100+ Free Facharzt FMH Orthopädische Chirurgie Practice Questions

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2026 Statistics

Key Facts: Facharzt FMH Orthopädische Chirurgie Exam

Swiss Orthopaedics / SIWF

Exam Body

Swiss Orthopaedics Society

5 parts (Basis + 3 Zwischen + Schluss)

Exam Format

SIWF Weiterbildungsprogramm 4.4

CHF 3'860

Total Exam Fees

SIWF / Swiss Orthopaedics / basisexamen.ch

EN written; DE/FR/IT oral

Exam Languages

SIWF Weiterbildungsprogramm 4.5.5

6 Years

Residency Duration

SIWF Orthopädie Curriculum

100

Practice Bank Items

OpenExamPrep

The Facharzt FMH Orthopädische Chirurgie certifies orthopaedic surgeons for independent surgical practice throughout Switzerland. Certification involves a 6-year residency, surgical logbook, and passing modular exams: Basisexamen Chirurgie, Zwischenprüfungen (Anatomie CHF 1'650, Kinder/Tumore CHF 370), and final Schlussprüfung (Teil 1 written CHF 550, Teil 2 oral CHF 690). This bank provides 100 high-yield English-language MCQ practice items covering arthroplasty, AO trauma, spine, sports, and oncology. Note: This is an English MCQ study adaptation, not an official exam simulation or clinical substitute.

Sample Facharzt FMH Orthopädische Chirurgie Practice Questions

Try these sample questions to test your Facharzt FMH Orthopädische Chirurgie exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 68-year-old female undergoes primary Total Hip Arthroplasty (THA) for severe end-stage primary osteoarthritis. According to the classic Lewinnek safe zone and modern spinopelvic principles, what radiographic orientation of the acetabular cup minimizes the risk of prosthetic impingement, edge loading, and anterior/posterior dislocation in a patient with normal sagittal pelvic mobility?

A.Acetabular cup inclination of 40° ± 10° and anteversion of 15° ± 10° relative to the anterior pelvic plane.

B.Acetabular cup inclination of 20° ± 5° and anteversion of 5° ± 5° relative to the coronal plane.

C.Acetabular cup inclination of 55° ± 5° and retroversion of 10° ± 5° relative to the transverse axis.

D.Acetabular cup inclination of 65° ± 10° and anteversion of 35° ± 5° relative to the sagittal plane.

Explanation: The classic Lewinnek safe zone defines the target radiographic orientation for the acetabular component as an inclination (abduction) angle of 40° ± 10° (30°–50°) and an anteversion angle of 15° ± 10° (5°–25°). Positioning within these parameters optimizes the range of motion before component-on-component or bone-on-bone impingement occurs, reducing edge loading, wear rates, and instability.

2An orthopaedic surgeon performs a primary total hip arthroplasty via the Direct Anterior Approach (DAA / Hueter approach). Which intermuscular and internervous interval is developed during superficial dissection, and which neural structure is most at risk for traction injury or transection?

A.Interval between Gluteus Medius (superior gluteal nerve) and Vastus Lateralis (femoral nerve); Femoral nerve main trunk.

B.Interval between Tensor Fasciae Latae (superior gluteal nerve) and Sartorius (femoral nerve); Lateral Femoral Cutaneous Nerve (LFCN).

C.Interval between Gluteus Maximus (inferior gluteal nerve) and Piriformis (sacral plexus); Sciatic nerve.

D.Interval between Rectus Femoris (femoral nerve) and Pectineus (obturator nerve); Anterior division of the obturator nerve.

Explanation: The Direct Anterior Approach (Hueter approach) exploits the true internervous and intermuscular plane between the Tensor Fasciae Latae (innervated by the superior gluteal nerve laterally) and the Sartorius (innervated by the femoral nerve medially). The lateral femoral cutaneous nerve (LFCN) passes subfascially near the anterior superior iliac spine and divides into branching arborizations over the sartorius fascia, making it highly susceptible to neuropraxia, laceration, or inclusion in fascial closure.

3During a posterolateral approach (Moore/Southern) for total hip arthroplasty, the surgeon detaches the short external rotators from their femoral insertion. Which anatomical structures must be carefully identified, mobilized, and repaired at closure to restore posterior joint stability and protect the sciatic nerve?

