Pimp Questions from Handbook to know.

[Orthojoe]

I've been passing this out to my fellow classmates as I've just matched ortho. This list encompasses the most commonly encountered "pimp" questions and topics my fellow fourth years and I encountered while on audition rotation. Reference handbook of Fractures 4th edition. Supplementing this with "hoppenfields exposures" and "netters ortho anatomy" - you should be golden

1. Section I: General Considerations - most of it is not very high yield; focus on following points
a. Open Fractures
i. Table 3.2
b. Muscle Viability
i. Table 3.4
2. Section 2: Axial Skeleton Fractures - again, not very high yield for ortho auditions
a. Chance, Compression, Burst, and Jefferson fractures
b. know diagram on p. 137
3. Section 3: Upper Extremity Fractures and Dislocations
a. Allman classification (p. 145)
i. Look at Tarascon's for Neer modification
b. AC joint (p. 154)
i. Table 12.1 and Figure 12.3
c. Hill-Sachs, HAGL, and Bankart lesions (p. 174)
d. Proximal humerus fractures (p. 194)
i. displacing forces (figure 15.1)
e. Holstein Lewis type fractures (p. 211)
f. Tolerances of humeral shaft fractures (p. 206)
g. Circle of Hori (p. 232-233)
h. Terrible triad of elbow - radial head fx, coronoid fx, and elbow dislocation
i. Radial Head - Mason classification (p. 250-252)
j. Bado classification (Figure 21.2)
k. Galiazzi and Monteggia (p. 267)
l. Frykman (p. 273)
m. Smith/Barton's (p. 274)
n. Scaphoid fx
i. blood supply of scaphoid (p. 288-289)
o. Triquetrum fx - classically seen on lateral xray as a fleck on dorsum of hand
p. "Terry Thomas sign" (p. 302)
q. Boxer's fx (5th metacarpal neck)
r. Bennet, Rolando (p. 312-313)
s. Stener lesion (Figure 24.9)
4. Section 4: Lower Extremity Fractures and Dislocations
a. Young and Burgess (Figure 25.6)
b. Vascular supply of femoral head (Figure 27.3)
c. Femoral neck fractures - Pauwel and Garden (p. 381-383)
d. Evans intertrochanteric fx (Figure 30.1)
e. Patellar fractures (p. 441)
f. Patellar radiographic lines (p. 446)
g. Schatzker classification (Figure 36.1)
h. Danis-Weber classification (Figure 38.8)
i. Lauge-Hansen (p. 485)
j. Ruedi and Allgower (p. 493, Figure 38.10)
k. Pilon fx (p. 495)
l. Calcaneal fx
i. radiographic lines/angles (Figures 39.1 and 39.2)
ii. Sander's (p. 513-514)
m. Hawkin's classes and sign (p. 522)
n. Lisfranc injury (p. 541-548)
o. Jones fx, (p. 551)
i. know what a true zone 2 is
5. Section 5: Pediatric Fractures and Dislocations
a. Salter-Harris type I - V (p. 567)
b. Gartland (p. 605-606)
c. Physeal fractures of lateral condyle (p. 609)
d. Juvenile Tillaux fx (Figure 51.3)

note: credit to many students that contributed to this list as I asked other fellow ortho students what they frequently were asked at each ortho audition.

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[Tygacil]

Just wanted to say thanks for taking the time to put this together, as a rising 3rd year who will be doing aways soon.

 

[Wannashmooze]

Very solid looking list. I matched at Meadowlands hospital ortho.
Lets try to put it into order so that students can triage and read the most important things first. Id say start with:

1. Hip fractures: garden classification, and how it affects management

2: rotational ankle injuries: lague/Hansen classification

3: proximal humerus fractures, neer classification, shoulder/rotator cuff physical exam

4: distal radius: colles fracture, and radiographic anatomy/line/angles

That should help a beginning third year get their feet wet in the right direction.

Good luck on auditions!

 

[anony mouse]

A very thorough list. Without a doubt it would be beneficial to know all of that, but for those that may be feeling overwhelmed by that list I would say this: know the anatomy, that is all (Netter Ortho, Hoppenfeld approaches for specific cases). I was never asked fracture classification questions (nor my classmates from what I heard, but maybe there are programs out there that focus on that). Dominated anatomy/approach pimping, did well on aways, matched well.

Again, it would be great to know all of that info, but in the interest of not scaring people I would say it is not essential. Looks like a great starting point for incoming interns.

 

[bleeker10]

A very thorough list. Without a doubt it would be beneficial to know all of that, but for those that may be feeling overwhelmed by that list I would say this: know the anatomy, that is all (Netter Ortho, Hoppenfeld approaches for specific cases). I was never asked fracture classification questions (nor my classmates from what I heard, but maybe there are programs out there that focus on that). Dominated anatomy/approach pimping, did well on aways, matched well.

Again, it would be great to know all of that info, but in the interest of not scaring people I would say it is not essential. Looks like a great starting point for incoming interns.

