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Exam Review

Key Facts: Egyptian Board Orthopedics Exam

Law 12/2022

Governing Legislation (EHC)

Egyptian Health Council

3 Parts

Examination Stages (Part 1, 2 & Clinical OSCE)

EHC Regulations

Angoff / Hofstee

Written Standard Setting Method

EHC Assessment Framework

100 MCQs

Practice Bank Study Items

OpenExamPrep

The Egyptian Board in Orthopedic Surgery is administered by the Egyptian Health Council under Law 12/2022 and Decree 3798/2023. It comprises Part 1 (musculoskeletal anatomy, bone healing/biomechanics, biomaterials, pathology, shock resuscitation; held March/August), Part 2 (clinical trauma under AO principles, pediatric orthopedics, arthroplasty, spine, sports medicine, hand, foot/ankle, oncology; held April/September), and Part 3 (annual clinical/operative OSCE and viva; held Dec/Jan). This 100-question MCQ bank is an English-language study aid for Part 1 and Part 2 theoretical domains, focusing on surgical anatomy, classifications (AO/OTA, Gustilo-Anderson, Salter-Harris), and clinical decision-making; it is not a clinical simulation or substitute for operative training.

Sample Egyptian Board Orthopedics Practice Questions

Try these sample questions to review concepts for the Egyptian Board Orthopedics exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which of the following neural structures arises directly from the upper trunk of the brachial plexus and innervates both the supraspinatus and infraspinatus muscles?
A.Suprascapular nerve
B.Dorsal scapular nerve
C.Lateral pectoral nerve
D.Axillary nerve
Explanation: The suprascapular nerve originates directly from the superior (upper) trunk of the brachial plexus (C5-C6 ventral rami). It courses through the suprascapular notch beneath the superior transverse scapular ligament to innervate the supraspinatus and infraspinatus muscles. Entrapment at this notch causes shoulder pain and isolated weakness in abduction and external rotation.
2A neonate presents following a difficult breech delivery with shoulder adduction, internal rotation, elbow extension, forearm pronation, and wrist flexion. Which nerve roots are predominantly compromised in this condition?
A.C7 and C8 nerve roots
B.C5 and C6 nerve roots
C.C8 and T1 nerve roots
D.C6 and C7 nerve roots
Explanation: This presentation describes Erb-Duchenne palsy resulting from traction injury to the upper trunk of the brachial plexus (C5 and C6 nerve roots). Loss of the deltoid, supraspinatus, infraspinatus, biceps brachii, and brachioradialis produces the characteristic 'waiter's tip' posture. Most closed obstetric brachial plexus injuries recover spontaneously, but microsurgical reconstruction is considered if biceps function fails to return by 3 to 6 months.
3A 28-year-old rock climber falls and catches a branch with one arm, suffering hyperabduction traction. Physical exam reveals intrinsic hand muscle paralysis and ipsilateral miosis, ptosis, and anhidrosis. What is the anatomical level of the lesion?
A.Posterior cord injury
B.Upper trunk preganglionic avulsion
C.Lower trunk preganglionic avulsion
D.Medial cord postganglionic rupture
Explanation: Hyperabduction traction stresses the lower trunk (C8-T1), leading to Klumpke palsy characterized by intrinsic hand muscle clawing and sensory loss along the medial forearm and hand. The presence of Horner syndrome (miosis, ptosis, anhidrosis) confirms preganglionic avulsion of the T1 root proximal to the sympathetic chain. Preganglionic avulsions carry a poor prognosis for spontaneous recovery and cannot be repaired with primary nerve grafting.
4During surgical decompression for neurogenic thoracic outlet syndrome via a transaxillary or supraclavicular approach, which anatomical structure forms the posterior boundary of the interscalene triangle?
A.Anterior scalene muscle
B.Clavicle and subclavius
C.First thoracic rib surface
D.Middle scalene muscle
Explanation: The interscalene triangle is bounded anteriorly by the anterior scalene muscle, posteriorly by the middle scalene muscle, and inferiorly by the superior border of the first rib. The brachial plexus trunks and the subclavian artery pass through this triangle, whereas the subclavian vein passes anterior to the anterior scalene. Compression of the lower trunk (C8-T1) within this space represents the classic site for true neurogenic thoracic outlet syndrome.
5A 32-year-old male sustains a closed distal third spiral humerus fracture (Holstein-Lewis fracture) and develops wrist drop. Which anatomical relationship explains the high vulnerability of the radial nerve at this location?
A.The nerve pierces the lateral intermuscular septum
B.The nerve is tethered beneath the arcade of Frohse
C.The nerve enters the triangular space beneath teres major
