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100+ Free Examen Estatal de Ortopedia y Traumatología Practice Questions

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Sample Examen Estatal de Ortopedia y Traumatología Practice Questions

Try these sample questions to test your Examen Estatal de Ortopedia y Traumatología 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 cyclist falls directly onto his shoulder and sustains a closed midshaft clavicle fracture. Examination reveals 2.5 cm of shortening, 100% displacement, and prominent skin tenting with blanching over the distal fragment. Which management plan is indicated according to current surgical guidelines?
A.Application of a figure-of-eight bandage for 6 weeks with progressive pendular exercises
B.Urgent open reduction and internal fixation with a precontoured superior or anteroinferior plate
C.Immediate closed reduction and placement of a shoulder spica cast
D.Percutaneous pinning using smooth unthreaded Steinmann pins exiting through the back
Explanation: Skin tenting with blanching carries an imminent risk of skin necrosis and conversion of a closed fracture into an open fracture, which represents a clear absolute indication for surgical intervention. Significant shortening (>2 cm) and 100% displacement in an active adult are also strong relative indications for plate osteosynthesis to avoid malunion, nonunion, and shoulder girdle dysfunction.
2A 22-year-old athlete suffers an anterior glenohumeral dislocation during a contact sport. The arm is held in slight abduction and external rotation with flattening of the normal deltoid contour (epaulet sign). Before and after successful closed reduction, which neurovascular structure requires primary clinical assessment?
A.Axillary nerve, by evaluating cutaneous sensation over the lateral shoulder ('regimental badge' area)
B.Radial nerve, by testing sensation in the first dorsal web space and active wrist extension
C.Musculocutaneous nerve, by assessing elbow flexion strength against resistance
D.Suprascapular nerve, by testing resisted external rotation in neutral
Explanation: The axillary nerve winds around the surgical neck of the humerus in intimate proximity to the inferior glenohumeral joint capsule, making it the most vulnerable structure during anterior dislocation (occurring in up to 10-15% of cases). Clinical assessment is performed by evaluating sensation over the lateral deltoid ('regimental badge' area) and assessing isometric deltoid contraction.
3A 36-year-old man presents to the emergency department after a generalized tonic-clonic epileptic seizure. He complains of severe shoulder pain. On physical examination, the arm is locked in adduction and internal rotation, with completely absent external rotation. The standard AP radiograph demonstrates a symmetrical humeral head ('lightbulb sign'). What is the diagnosis?
A.Anterior glenohumeral dislocation
B.Subscapularis tendon complete rupture
C.Posterior glenohumeral dislocation
D.Acromioclavicular joint separation Grade III
Explanation: Posterior shoulder dislocations are classically associated with violent muscle contractions (epileptic seizures or high-voltage electrical shock), where the internal rotators (latissimus dorsi, pectoralis major, subscapularis) overpower the external rotators. Inability to externally rotate the humerus combined with the 'lightbulb sign' (fixed internal rotation making the humeral head appear circular on AP view) is diagnostic, requiring axillary lateral or scapular Y views for definitive confirmation.
4A 70-year-old woman sustains a four-part proximal humerus fracture with severe displacement of both tuberosities and the articular head segment. In surgical planning, which vascular pedicle represents the primary blood supply to the humeral head whose disruption poses the highest risk of avascular necrosis?
A.Nutrient artery entering the middle third of the humeral shaft diaphysis
B.Thoracoacromial artery through its deltoid and acromial branches
C.Suprascapular artery via collateral anastomosis at the neck
D.Ascending branch of the anterior humeral circumflex artery (arcuate artery of Laing) and the posterior humeral circumflex artery
Explanation: The blood supply of the humeral head is predominantly provided by the ascending anterolateral branch of the anterior humeral circumflex artery (arcuate artery of Laing) entering via the bicipital groove, together with substantial contributions from the posterior humeral circumflex artery through posteromedial periosteal vessels. In four-part fractures where the articular head is dissociated from the tuberosities and calcar, these vessels are torn, resulting in avascular necrosis rates exceeding 30-50%.
5A 44-year-old male sustains a closed, spiral fracture of the distal third of the humeral shaft (Holstein-Lewis fracture). On initial examination, he exhibits a complete wrist drop, inability to extend his metacarpophalangeal joints, and numbness over the dorsal first web space. What is the standard initial management of this primary nerve palsy in a closed injury?
A.Observation with functional bracing (Sarmiento) or closed reduction, as over 80-90% of primary radial nerve palsies are neuropraxias that resolve spontaneously
B.Emergency open exploratory surgery within 6 hours to decompress and repair the radial nerve
C.Immediate radial nerve transposition to the anterior compartment under regional anesthesia
D.Immediate tendon transfers (pronator teres to ECRB, FCR to EDC) within 48 hours