I agree. I was only asked fracture classification for Salter Harris and Weber (A/B/C). I was asked a lot of anatomy, especially radiographic anatomy. I was also asked to describe the nerve distributions of the hand/foot in terms of motor, reflex, sensory. Motor was described in terms of tests (ok, thumbs up, criss-crossing fingers with the specific nerves tested such as AIN, PIN, etc).

I would say knowing the path of UE/LE nerves and how you avoid damaging them during surgery is important. Things like how high above the lateral malleolus the SP nerve crosses anteriorly or how to protect the PIN when doing a posterolateral approach to the elbow (pronate the arm) are fair game and easy things to remember. Most of these pimp answers are in Netter's.

 

[Orthojoe]

A very thorough list. Without a doubt it would be beneficial to know all of that, but for those that may be feeling overwhelmed by that list I would say this: know the anatomy, that is all (Netter Ortho, Hoppenfeld approaches for specific cases). I was never asked fracture classification questions (nor my classmates from what I heard, but maybe there are programs out there that focus on that). Dominated anatomy/approach pimping, did well on aways, matched well.

Again, it would be great to know all of that info, but in the interest of not scaring people I would say it is not essential. Looks like a great starting point for incoming interns.

I was asked on nearly every classification on that list - repeatedly. Particularly when rotating through the local allopathic program. the scenario would go like this..I'd read an x-ray - followed by classification question, then treatment options then exposure questions ... rinse and repeat. Did this for every new consult in most places. in the OR obviously focused more on anatomy questions so hoppenfields was my best friend.

Wish I would have rotated where you guys went, it would have made my life way easier focusing on just anatomy.

 

[DarkHorizon]

A very thorough list. Without a doubt it would be beneficial to know all of that, but for those that may be feeling overwhelmed by that list I would say this: know the anatomy, that is all (Netter Ortho, Hoppenfeld approaches for specific cases). I was never asked fracture classification questions (nor my classmates from what I heard, but maybe there are programs out there that focus on that). Dominated anatomy/approach pimping, did well on aways, matched well.

Again, it would be great to know all of that info, but in the interest of not scaring people I would say it is not essential. Looks like a great starting point for incoming interns.

Looking at your post Hx, you're an allopathic student. From what I understand, and I could be wrong, most MD ortho programs only expect you to know anatomy.

However, DO ortho programs are on another level when it comes to auditions. I was asked almost everything that Orthojoe posted and some more! It's a gunnerfest out there, DO programs pimp the **** out of you and only take guys who rotated through. Therefore, it's paramount to know as much as you can. Most programs also pimp during the interview. One of the programs this year had a mayfield 4 film in their interview that they had us read. Another program put up lunate dislocation. One program had Ruedi Allgower 3.

As you can see, DO programs really want gunners to know their ****, along with high boards and all other intangibles. Anyone going for DO ortho would be well served to know the list Orthojoe provided. And if you're applying MD ortho, I imagine it would be impressive as well to know all that.

 

[bleeker10]

I rotated through military programs, which function like MD ones, so my experiences are different than the DO rotators.

It will never hurt you to know more than the minimum. We all have to learn this stuff eventually. Start with the anatomy and then move onto fracture classification.

 

[Wozo30]

I also agree with Dark and Orthojoe on the DO programs, can't speak for allo. Every program I was at pimped at minimum what wannasmooze triaged and most expanded into Orthojoe's list. Anatomy was expected so not too many were impressed unless you got a difficult question correct. And I didnt get too many straight up approach questions (what THA approach am I using?), mostly what structures are in realtion to the incision being made. All interviews I went on showed x-rays and had you classify them. The two I found most difficult were a Hawkings 3 and a Gartland 2A (doc wanted to know the difference btw A and B with regards to rotational stability). So anatomy and wannasmooze's list at minimum but work on Orthojoe's list to be comprehensive.

 

[anony mouse]

DO ortho programs are on another level when it comes to auditions.

Dude, it sounds like you are correct, sir. Rotated at good allo programs (Stanford, Utah) in addition to home and did not come across any of this. I am sure you will be better off for it, and props to you guys for memorizing all that stuff.

Again, just didn't want people (I guess just allo students) to get freaked out, as this stuff rarely came up. Apparently if you are a DO student, you'd best get to studying.

 

[Orthojoe]

Dude, it sounds like you are correct, sir. Rotated at good allo programs (Stanford, Utah) in addition to home and did not come across any of this. I am sure you will be better off for it, and props to you guys for memorizing all that stuff.

Again, just didn't want people (I guess just allo students) to get freaked out, as this stuff rarely came up. Apparently if you are a DO student, you'd best get to studying.

Yea I rotated through both sides.. DO ortho required way more "ortho" knowledge while when I rotated allo (AZ/Mayo) it was more anatomy, approaches, diagnoses,etc.

Although I rotated with some big names who gave me a few zingers from left field ..ie modulus of elasticity between steel and titanium (this is actually a good question now that I understand), who invented the adsons ("Ummmm, Dr Adson" -serious that is how I said it)..