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Key Facts: Iran Orthopedic Surgery Board Exam Exam

152 MCQs

Written examination questions in a single 240-minute session

Council for Medical and Specialized Education & Sanjesh Pezeshki

70% Pass Mark

Minimum qualifying score (105/150) required to advance to the clinical oral/OSCE exam

Sanjesh Pezeshki Board Examination Bylaws

No Negative Marking

Candidates are advised to answer all questions without penalty for wrong answers

Sanjesh Pezeshki Examination Rules

4-Year Residency

Accredited hospital-based orthopedic surgical training required for eligibility

Iranian Ministry of Health and Medical Education

6 Specialty Domains

Trauma (25%), Arthroplasty (20%), Spine (15%), Sports (15%), Pediatrics (15%), Hand/Foot/Tumors (10%)

National Orthopedic Board Curriculum Blueprint

The Iranian Orthopedic Surgery Specialty Board Examination is a premier two-stage assessment administered by Sanjesh Pezeshki. The written component consists of 152 four-option MCQs across 240 minutes without negative marking, requiring a 70% (105/150) qualifying score to advance to the clinical OSCE/oral examination. This 100-question practice set provides specialty-level preparation across all six blueprint domains.

Sample Iran Orthopedic Surgery Board Exam Practice Questions

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

1According to the Young-Burgess classification of pelvic ring disruptions, which injury pattern is characterized by complete disruption of the posterior sacroiliac ligaments, sacrotuberous and sacrospinous ligaments, resulting in both vertical and rotational instability?
A.Vertical shear (VS)
B.Anteroposterior compression type I (APC-I)
C.Lateral compression type I (LC-I)
D.Lateral compression type II (LC-II)
Explanation: Vertical shear (VS) injuries involve complete disruption of all anterior and posterior ligamentous constraints, including the strong posterior sacroiliac complex, sacrotuberous, and sacrospinous ligaments. This results in gross multidirectional instability, manifesting with vertical hemipelvis displacement and high risk of retroperitoneal vascular hemorrhage.
2In the management of high-energy open tibial shaft fractures (Gustilo-Anderson type IIIA), what is the most appropriate initial intravenous antibiotic regimen recommended within 1 hour of trauma?
A.Oral cephalexin monotherapy
B.First-generation cephalosporin combined with an aminoglycoside
C.Vancomycin monotherapy without gram-negative coverage
D.Metronidazole monotherapy
Explanation: Current evidence-based trauma guidelines and Rockwood & Green recommend a first-generation cephalosporin (e.g., cefazolin) supplemented with an aminoglycoside (e.g., gentamicin) for Gustilo-Anderson type III open fractures to provide broad coverage against both gram-positive organisms and gram-negative bacilli. High-dose penicillin is added if there is barnyard or farm contamination to protect against Clostridium species.
3A 28-year-old polytrauma patient with a closed comminuted diaphyseal femoral fracture exhibits severe unyielding leg pain out of proportion to injury, tense swelling, and pain exacerbated by passive toe extension. Measurement of intracompartmental pressure demonstrates an absolute pressure of 45 mmHg and a diastolic blood pressure of 65 mmHg (delta P = 20 mmHg). What is the definitive emergency intervention?
A.Application of a circular compression cast and limb elevation
B.Immediate intravenous administration of mannitol and delayed re-evaluation
C.Emergency two-incision four-compartment fasciotomy of the leg
D.High-dose systemic corticosteroids and observation in the surgical intensive care unit
Explanation: An absolute compartment pressure exceeding 30 mmHg or a perfusion differential (diastolic blood pressure minus compartment pressure, delta P) of 30 mmHg or less confirms acute compartment syndrome. Emergency complete surgical decompression via two-incision four-compartment fasciotomy is mandatory to prevent irreversible neuromuscular ischemic necrosis.
4Which radiographic parameter measured on Judet obturator and iliac oblique pelvis views confirms anatomical restoration of the anterior column and posterior wall in acetabular fractures?
A.Anterior superior iliac spine distance
B.Ischial tuberosity contour symmetry
C.Cervico-diaphyseal angle
D.Congruence of the femoral head with the acetabular roof and intact Kohler line
Explanation: On 45-degree Judet views, the iliopectineal line (anterior column) and ilioischial line (posterior column) delineate column integrity. Congruence of the femoral head with the acetabular dome on AP and oblique views, along with reconstitution of Kohler line (ilioischial line) and the teardrop, confirms anatomical joint restoration.