Explanation: Primary radial nerve palsy associated with closed humeral shaft fractures (including Holstein-Lewis fractures) represents a neuropraxia or axonotmesis in over 85% of cases. Cuban and international orthopedic consensus recommends non-operative fracture management (or appropriate internal fixation if unstable) and clinical/electrodiagnostic observation for 3 to 4 months; surgical nerve exploration is reserved for secondary palsy developing after closed reduction, open fractures, or failure of spontaneous recovery after 3-4 months.
6A 6-year-old boy falls from playground equipment and sustains a completely displaced extension-type supracondylar humerus fracture (Gartland Type III). On physical examination, the radial pulse is strong and palpable. When asked to make an 'OK' sign, he touches the tips of his thumb and index finger flatly (pad-to-pad) rather than tip-to-tip, with inability to flex the distal phalanx of the index finger. Which nerve branch is affected?
A.Ulnar nerve motor branch to the first dorsal interosseous
B.Anterior interosseous nerve (AIN), motor branch of the median nerve
C.Posterior interosseous nerve (PIN), branch of the radial nerve
D.Superficial sensory branch of the radial nerve
Explanation: The anterior interosseous nerve (AIN) is a pure motor branch of the median nerve that innervates the flexor pollicis longus (FPL), flexor digitorum profundus (FDP) to the index finger, and pronator quadratus. In extension-type supracondylar fractures where the proximal metaphyseal spike displaces anteriorly, the median nerve and specifically the AIN are stretched over the bone edge, preventing tip-to-tip pinch ('OK' sign).
7During closed reduction and percutaneous Kirschner wire fixation of an unstable Gartland Type III supracondylar humerus fracture in a 7-year-old child, what pinning technique provides adequate biomechanical stability while minimizing the risk of iatrogenic nerve injury?
A.Placement of a single large 2.5 mm central intramedullary Steinmann pin
B.Insertion of two medial pins angled strictly anteriorly to penetrate the capitellum
C.Two or three lateral divergent Kirschner wires engaging the medial cortex above the fracture
D.Cross-pinning with entry of the medial wire without elbow extension or palpatory protection of the cubital tunnel
Explanation: Lateral divergent Kirschner wires (with pins engaging the far cortex and spaced at the fracture line) provide rotational stability comparable to cross-pinning while completely eliminating the 4-8% risk of iatrogenic ulnar nerve injury associated with medial pin placement. If a medial pin is deemed necessary for severe torsional instability, it must be placed with the elbow extended and the ulnar nerve palpated or directly visualized via a mini-open incision.
8A 28-year-old construction worker falls onto his outstretched hand and sustains a high-energy 'terrible triad' injury of the elbow. Which combination of injuries constitutes this severe, highly unstable elbow pattern?
A.Posterior elbow dislocation, radial head fracture, and coronoid process fracture
B.Anterior elbow dislocation, olecranon fracture, and capitellar shear fracture
C.Medial elbow dislocation, medial epicondyle avulsion, and triceps rupture
D.Posterolateral elbow dislocation, distal humerus intercondylar fracture, and biceps tendon avulsion
Explanation: The 'terrible triad' of the elbow, originally coined by Hotchkiss, consists of: (1) posterior glenohumeral/ulnohumeral dislocation, (2) radial head fracture, and (3) coronoid process fracture (typically involving the tip or anteromedial facet), accompanied by rupture of the lateral collateral ligament (LCL) complex. It requires systematic surgical reconstruction of the coronoid, radial head (repair or arthroplasty), and LCL repair to restore stability.
9A 24-year-old rugby player sustains a Monteggia fracture-dislocation (Bado Type I: fracture of the proximal third of the ulna with anterior dislocation of the radial head). Which peripheral nerve branch is most commonly compromised by traction or direct contusion in this injury?
A.Superficial branch of the radial nerve
B.Anterior interosseous nerve
C.Recurrent motor branch of the median nerve
D.Posterior interosseous nerve (deep branch of the radial nerve)
Explanation: In Monteggia fracture-dislocations, particularly Bado Type I with anterior radial head displacement, the posterior interosseous nerve (PIN) as it enters the arcade of Frohse into the supinator muscle is directly stretched or compressed over the displaced radial head. This results in weakness of finger and thumb extension at the MCP joints and wrist extension with radial deviation, while sensation remains intact.
10A 35-year-old motor vehicle operator sustains a Galeazzi fracture-dislocation. Which anatomical injury components define this injury, and what is the primary surgical doctrine for achieving stability in adult patients?
A.Fracture of the proximal third of the radius with proximal radioulnar joint dislocation; managed by closed intramedullary Rush pin
B.Fracture of the distal third of the radius with dislocation or instability of the distal radioulnar joint (DRUJ); managed by rigid anatomic plate fixation of the radius
C.Fracture of the middle third of the ulna with triangular fibrocartilage complex tear; managed by sugar-tong splint immobilization
D.Isolated distal radial metaphyseal fracture with intact DRUJ; managed by percutaneous Kirschner wires
Explanation: A Galeazzi fracture-dislocation consists of a fracture of the shaft of the radius (most commonly at the junction of the middle and distal thirds) associated with disruption/subluxation of the distal radioulnar joint (DRUJ). Non-operative management fails in over 90% of adults due to deforming muscular forces (pronator quadratus, brachioradialis). Standard management requires open anatomical reduction and rigid compression plating (3.5 mm dynamic compression or LCDCP plate) of the radius; if the DRUJ remains unstable after radial fixation, it is pinned or immobilized in supination.