A.Iliopsoas tendon and pectineus muscle; repaired to the anterior capsule.

B.Tensor fasciae latae and sartorius fascia; repaired to the anterior superior iliac spine.

C.Piriformis and obturator internus with conjoint gemelli tendons together with the posterior capsule; transosseously repaired to the greater trochanter.

D.Quadratus femoris and gluteus medius anterior third; reattached to the lesser trochanter.

Explanation: In the posterolateral approach, the piriformis, obturator internus, and superior/inferior gemelli tendons are tagged and detached near their trochanteric insertion along with a posterior capsulotomy. Anatomical transosseous reattachment of the posterior capsule and short external rotator sleeve at closure substantially reduces the dislocation rate to levels comparable to anterior approaches while providing a soft-tissue buffer over the sciatic nerve.

4A 72-year-old male undergoes primary THA via a direct lateral transgluteal approach (Hardinge). Postoperatively, he exhibits a persistent Trendelenburg limp with lateral pelvic drop when standing on the operative extremity. Injury to which nerve during proximal dissection of the gluteus medius is the primary cause of this deficit?

A.Femoral nerve supplying the rectus femoris and vastus medialis.

B.Inferior gluteal nerve supplying the gluteus maximus.

C.Sciatic nerve descending over the quadratus femoris.

D.Superior gluteal nerve branching into the anterior gluteus medius and tensor fasciae latae.

Explanation: The superior gluteal nerve emerges from the greater sciatic foramen above the piriformis and courses between the gluteus medius and minimus, typically branching 3 to 5 cm proximal to the tip of the greater trochanter. Extending the longitudinal split of the gluteus medius more than 3–5 cm cranial to the trochanter denervates the anterior portions of the gluteus medius, minimus, and tensor fasciae latae, resulting in abductor insufficiency and a positive Trendelenburg sign.

5During total hip arthroplasty reconstruction, a surgeon chooses a prosthetic femoral stem that significantly under-restores the patient's native femoral offset (i.e. reduces offset by 12 mm). What biomechanical and clinical alterations are produced by this decreased femoral offset?

A.Shortened abductor moment arm, increased abductor muscle force required for pelvic stability, elevated joint reaction force, and increased risk of bony impingement.

B.Elongated abductor moment arm, decreased joint reaction force, increased lateral soft tissue tension, and reduced range of motion.

C.Increased femoral neck-shaft angle, excessive abductor muscle tension leading to trochanteric bursitis, and complete elimination of dislocation risk.

D.Neutralization of the joint center of rotation with complete prevention of polyethylene wear and elimination of limp.

Explanation: Femoral offset is the perpendicular distance between the center of rotation of the femoral head and the longitudinal axis of the femoral shaft. Decreasing femoral offset shortens the abductor muscle lever arm, which forces the abductor musculature to generate greater contractile tension to maintain coronal pelvic balance, thereby increasing the net hip joint reaction force, promoting abductor fatigue/limp, and increasing the risk of bony impingement between the pelvis and proximal femur.

6When templating and intraoperatively measuring leg length discrepancy (LLD) during primary total hip arthroplasty, which radiographic reference landmark on an anteroposterior pelvic radiograph provides the most reliable fixed anatomical reference line to assess vertical limb restoration?

A.The superior border of the iliac crests bilaterally.

B.The inter-teardrop line connecting the inferior margins of the acetabular teardrops.

C.The line connecting the tips of the greater trochanters.

D.The line tangent to the lower margins of the sacroiliac joints.

Explanation: The inter-teardrop line (connecting the inferior aspects of the radiographic acetabular teardrops) represents the most reliable, fixed pelvic reference axis because the teardrop is situated close to the hip joint center and is minimally affected by pelvic rotation or tilt. Measuring the perpendicular distance from this line to the lesser trochanter before and after implantation allows precise quantification of leg length restoration.

7A 54-year-old active male who received a ceramic-on-ceramic (CoC) bearing total hip arthroplasty presents 3 years postoperatively complaining of an audible, high-pitched 'squeaking' sound during deep hip flexion and stair climbing. Radiographs show acetabular cup inclination of 58° and anteversion of 28°. What is the primary underlying tribological mechanism of this squeaking phenomenon?