D.The nerve passes through the pronator teres muscle heads
Explanation: In the distal third of the arm, approximately 7.5 to 10 cm proximal to the lateral epicondyle, the radial nerve pierces the lateral intermuscular septum to enter the anterior compartment. At this fixed tethering point, spiral fractures of the distal third humerus (Holstein-Lewis fracture) put the radial nerve at significant risk for entrapment or neuropraxia. Over 85% of closed radial nerve palsies in this setting are neuropraxias that resolve spontaneously within 3 to 4 months.
6Following a motor vehicle collision, a patient sustains a posterior hip dislocation. On examination, which sensory and motor deficit indicates injury to the division of the sciatic nerve most commonly vulnerable to traction?
A.Loss of plantar sensation and absent Achilles tendon reflex
B.Loss of first webspace sensation and weakness of ankle dorsiflexion
C.Loss of medial calf sensation and absent patellar tendon reflex
D.Loss of anterior thigh sensation and weakness of knee extension
Explanation: The common peroneal division of the sciatic nerve lies more lateral and posterior, has fewer supporting fascicles with less connective tissue, and is tethered at the fibular head. Consequently, posterior hip dislocation or posterior acetabular wall fractures disproportionately cause traction injury to the peroneal division, producing weakness in ankle/toe dorsiflexion (foot drop) and sensory loss over the first webspace and anterolateral leg.
7A 22-year-old soccer player sustains a multiligament knee injury involving the posterolateral corner and lateral collateral ligament. Which peripheral nerve is most susceptible to direct stretch injury as it wraps around the fibular neck?
A.Tibial nerve
B.Saphenous nerve
C.Common peroneal nerve
D.Deep femoral nerve
Explanation: The common peroneal nerve wraps subcutaneous and tightly around the lateral aspect of the fibular neck before bifurcating into the superficial and deep peroneal nerves. It is tethered against the unyielding periosteum, making it highly vulnerable to stretch injury during knee dislocations, varus impact, or proximal fibular fractures. Complete paralysis results in loss of ankle eversion, dorsiflexion, and dorsal foot sensation.
8A 40-year-old carpenter presents with dull proximal forearm pain and inability to make the 'OK' sign with the thumb and index finger, but with completely intact cutaneous sensation. Which nerve is compressed?
A.Posterior interosseous nerve
B.Superficial radial nerve
C.Recurrent branch of median nerve
D.Anterior interosseous nerve
Explanation: The anterior interosseous nerve (AIN) is a pure motor branch of the median nerve that innervates the flexor pollicis longus (FPL), the pronator quadratus (PQ), and the lateral half of the flexor digitorum profundus (FDP to index and middle fingers). Compression (Kiloh-Nevin syndrome) causes loss of DIP flexion of the index finger and IP flexion of the thumb, creating a flat pad-to-pad pinch rather than a tip-to-tip circle ('OK' sign), with no sensory deficit.
9During a Southern-Moore (posterior) surgical approach to the hip for total hip arthroplasty, which muscular structure is intentionally incised and subsequently repaired to protect against early postoperative posterior dislocation?
A.Short external rotators and posterior capsule
B.Tensor fasciae latae and gluteus medius
C.Pectineus and iliopsoas tendon
D.Rectus femoris and sartorius muscle
Explanation: The posterior (Southern-Moore) approach involves splitting the gluteus maximus along its muscle fibers and detaching the short external rotators (piriformis, superior gemellus, obturator internus, inferior gemellus) along with a capsulotomy close to their femoral insertion. Meticulous transosseous repair of the posterior capsule and short external rotators substantially lowers the postoperative dislocation rate from over 4% down to under 1%.
10The direct anterior approach (Smith-Petersen) to the hip exploits which true internervous and intermuscular plane superficially?
A.Between gluteus medius (superior gluteal) and piriformis (S1-S2)
B.Between sartorius (femoral nerve) and tensor fasciae latae (superior gluteal nerve)
C.Between tensor fasciae latae (superior gluteal) and vastus lateralis (femoral nerve)
D.Between rectus femoris (femoral nerve) and gluteus minimus (superior gluteal nerve)
Explanation: The direct anterior (Smith-Petersen) approach uses the superficial intermuscular and internervous plane between the sartorius (innervated by the femoral nerve) and the tensor fasciae latae (innervated by the superior gluteal nerve). Deeply, the plane lies between the rectus femoris (femoral nerve) and the gluteus medius (superior gluteal nerve). The lateral femoral cutaneous nerve runs adjacent to the sartorius and is the structure most commonly at risk.