5In an 82-year-old active community ambulator who sustains a displaced femoral neck fracture (Garden type IV, Pauwels type III), which surgical management is associated with the lowest reoperation rate and superior functional outcomes?
A.Total hip arthroplasty (THA)
B.Closed reduction and percutaneous cancellous screw fixation
C.Open reduction and dynamic hip screw (DHS) fixation with a side plate
D.Bed rest, skeletal traction, and delayed weight-bearing
Explanation: For active, cognitively intact elderly patients with displaced intracapsular femoral neck fractures (Garden III/IV), total hip arthroplasty provides immediate stability, early mobilization, superior functional outcomes, and a significantly lower reoperation rate compared to internal fixation, which carries a 30-40% risk of avascular necrosis or nonunion.
6Which anatomical structure is at greatest risk of iatrogenic injury during placement of percutaneous anteroposterior sacroiliac screws across the upper sacral segment (S1) for unstable pelvic ring disruptions?
A.Femoral nerve in the iliopsoas groove
B.L5 nerve root coursing across the sacral ala
C.Sciatic nerve exiting beneath the piriformis muscle
D.Obturator nerve traversing the obturator canal
Explanation: During insertion of S1 sacroiliac screws, anterior cortical breach of the sacral ala directly places the L5 nerve root at risk as it descends across the sacral ala into the pelvis. Screw misplacement into the neural canal or anterior sacral cortex can cause devastating foot drop and radicular sensory loss.
7A 35-year-old male sustained a closed, comminuted midshaft humeral fracture associated with immediate complete wrist drop, loss of thumb extension, and sensory loss over the first dorsal web space. What is the standard initial management of this primary nerve palsy in a closed injury?
A.Immediate emergency open exploration and microsurgical nerve repair
B.Immediate open plating with nerve grafting
C.Initial observation with functional splinting and repeat clinical/EMG evaluation at 3 to 4 months
D.Immediate tendon transfer of the pronator teres to extensor carpi radialis brevis
Explanation: Primary radial nerve palsy associated with closed humeral shaft fractures is most commonly a neurapraxia or axonotmesis, with spontaneous functional recovery occurring in greater than 85-90% of patients. Initial conservative management with functional bracing and observation is indicated, reserving exploration for failed recovery after 3-4 months or in open fractures.
8What is the primary mechanical deforming force acting on the proximal fragment in subtrochanteric femur fractures, dictating its characteristic flexed, abducted, and externally rotated posture?
A.Rectus abdominis and pectineus
B.Adductor longus, magnus, and gracilis
C.Hamstring muscle complex and gastrocnemius
D.Iliopsoas, abductors (gluteus medius and minimus), and external rotators
Explanation: In subtrochanteric fractures, the proximal fragment is pulled into flexion by the iliopsoas, abduction by the gluteus medius and minimus, and external rotation by the short external rotators. Meanwhile, the distal shaft fragment is adducted and shortened by the adductor muscle group.
9Which classification system is most universally applied to categorize tibial plateau fractures, dividing them into lateral split, lateral split-depression, pure central depression, medial plateau, bicondylar, and metaphyseal-diaphyseal dissociation?
A.Schatzker classification
B.Neer classification
C.Hawkins classification
D.Pauwels classification
Explanation: The Schatzker classification divides tibial plateau fractures into six types: Type I (pure lateral split), Type II (split-depression), Type III (pure central depression), Type IV (medial plateau), Type V (bicondylar), and Type VI (metaphyseal-diaphyseal dissociation with subcondylar comminution).
10In the surgical stabilization of a Pauwels type III femoral neck fracture in a 32-year-old athlete, which biomechanical principle is most critical to counteract the excessive shear forces across the fracture line?
A.Application of a dynamic hip screw with a 135-degree barrel plate alone without anti-rotation
B.Conversion of shear stress into compressive stress using a steep fixed-angle construct or valgus intertrochanteric osteotomy
C.Resection arthroplasty with an unconstrained bipolar hemiarthroplasty
D.Non-weight-bearing in a spica cast for twelve weeks
Explanation: Pauwels type III fractures have a vertical fracture angle exceeding 50 degrees relative to the horizontal plane, creating high vertical shear forces that lead to fixation failure, varus collapse, and nonunion. Successful salvage or primary fixation requires transforming shear into compression using vertical parallel sliding screws, fixed-angle constructs with an anti-rotation screw, or a valgus-producing osteotomy.