A.Catastrophic ceramic liner fracture with intra-articular fragmentation creating third-body abrasive wear.

B.Severe polyethylene oxidation due to gamma irradiation in air generating delamination.

C.Corrosion at the femoral head-neck taper junction (trunnionosis) releasing cobalt-chromium microparticles.

D.Micro-separation and edge-loading causing fluid film lubrication breakdown, stripe wear, and resonant ceramic vibration.

Explanation: Squeaking in ceramic-on-ceramic total hip bearings is primarily triggered by micro-separation and edge loading due to component malposition (e.g. steep cup inclination > 50° or excessive anteversion). This disrupts fluid-film lubrication, creating high friction, focal stripe wear on the ceramic surface, and stick-slip friction that induces high-frequency acoustic resonance across the femoral stem and acetabular shell.

8A 28-year-old professional football player presents with progressive groin pain aggravated by hip flexion and internal rotation (positive FADIR test). Radial sequence MRI of the hip reveals an aspherical femoral head-neck junction with loss of femoral head-neck offset anterosuperiorly and an alpha angle of 68° on the Dunn 45° view, alongside an anterosuperior acetabular labral tear and chondral delamination. What is the diagnosis and the primary surgical objective?

A.Pincer femoroacetabular impingement; treated with circumferential acetabular labral resection without bony modification.

B.Developmental hip dysplasia (DDH); treated with an emergency Ganz periacetabular osteotomy (PAO).

C.Cam femoroacetabular impingement; treated with arthroscopic osteochondroplasty (cam resection) restoring head-neck offset and labral repair.

D.Avascular necrosis of the femoral head (Ficat Stage IV); treated with total hip arthroplasty.

Explanation: The clinical presentation (groin pain in flexion/internal rotation), elevated alpha angle (> 55°), aspherical femoral head-neck junction ('pistol-grip' deformity), and anterosuperior chondral delamination are classic for Cam-type femoroacetabular impingement (FAI). Arthroscopic or open surgical treatment aims to resect the bony prominence (cam osteochondroplasty) to restore the femoral head-neck concavity and repair/refix the acetabular labrum.

9A 32-year-old female presents with activity-related anterior hip pain. Anteroposterior pelvic radiography reveals a positive 'crossover sign' (anterior acetabular wall projecting lateral to the posterior wall in the superior half of the acetabulum), a prominent ischial spine sign, and a lateral center-edge angle (LCEA) of 42°. Which form of femoroacetabular impingement is characterized by these radiographic findings?

A.Isolated Cam impingement secondary to proximal femoral epiphysiolysis remodeling.

B.Femoral neck retroversion with posterior extra-articular ischiofemoral impingement.

C.Generalized acetabular dysplasia with severe posterior wall deficiency.

D.Acetabular retroversion causing focal anterior Pincer impingement.

Explanation: A positive crossover sign (where the anterior acetabular rim crosses lateral to the posterior rim superiorly), an ischial spine sign (ischial spine projecting into the pelvic cavity), and an elevated lateral center-edge angle (> 40°) signify cranial acetabular retroversion and focal anterior over-coverage, which produces Pincer-type femoroacetabular impingement.

10A 38-year-old male with a history of systemic corticosteroid therapy for glomerulonephritis presents with deep left hip pain. Plain radiographs show patchy sclerosis and small subchondral cystic change in the anterosuperior femoral head with a perfectly preserved spherical contour and no crescent sign, and MRI demonstrates a distinct serpentinous low-signal band on T1-weighted images demarcating the same region, with a 'double-line sign' on T2-weighted sequences and no femoral head flattening. Under the Steinberg (University of Pennsylvania) classification, what is the stage of this avascular necrosis (AVN), and what joint-preserving surgical intervention is indicated?

A.Steinberg Stage 0; observation and immediate unrestricted weight bearing.

B.Steinberg Stage IV (subchondral collapse / crescent sign); immediate total hip arthroplasty.

C.Steinberg Stage VI (advanced degenerative joint disease); rotational femoral osteotomy.

D.Steinberg Stage II (pre-collapse); core decompression with or without biological adjuncts / bone marrow aspirate concentrate.