About the Examen Estatal de Ortopedia y Traumatología Exam

The Examen Estatal de la Especialidad en Ortopedia y Traumatología is the definitive credentialing milestone for postgraduate medical residents completing Cuba's 4-year national residency programme in Orthopedics and Traumatology (grounded at national centers such as the Complejo Científico Ortopédico Internacional 'Frank País'). Administered biannually under MINSAP Resolución Ministerial No. 108/2004, the exam is evaluated by external (cruzados) national or provincial tribunals and combines academic transcript scoring, thesis defense (Trabajo de Terminación de la Especialidad), and theoretical and practical clinical examinations. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice.

Assessment

The graduation evaluation (Evaluación de Graduación) consists of three mandatory components: (1) Final Academic Transcript Evaluation (Calificación Final del Expediente); (2) Thesis defense (Trabajo de Terminación de la Especialidad - TTE); and (3) Examen Estatal, comprising an Ejercicio Teórico-Práctico (direct clinical case management and surgical patient evaluation) and an Ejercicio Teórico (oral or written examination of 5 to 10 generalizing clinical questions evaluated by an external national or provincial tribunal).

Time Limit

Multi-day schedule convened twice annually (April-May and October-November)

Passing Score

70% of the marks assigned by the plan de estudios (MINSAP Res. 108/2004 Art. 116)

Exam Fee

There is no candidate sitting fee for Cuban nationals (postgraduate medical residency in Cuba is state-funded and salaried). Self-financed international residents pay tuition through Servicios Médicos Cubanos (SMC), which covers all examinations including the final state exam. (Ministerio de Salud Pública de Cuba (MINSAP) — Dirección de Docencia Médica)

Examen Estatal de Ortopedia y Traumatología Exam Content Outline

~18% of this local bank

Upper Extremity Trauma and Fractures

Shoulder girdle trauma, humeral fractures, elbow dislocations, forearm fractures, wrist and distal radius fractures, carpal and metacarpal trauma, and upper limb peripheral nerve injuries.

~22% of this local bank

Lower Extremity and Pelvic Trauma

Pelvic ring disruptions, acetabular fractures, femoral neck and pertrochanteric fractures, femoral and tibial diaphyseal fractures, knee dislocations, ankle and foot trauma, and acute compartment syndrome.

~15% of this local bank

External Fixation and the Cuban RALCA Technique

Biomechanical principles of external fixators, the RALCA system designed by Álvarez Cambras, open fracture stabilization, callotasis and distraction osteogenesis, bone transport for segmental defects, and infected nonunion management.

~15% of this local bank

Pediatric Orthopedics and Deformities

Developmental dysplasia of the hip (DDH), congenital clubfoot (Ponseti method), Legg-Calvé-Perthes disease, slipped capital femoral epiphysis (SCFE), Salter-Harris physeal fractures, and cerebral palsy gait management.