About the Iran Orthopedic Surgery Board Exam Exam

The Iranian Medical Specialty Board Examination in Orthopedic Surgery (آزمون دانشنامه تخصصی ارتوپدی و جراحی استخوان و مفاصل) is the highest professional credential for orthopedic surgeons in the Islamic Republic of Iran. Administered annually by the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki) under the Secretariat of the Council for Medical and Specialized Education of the Ministry of Health and Medical Education (MOHME), the examination certifies surgical competence following the completion of a demanding 4-year accredited hospital residency training program. The national written paper comprises 152 four-option multiple-choice questions administered over a single 240-minute session. The curriculum is primarily referenced to Campbell's Operative Orthopaedics and Rockwood and Green's Fractures in Adults, encompassing six major domains: Trauma & Fracture Management (~25%), Adult Reconstruction & Arthroplasty (~20%), Spine Surgery (~15%), Sports Medicine & Arthroscopic Surgery (~15%), Pediatric Orthopedics (~15%), and Hand, Foot & Ankle, Oncology & Infections (~10%). In accordance with Sanjesh Pezeshki regulations, there is no negative marking, and candidates must attain a passing threshold of 70% (105 points out of a written total of 150) to qualify for the practical clinical OSCE and oral examination phase. Passing both stages confers the Daneshnameh Takhasosi diploma, which is mandatory for university faculty appointments, subspecialty fellowship eligibility, and senior hospital surgical leadership across Iran. This practice question bank is an independent English-language MCQ study adaptation authored by OpenExamPrep. It delivers 100 board-caliber practice questions with comprehensive pedagogical rationales and distractor analyses, structured according to the official Sanjesh Pezeshki curricular blueprint. It is not an official translation, not an official examination simulation, and is not affiliated with or endorsed by Sanjesh Pezeshki, the Council for Medical and Specialized Education, or the Iranian Ministry of Health and Medical Education.

Exam sponsor: National Center for Health Assessment / Sanjesh Pezeshki & Council for Medical and Specialized Education. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The Iranian Medical Specialty Board Examination in Orthopedic Surgery is administered annually in late summer (Shahrivar) by Sanjesh Pezeshki under the Council for Medical and Specialized Education. It comprises two mandatory sequential phases: (1) A comprehensive national written examination featuring 152 multiple-choice questions (240 minutes, 4 options, no negative marking, requiring 70% to pass); and (2) An advanced clinical and oral board stage (OSCE stations, imaging interpretation, surgical technique stations, oral case scenario defense, and patient management problems) reserved for candidates who clear the written cutoff score. Both stages must be passed to earn the national Daneshnameh Takhasosi (Specialty Board Diploma) in Orthopedic Surgery.

Time Limit

240 minutes

Passing Score

70% of the written total (105 of 150 points)

Exam / Certification Fees

Set annually by the Ministry of Health and Medical Education, payable online via sanjeshp.ir during official board examination registration

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.

25%

Trauma & Fracture Management

Polytrauma resuscitation, damage control orthopedics, Gustilo-Anderson open fracture protocols, compartment syndrome emergency decompression, pelvic ring injuries (Young-Burgess, Tile), acetabular fractures (Letournel-Judet), proximal femur fractures, intramedullary vs extramedullary fixation, pilon and tibial plateau reconstructions, and nonunion management.

20%

Adult Reconstruction & Arthroplasty

Primary total hip arthroplasty (THA) biomechanics, surgical approaches, bearing surface tribology, revision THA acetabular and femoral defect management (Paprosky classification), periprosthetic hip fractures (Vancouver classification), primary total knee arthroplasty (TKA) alignment and ligament balancing, revision TKA (AORI classification), and periprosthetic joint infection (MSIS criteria).

15%

Spine Surgery

Subaxial cervical spine injury classification (SLIC), odontoid fractures, thoracolumbar trauma classification (TLICS), cervical spondylotic myelopathy surgical indications, adolescent idiopathic scoliosis (Lenke classification), adult spinal deformity sagittal balance parameters (SVA, PI-LL), lumbar spondylolisthesis, and spinal epidural abscess/discitis management.

15%

Sports Medicine & Arthroscopic Surgery

Anterior cruciate ligament (ACL) reconstruction techniques and tunnel positioning, revision ACL, posterior cruciate ligament (PCL) and posterolateral corner (PLC) injuries, meniscal preservation and root tears, shoulder anterior instability (Bankart, Hill-Sachs, Latarjet indications), rotator cuff repair strategies, superior capsular reconstruction, and femoroacetabular impingement (FAI).

15%

Pediatric Orthopedics

Developmental dysplasia of the hip (DDH) screening, Pavlik harness protocols, closed and open reduction, pelvic osteotomies (Salter, Pemberton, Dega), congenital talipes equinovarus (Ponseti casting sequence and Achilles tenotomy), slipped capital femoral epiphysis (SCFE), Legg-Calvé-Perthes disease lateral pillar classification, cerebral palsy neuromuscular deformities, and pediatric physeal fractures (Salter-Harris, supracondylar humerus).

