3 hours
Exam fee: Set by ABHS and national councils

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 Final Study Tips from Top Performers

1Master standard classification systems (e.g., Gustilo-Anderson, Young-Burgess, Letournel-Judet, Garden, Schatzker, Salter-Harris, Paprosky, Lauge-Hansen, Rockwood) along with their immediate surgical implications.

2Focus heavily on emergency management algorithms, including acute compartment syndrome, open fracture antibiotic timing, damage control orthopedics in polytrauma, cauda equina decompression, and septic arthritis criteria.

3Practice clinical vignette multiple-choice questions under strict time constraints (approximately 70-75 seconds per question) to hone rapid pattern recognition and surgical step prioritization.

Frequently Asked Questions

What is the format and duration of the Arab Board Orthopedic Surgery Final Written Exam?

The examination consists of a single written paper containing approximately 150 single-best-answer multiple choice questions (MCQs) administered over a 3-hour session, testing comprehensive diagnostic, operative, and perioperative clinical decision-making.

What is the passing score for the Arab Board Orthopedic Surgery Final Written Exam?

The passing mark is established by the ABHS Scientific Council of Orthopedic Surgery and is traditionally set at approximately 60%. Candidates are advised to achieve consistent practice scores above 70% to ensure success on exam day.

What core subspecialties are covered in the ABHS Orthopedics Final Written Examination?

The examination blueprint comprehensively spans adult trauma and fracture management, joint reconstruction and arthroplasty, pediatric orthopedics, spine disorders and trauma, sports medicine and arthroscopy, hand and upper extremity surgery, foot and ankle surgery, and orthopedic oncology and pathology.

How and where do candidates apply and sit for the examination?

Candidates apply through their accredited residency training program director and local national Arab Board council across Arab League member countries. The exam is administered at designated regional computer-based testing centers or official examination halls.

100+ Free Arab Board Orthopedic Surgery Final Practice Questions

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