~15% of this local bank

Spine Pathology, Deformities, and Traumatology

Adolescent idiopathic scoliosis, Scheuermann kyphosis, spondylolysis and spondylolisthesis, cervical spine injuries, thoracolumbar burst fractures (TLICS), spinal cord injury assessment (ASIA), and degenerative disc diseases.

~15% of this local bank

Joint Reconstruction, Bone Tumors, and Musculoskeletal Infections

Hip and knee osteoarthritis arthroplasty, acute hematogenous osteomyelitis, chronic osteomyelitis (Cierny-Mader), septic arthritis, primary bone tumors (osteosarcoma, Ewing, giant cell tumor), and sports injuries.

How to Pass the Examen Estatal de Ortopedia y Traumatología Exam

What You Need to Know

  • Passing score: 70% of the marks assigned by the plan de estudios (MINSAP Res. 108/2004 Art. 116)
  • Assessment: The graduation evaluation (Evaluación de Graduación) consists of three mandatory components: (1) Final Academic Transcript Evaluation (Calificación Final del Expediente); (2) Thesis defense (Trabajo de Terminación de la Especialidad - TTE); and (3) Examen Estatal, comprising an Ejercicio Teórico-Práctico (direct clinical case management and surgical patient evaluation) and an Ejercicio Teórico (oral or written examination of 5 to 10 generalizing clinical questions evaluated by an external national or provincial tribunal).
  • Time limit: Multi-day schedule convened twice annually (April-May and October-November)
  • Exam fee: There is no candidate sitting fee for Cuban nationals (postgraduate medical residency in Cuba is state-funded and salaried). Self-financed international residents pay tuition through Servicios Médicos Cubanos (SMC), which covers all examinations including the final state exam.

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

Examen Estatal de Ortopedia y Traumatología Study Tips from Top Performers

1Review the clinical guidelines and surgical doctrines published by the Sociedad Cubana de Ortopedia y Traumatología (SCOT) and the Revista Cubana de Ortopedia y Traumatología.
2Master the principles, indications, and mounting techniques of the Cuban RALCA external fixator system developed by Prof. Rodrigo Álvarez Cambras at CCOI Frank País.
3Thoroughly understand pediatric orthopedic screening protocols under the Programa de Atención Materno Infantil (PAMI), including neonatal hip ultrasound and early Ponseti clubfoot casting.
4Consolidate emergency trauma algorithms: damage control orthopedics, pelvic binder stabilization, immediate compartment syndrome fasciotomies, and open fracture classification and debridement.

Frequently Asked Questions

What is the official structure of the Cuban Examen Estatal in Orthopedics and Traumatology?

Under MINSAP Resolución Ministerial No. 108/2004 (Capítulo VI, Arts. 115-118), the evaluation of graduation consists of three components: (1) Final Academic Transcript Evaluation (Expediente); (2) Evaluation of the Trabajo de Terminación de la Especialidad (TTE thesis and oral defense); and (3) The Examen Estatal itself, which includes a clinical practical examination (ejercicio teórico-práctico) managing patients and demonstrating operative judgment in orthopedic surgery, and a theoretical examination (ejercicio teórico) consisting of 5 to 10 generalizing questions. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice.

What is the passing score for the Examen Estatal in Cuba?

According to Article 116 of MINSAP Resolution 108/2004, every component (academic record, thesis defense, and practical/theoretical state examination) must be passed with a minimum score of 70% of the maximum marks allocated by the Plan de Estudios. Failing any component requires repeating that evaluation in its entirety, with a maximum attainable mark of 70% upon re-examination (Art. 121).

When and how are the tribunals convened?

Under Article 109 of Resolution 108/2004, state examinations are convened twice annually in April-May and October-November. The tribunals (Tribunales Estatales) may be provincial or national and are composed of external examiners ('tribunales cruzados') appointed by MINSAP to ensure objective, rigorous evaluation (Arts. 110-111).

What are the fees to sit the Cuban Orthopedics State Exam?

There is no candidate sitting fee for Cuban citizens, as all postgraduate medical education in Cuba is state-funded and residents receive a salary throughout their 4-year training. Self-financed international residents pay training fees via Servicios Médicos Cubanos (SMC), which encompasses all examination and degree administration costs.

Is this 100-question practice test an official MINSAP examination?

No. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice. It is designed as an educational tool to test core knowledge across all curriculum domains.