Explanation: Steinberg Stage II is pre-collapse osteonecrosis in which the plain radiograph has become abnormal — sclerotic and/or cystic change — while the femoral head remains spherical with no subchondral fracture. Stage I is the radiographically occult stage, abnormal only on MRI or bone scan. In young patients with pre-collapse disease and no crescent sign, core decompression reduces intraosseous pressure, promotes neo-vascularization, and halts progression in a high proportion of cases.

About the Facharzt FMH Orthopädische Chirurgie Exam

The Facharzt FMH für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates is the official postgraduate medical specialist qualification in Switzerland certifying surgeons for independent practice in orthopaedic surgery and musculoskeletal traumatology. Governed by the SIWF and Swiss Orthopaedics, obtaining the title requires completing 6 years of residency training, documenting operative case volumes in the SIWF e-Logbook, and passing the modular examination sequence: the Basisexamen Chirurgie, the practical intermediate examinations (Anatomie und Zugangswege, Kinderorthopädie & Tumore), and the final Schlussprüfung (Teil 1 written MCQs and Teil 2 oral-practical cases). Note on study adaptation: This question bank is an independent English-language MCQ practice resource created by OpenExamPrep—not an official release of Swiss Orthopaedics or SIWF—designed to reinforce core theoretical, diagnostic, biomechanical, and operative decision-making knowledge.

Assessment

Modular five-stage qualification (Weiterbildungsprogramm 4.4): (1) Basisexamen Chirurgie — a written common-trunk surgical examination run and marked by the fmCh, and a precondition for every later part; (2) Zwischenprüfung Anatomie und orthopädische Zugangswege — the candidate demonstrates two orthopaedic-traumatological approaches on a specimen plus examiner questions across the whole of anatomy, 1–2 hours; (3) Zwischenprüfung Tumoren des Bewegungsapparates — online, 6 clinical cases, 1–2 hours; (4) Zwischenprüfung Kinderorthopädie — online, 6 clinical cases, 1–2 hours; (5) Schlussprüfung Teil 1 (approx. 150 MCQs in 4 hours) followed by Teil 2, an oral interview on two orthopaedic and two traumatology cases worked through from the patient record and imaging. The written examinations are held in English; the oral examinations are held in German, French or Italian, and in English with the candidate's agreement.

Time Limit

Schlussprüfung Teil 1: approx. 150 MCQs in 4 hours | each Zwischenprüfung: 1–2 hours | Schlussprüfung Teil 2 (oral case interview): duration not published

Passing Score

Every part is graded «bestanden» / «nicht bestanden»; the specialist examination counts as passed only when all parts have been passed. Swiss Orthopaedics does not publish a numeric cut score for any part.

Exam Fee

Basisexamen Chirurgie CHF 600 (fmCh), Zwischenprüfung Anatomie und orthopädische Zugangswege CHF 1'650, online Zwischenprüfungen Kinderorthopädie & Tumore des Bewegungsapparates CHF 370, Schlussprüfung Teil 1 (written) CHF 550, Schlussprüfung Teil 2 (oral) CHF 690 — CHF 3'860 across the whole pathway, plus the SIWF title fee (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) & Swiss Orthopaedics (Schweizerische Gesellschaft für Orthopädie und Traumatologie))

Facharzt FMH Orthopädische Chirurgie Exam Content Outline

25%

Lower Extremity, Hip & Knee Arthroplasty and Joint Reconstruction

Total hip arthroplasty approaches (direct anterior, posterior, direct lateral), component alignment (Lewinnek safe zone, functional spinopelvic positioning), offset and leg length restoration, bearing tribology (ceramic, polyethylene), femoroacetabular impingement (cam/pincer), avascular necrosis (Steinberg classification), total knee alignment (mechanical vs kinematic), gap balancing, unicompartmental knee arthroplasty, ACL/PCL/multiligament reconstructions, meniscal repair and root tears, and periprosthetic joint infection (MSIS/ICM criteria, DAIR vs revision).