About the Egyptian Board Orthopedics Exam

The Egyptian Board in Orthopedic Surgery (جراحة العظام) is the national postgraduate surgical qualification governed by the Egyptian Health Council (EHC), established under Law No. 12 of 2022 and Prime Ministerial Decree No. 3798 of 2023, unifying and replacing the former Egyptian Fellowship (الزمالة المصرية). The 5-year structured curriculum provides comprehensive training across trauma resuscitation, complex fracture care, arthroplasty, spine surgery, pediatric orthopedics, hand, foot/ankle, sports medicine, and musculoskeletal oncology. Important disclosure: Part Three is a dedicated clinical/operative OSCE and surgical viva examination; this 100-question multiple-choice question bank is an English-language study aid created to strengthen orthopedic clinical decision-making, classifications (such as AO/OTA, Gustilo-Anderson, and Salter-Harris), and surgical anatomy for Part One and Part Two—it is not a clinical simulation or substitute for hands-on operative training.

Exam sponsor: Egyptian Health Council (EHC) — Egyptian Board (المجلس الصحي المصري — البورد المصري). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The Egyptian Board in Orthopedic Surgery features a three-part assessment structure governed by the Egyptian Health Council (EHC): Part One is a written MCQ examination focusing on musculoskeletal basic sciences (applied surgical anatomy, bone healing biology, biomechanics, biomaterials, orthopedic pathology, and shock/trauma resuscitation) held twice yearly in March and August. Part Two is a written MCQ examination focusing on clinical orthopedic surgery (fractures and trauma under AO principles, pediatric orthopedics, adult reconstruction/arthroplasty, spine surgery, sports medicine and arthroscopy, foot and ankle, hand surgery, and musculoskeletal oncology) held twice yearly in April and September. Part Three is an annual clinical examination held in December/January consisting of OSCE stations, surgical viva voce, radiologic spotters, and clinical case presentations.

Time Limit

Varies by examination part

Passing Score

Set by psychometric standard-setting (Angoff/Hofstee method); no fixed percentage published

Exam / Certification Fees

Prescribed by Egyptian Health Council regulatory bylaws

Exam sponsor website

Reported exam pass rate: Determined by psychometric standard-setting per diet. Written examination cut scores (Part One and Part Two) are established using criterion-referenced psychometric standard-setting procedures (Angoff, Modified Angoff, or Hofstee). The Part Three clinical examination utilizes the Borderline Regression Method. There is no static passing percentage published. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

20%

Musculoskeletal Anatomy & Surgical Approaches

Cross-sectional anatomy of the upper and lower extremities, pelvis, and spine; internervous planes; neurovascular danger zones; classic surgical approaches including Henry, Thompson, Kocher, posterior hip, anterior hip, and anterolateral tibia.

20%

Bone Biology, Healing, Biomechanics & Biomaterials

Primary (direct) vs. secondary (indirect) bone healing; Perren interfragmentary strain theory; implant biomechanics (lag screws, neutralization/compression/bridging plates, intramedullary nails); biomaterials (metals, UHMWPE, ceramics, PMMA).

25%

Trauma, Polytrauma & Fracture Management (AO Principles)

Damage control orthopedics (DCO) vs. early total care (ETC); ATLS shock resuscitation; open fracture classification (Gustilo-Anderson); acute compartment syndrome diagnosis and emergent fasciotomy; pelvic ring/acetabular injuries; periarticular fracture fixation.

20%

Reconstruction, Arthroplasty & Spine Surgery

Hip and knee joint biomechanics; primary and revision total joint arthroplasty; wear debris and osteolysis; periprosthetic joint infection (MSIS/ICM criteria); cervical/thoracolumbar spine trauma (SLIC/TLICS); cauda equina syndrome; spinal stenosis.

15%

Subspecialties: Pediatrics, Hand, Foot & Ankle, Oncology & Sports Medicine

Pediatric conditions (DDH, SCFE, Perthes, Salter-Harris physeal fractures, CTEV); flexor tendon repairs and carpal tunnel syndrome; foot/ankle trauma and deformities; ligamentous/meniscal knee tears and shoulder instability; bone tumor staging.