10%

Hand & Upper Extremity, Foot & Ankle, Musculoskeletal Oncology & Orthopedic Infections

Flexor and extensor tendon zone repairs, scaphoid nonunion and avascular necrosis, carpal and cubital tunnel releases, Lisfranc joint injury stabilization, syndesmotic disruption fixation, Charcot neuroarthropathy, Enneking oncologic staging, biopsy principles for bone and soft-tissue sarcomas, and acute hematogenous osteomyelitis.

Preparing for the Iran Orthopedic Surgery Board Exam Exam

What You Need to Know

  • Passing score: 70% of the written total (105 of 150 points)
  • Assessment: The Iranian Medical Specialty Board Examination in Orthopedic Surgery is administered annually in late summer (Shahrivar) by Sanjesh Pezeshki under the Council for Medical and Specialized Education. It comprises two mandatory sequential phases: (1) A comprehensive national written examination featuring 152 multiple-choice questions (240 minutes, 4 options, no negative marking, requiring 70% to pass); and (2) An advanced clinical and oral board stage (OSCE stations, imaging interpretation, surgical technique stations, oral case scenario defense, and patient management problems) reserved for candidates who clear the written cutoff score. Both stages must be passed to earn the national Daneshnameh Takhasosi (Specialty Board Diploma) in Orthopedic Surgery.
  • Time limit: 240 minutes
  • Exam / certification fees: Set annually by the Ministry of Health and Medical Education, payable online via sanjeshp.ir during official board examination registration Official sources

Using Our Practice Resources

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

Iran Orthopedic Surgery Board Exam: Suggested Study Strategy

1Master fracture classification systems and their direct operative implications, specifically Young-Burgess for pelvic rings, Letournel-Judet for acetabulum, and Garden/Pauwels for femoral neck fractures.
2Thoroughly review primary and revision total joint arthroplasty principles, including Paprosky acetabular and femoral bone loss classifications, Vancouver periprosthetic femur fracture management, and MSIS periprosthetic joint infection criteria.
3Focus heavily on pediatric hip conditions (DDH, SCFE, Perthes), memorizing the exact age-dependent treatment algorithms from Pavlik harness to open reduction and pelvic osteotomies.
4Understand spine instability algorithms, particularly the Thoracolumbar Injury Classification and Severity Score (TLICS) and Subaxial Cervical Spine Injury Classification (SLIC), to determine surgical versus non-operative management.
5Pace yourself during practice: with 152 questions in 240 minutes, you have roughly 1.6 minutes per question. Target answering first-pass questions in 60-75 seconds to leave 25-30 minutes for complex trauma and reconstructive scenarios.

Frequently Asked Questions

What is the format and duration of the written Iranian Orthopedic Surgery Board Examination?

The written examination consists of 152 four-option multiple-choice questions administered in a single 240-minute testing session. Questions are drafted in Persian by the National Board Examination Board under Sanjesh Pezeshki, with no negative marking for incorrect responses.

What passing score is required to qualify for the oral and clinical practical board exam?

Candidates must achieve a minimum qualifying score of 70% (105 points out of a written total of 150) on the written examination to be declared eligible to sit for the subsequent practical OSCE and oral case-scenario examination.

What are the primary reference textbooks specified for the Iranian Orthopedic Surgery Specialty Board?

The official national references mandated by the Secretariat of the Council for Medical and Specialized Education are Campbell's Operative Orthopaedics and Rockwood and Green's Fractures in Adults, alongside contemporary clinical guidelines published in major orthopedic literature.

Who is eligible to register for the Iranian Orthopedic Surgery Specialty Board Examination?

Orthopedic surgery residents who have completed their accredited 4-year residency training program at a recognized Iranian university of medical sciences and successfully passed their institutional pre-board certification examinations are eligible to register via sanjeshp.ir.

What happens if a candidate passes the written exam but does not pass the clinical OSCE/oral stage?

Under Ministry of Health and Medical Education regulations, candidates who successfully clear the written threshold (>=70%) may carry over their written passing status to retake the clinical/oral examination during subsequent examination cycles, up to the legally permitted limit.

Is this OpenExamPrep question bank an official Sanjesh Pezeshki product?

No. This question bank is an independent English-language educational study resource developed by OpenExamPrep for residency review and specialty preparation. It is not an official translation, not an official-format simulation, and is not affiliated with, sponsored by, or endorsed by Sanjesh Pezeshki or the Ministry of Health and Medical Education.