20%

Upper Extremity, Shoulder & Elbow Surgery

Rotator cuff tear evaluation (Patte, Goutallier), repair biomechanics (margin convergence), massive irreparable cuff management (tendon transfer, superior capsular reconstruction), reverse total shoulder arthroplasty (Grammont principles), anatomic shoulder arthroplasty, anterior shoulder instability (on/off-track Hill-Sachs, Latarjet), posterior instability, adhesive capsulitis, calcific tendinitis, distal biceps repair, terrible triad of the elbow, carpal tunnel variations, distal radius fixation (volar locking plates), and scaphoid nonunion.

20%

Musculoskeletal Traumatology & Fracture Management (AO Principles)

AO/OTA classification, Perren's strain theory (absolute vs relative stability), polytrauma damage control orthopaedics (DCO vs ETC), open fracture management (Gustilo-Anderson), acute compartment syndrome (delta pressure <= 30 mmHg, 2-incision 4-compartment fasciotomy), proximal femur fractures (Pauwels/Garden, cephalomedullary nailing vs DHS vs arthroplasty), tibial plateau fractures, suprapatellar tibial nailing, staged pilon protocols, pelvic ring injuries (pelvic binder, preperitoneal packing), acetabular fractures (Judet-Letournel), and nonunions.

15%

Spine Surgery, Spinal Pathology & Deformity

Lumbar disc herniation (traversing vs exiting root compression), lumbar spinal stenosis and neurogenic claudication, cauda equina syndrome emergent decompression, cervical spondylotic myelopathy (upper motor neuron signs, mJOA), cervical radiculopathy, spondylolisthesis (Meyerding, isthmic vs degenerative), spinopelvic sagittal alignment (PI-LL mismatch), cervical facet dislocations, odontoid fractures, Jefferson C1 burst fracture, thoracolumbar trauma (TLICS score), and spondylodiscitis.

10%

Foot & Ankle Surgery

Hallux valgus correction (Chevron vs Scarf vs Lapidus), hallux rigidus (cheilectomy vs MTP arthrodesis), posterior tibial tendon dysfunction / flatfoot (Myerson stages, FDL transfer + calcaneal osteotomy), cavovarus foot (Coleman block test), total ankle replacement vs arthrodesis, acute Achilles tendon rupture, chronic lateral ankle instability (Broström-Gould repair), and Lisfranc fracture-dislocation.

10%

Pediatric Orthopaedics, Musculoskeletal Oncology & Basic Science

Developmental dysplasia of the hip (Graf ultrasound, Pavlik harness), slipped capital femoral epiphysis (in situ single screw), Legg-Calvé-Perthes disease (Herring lateral pillar), clubfoot (Ponseti method), pediatric physeal fractures (Salter-Harris classification), osteosarcoma (chemotherapy + wide limb-salvage resection), Ewing sarcoma (t(11;22)), chondrosarcoma, giant cell tumor of bone (RANKL, Denosumab), and bone healing biology.

How to Pass the Facharzt FMH Orthopädische Chirurgie Exam

What You Need to Know

Passing score: Every part is graded «bestanden» / «nicht bestanden»; the specialist examination counts as passed only when all parts have been passed. Swiss Orthopaedics does not publish a numeric cut score for any part.
Assessment: Modular five-stage qualification (Weiterbildungsprogramm 4.4): (1) Basisexamen Chirurgie — a written common-trunk surgical examination run and marked by the fmCh, and a precondition for every later part; (2) Zwischenprüfung Anatomie und orthopädische Zugangswege — the candidate demonstrates two orthopaedic-traumatological approaches on a specimen plus examiner questions across the whole of anatomy, 1–2 hours; (3) Zwischenprüfung Tumoren des Bewegungsapparates — online, 6 clinical cases, 1–2 hours; (4) Zwischenprüfung Kinderorthopädie — online, 6 clinical cases, 1–2 hours; (5) Schlussprüfung Teil 1 (approx. 150 MCQs in 4 hours) followed by Teil 2, an oral interview on two orthopaedic and two traumatology cases worked through from the patient record and imaging. The written examinations are held in English; the oral examinations are held in German, French or Italian, and in English with the candidate's agreement.
Time limit: Schlussprüfung Teil 1: approx. 150 MCQs in 4 hours | each Zwischenprüfung: 1–2 hours | Schlussprüfung Teil 2 (oral case interview): duration not published
Exam fee: Basisexamen Chirurgie CHF 600 (fmCh), Zwischenprüfung Anatomie und orthopädische Zugangswege CHF 1'650, online Zwischenprüfungen Kinderorthopädie & Tumore des Bewegungsapparates CHF 370, Schlussprüfung Teil 1 (written) CHF 550, Schlussprüfung Teil 2 (oral) CHF 690 — CHF 3'860 across the whole pathway, plus the SIWF title fee