Preparing for the Egyptian Board Orthopedics Exam

What You Need to Know

  • Passing score: Set by psychometric standard-setting (Angoff/Hofstee method); no fixed percentage published
  • Assessment: The Egyptian Board in Orthopedic Surgery features a three-part assessment structure governed by the Egyptian Health Council (EHC): Part One is a written MCQ examination focusing on musculoskeletal basic sciences (applied surgical anatomy, bone healing biology, biomechanics, biomaterials, orthopedic pathology, and shock/trauma resuscitation) held twice yearly in March and August. Part Two is a written MCQ examination focusing on clinical orthopedic surgery (fractures and trauma under AO principles, pediatric orthopedics, adult reconstruction/arthroplasty, spine surgery, sports medicine and arthroscopy, foot and ankle, hand surgery, and musculoskeletal oncology) held twice yearly in April and September. Part Three is an annual clinical examination held in December/January consisting of OSCE stations, surgical viva voce, radiologic spotters, and clinical case presentations.
  • Time limit: Varies by examination part
  • Exam / certification fees: Prescribed by Egyptian Health Council regulatory bylaws Official sources

Using Our Practice Resources

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Egyptian Board Orthopedics: Suggested Study Strategy

1Master the internervous and intermuscular planes of classic surgical approaches (e.g., Henry approach between brachioradialis and FCR, Thompson approach between ECRB and EDC, Moore posterior hip approach split of gluteus maximus).
2Thoroughly review Perren interfragmentary strain theory: know exact strain thresholds (< 2% for primary direct bone healing under absolute stability, 2–10% for secondary indirect healing under relative stability, > 10% resulting in nonunion).
3Memorize the key orthopedic classifications: Gustilo-Anderson for open fractures, Salter-Harris for physeal injuries, Garden and Pauwels for femoral neck fractures, Schatzker for tibial plateau fractures, and Young-Burgess for pelvic ring fractures.
4Understand the physiological criteria for Damage Control Orthopedics (DCO) versus Early Total Care (ETC) in polytrauma (temperature < 35°C, pH < 7.24, base deficit > -6 mmol/L, lactate > 2.5 mmol/L, coagulopathy).
5Review the International Consensus Meeting (ICM/MSIS) criteria for periprosthetic joint infection (PJI) and understand the diagnostic cutoffs for synovial fluid leukocyte count and polymorphonuclear percentage.

Frequently Asked Questions

What is the governing authority of the Egyptian Board in Orthopedic Surgery?

The Egyptian Board (البورد المصري) is governed by the Egyptian Health Council (EHC / المجلس الصحي المصري), established pursuant to Law No. 12 of 2022 and Prime Ministerial Decree No. 3798 of 2023. It unifies postgraduate medical qualification in Egypt and replaces the former Egyptian Fellowship (الزمالة المصرية).

What is the examination structure of the Egyptian Board in Orthopedic Surgery?

The board examination has three parts: Part One is a written MCQ exam covering musculoskeletal basic sciences (anatomy, biomechanics, biomaterials, pathology, resuscitation) held twice yearly in March and August. Part Two is a written MCQ exam covering clinical orthopedic surgery and subspecialties held twice yearly in April and September. Part Three is an annual clinical examination held in December/January comprising OSCE stations, surgical viva voce, radiologic spotters, and clinical cases.

What is the passing score for the written examinations?

There is no fixed published percentage pass mark. The Egyptian Health Council employs criterion-referenced psychometric standard-setting methodologies—specifically the Angoff, Modified Angoff, or Hofstee methods—to establish passing cut scores for Part One and Part Two written diets. Part Three clinical OSCE stations are scored using the Borderline Regression Method.

How many attempts are permitted for Part One?

Candidates may attempt Part One after completing the required initial residency training period and are permitted a maximum of six attempts to pass Part One under Egyptian Health Council regulations.

Does this question bank substitute for Part Three clinical training?

No. Part Three is an in-person clinical and operative assessment consisting of Objective Structured Clinical Examination (OSCE) stations, surgical viva voce, and radiologic case evaluations. This 100-question multiple-choice question bank is an English-language theoretical study aid designed to reinforce core knowledge, classifications (AO/OTA, Gustilo-Anderson, Salter-Harris), and surgical anatomy for Part One and Part Two; it is not a clinical simulation or a substitute for hands-on operative training.

What official syllabus framework guides the orthopedic examination?

The examination blueprint is aligned with the Egyptian Health Council reference framework and LMS training guidelines for Orthopedic Surgery (جراحة العظام), accessible through the official EHC LMS portal.