Keys to Passing

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Facharzt FMH Orthopädische Chirurgie Study Tips from Top Performers

1Master AO Fracture Principles & Biomechanics: Understand absolute vs relative stability, contact vs gap healing, strain theory thresholds (<2% for absolute, 2-10% for relative), and implant mechanics (locking plates, cephalomedullary nails).

2Internalize Arthroplasty Positioning & Tribology: Know the Lewinnek safe zone and functional spinopelvic positioning for THA, gap balancing vs measured resection in TKA, and Grammont principles in reverse shoulder arthroplasty.

3Review Spinal Alignment & Trauma Classifications: Practice calculating pelvic incidence, pelvic tilt, and sacral slope (PI = PT + SS), know PI-LL mismatch targets (<10°), and memorize TLICS and Subaxial AO Spine fracture classifications.

4Consolidate Pediatric Orthopaedic Milestones: Memorize Graf ultrasound types for DDH, Pavlik harness criteria, SCFE Drehmann sign and in situ single-screw fixation principles, and Ponseti clubfoot correction sequences.

Frequently Asked Questions

What is the Facharzt FMH für Orthopädische Chirurgie qualification?

The Facharzt FMH für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates is the federally accredited surgical specialist title in Switzerland awarded by SIWF/FMH in partnership with Swiss Orthopaedics. It authorizes independent practice in orthopaedic surgery and musculoskeletal traumatology in hospital and private practice settings. Note: This question bank is an English-language MCQ study adaptation—not an official translation, not a simulation of the oral/practical viva format, and not a substitute for surgical logbook or hands-on clinical residency training.

What are the required examination components and their fees?

The Weiterbildungsprogramm defines five components. (1) Basisexamen Chirurgie — the written common-trunk surgical examination, run by the fmCh rather than by Swiss Orthopaedics, CHF 600. (2) Zwischenprüfung Anatomie und orthopädische Zugangswege — demonstration of two orthopaedic-traumatological approaches on a specimen plus examiner questions across anatomy, 1–2 hours at the SFITS in Geneva, CHF 1'650. (3) and (4) Zwischenprüfungen Tumoren des Bewegungsapparates and Kinderorthopädie — two separate online examinations of 6 clinical cases each, 1–2 hours, currently sat online for a combined CHF 370. (5) Schlussprüfung Teil 1, approximately 150 multiple-choice questions in 4 hours (CHF 550), followed by Teil 2, an oral interview on two orthopaedic and two traumatology cases (CHF 690). The pathway therefore costs CHF 3'860 in examination fees alone.

In what languages are the official Swiss Orthopaedics examinations conducted?

The languages differ by format, which surprises many candidates. Under Weiterbildungsprogramm 4.5.5 the written examinations are conducted in English — that includes the Basisexamen Chirurgie and the Schlussprüfung Teil 1. The oral examinations may be taken in German, French or Italian, and in English if the candidate agrees.

What are the passing standards for the Swiss Orthopaedics examinations?

No numeric cut score is published for any component. Weiterbildungsprogramm 4.6 states only that every part is graded «bestanden» or «nicht bestanden» and that the specialist examination counts as passed once all parts have been passed. Do not rely on a percentage figure quoted by a third-party preparation site.

What clinical and surgical domains are covered in this practice bank?

The practice bank covers 6 core syllabus areas: Lower Extremity & Arthroplasty (25%), Upper Extremity & Shoulder/Elbow Surgery (20%), Musculoskeletal Traumatology & AO Principles (20%), Spine Surgery & Deformity (15%), Foot & Ankle Surgery (10%), and Pediatric Orthopaedics, Musculoskeletal Oncology & Basic Science (10%).

100+ Free Facharzt FMH Orthopädische Chirurgie Practice Questions

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