Free Intercollegiate Specialty Examination in Trauma & Orthopaedic Surgery — Section 1 Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Intercollegiate Specialty Examination in Trauma & Orthopaedic Surgery — Section 1 practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A 13-month-old child has developmental dysplasia of the hip. Under anaesthesia, the femoral head cannot be placed concentrically in the acetabulum by closed reduction. Which approach is indicated to obtain reduction?

   1. A.Repeat closed manipulation
   2. B.Open reduction of the hipCorrect answer: B
   3. C.Isolated pelvic osteotomy
   4. D.Isolated femoral osteotomy

   Explanation: AAOS states, "If a closed reduction is not successful at putting the thighbone in its proper position, open surgery is necessary." The failed closed reduction in this child requires open access to achieve reduction; an isolated bone realignment does not address the failed reduction itself.

   Reference: AAOS: Developmental Dysplasia of the Hip — Treatment for DDH — Surgical Treatment, 6 months to 2 years

2. 2An adult sustains an open tibial shaft fracture. Resuscitation and splintage are under way. What is the ideal maximum interval from injury to the first intravenous prophylactic antibiotic dose in the BOAST standard?

   1. A.1 hourCorrect answer: A
   2. B.12 hours
   3. C.24 hours
   4. D.72 hours

   Explanation: BOAST states that antibiotics should be given "as soon as possible, ideally within 1 hour of injury." The 12-, 24- and 72-hour intervals belong to other open-fracture treatment milestones, not the ideal first antibiotic timing.

   Reference: BOAST: Open Fractures — Standards for Practice, 2

3. 3When preserving the vascular supply during surgery around an adult femoral neck, which artery is the principal source of the retinacular vessels supplying the femoral head?

   1. A.Lateral femoral circumflex artery
   2. B.Medial femoral circumflex arteryCorrect answer: B
   3. C.Superior gluteal artery
   4. D.Inferior gluteal artery

   Explanation: AO states, "Most of the blood supply of the femoral head comes from the medial femoral circumflex artery". Its retinacular branches are crucial to femoral-head perfusion. The other named regional arteries do not provide the principal retinacular supply described.

   Reference: AO Surgery Reference: Femoral Head Fractures — Definition — The blood supply of the femoral head

4. 4A teenager with a confirmed stable slipped capital femoral epiphysis can still walk with crutches. While arranging definitive treatment, what loading instruction should the orthopaedic team give for the affected limb?

   1. A.Full weight-bearing with two crutches
   2. B.Partial weight-bearing with two crutches
   3. C.Non-weight-bearing with walking aidsCorrect answer: C
   4. D.Heel weight-bearing with walking aids

   Explanation: AAOS states, "Once SCFE is confirmed, your child will not be allowed to put weight on their hip". The ability to walk defines stability but does not make continued loading appropriate after diagnosis. The other instructions all permit loading before definitive treatment.

   Reference: AAOS: Slipped Capital Femoral Epiphysis — Treatment, paragraph before Procedures

5. 5After a high-energy knee dislocation, an adult has findings suspicious for arterial injury. The patient is stable enough for whole-body CT. According to the current BOAST arterial-injury standard, which additional vascular study should be performed concurrently?

   1. A.Magnetic resonance angiography
   2. B.Duplex arterial ultrasonography
   3. C.CT angiography of the injured limbCorrect answer: C
   4. D.Catheter digital subtraction angiography

   Explanation: The June 2026 BOAST states, "CT angiogram is recommended if arterial injury is suspected and should be performed concurrently with whole-body CT." This directly applies to the stable patient already undergoing CT. The other vascular tests do not match that specified concurrent investigation.

   Reference: BOAST: Arterial Injuries Associated with Musculoskeletal Trauma — Emergency clinical care, standard 8

6. 6Examination after a knee injury shows excessive anterior translation of the tibia relative to the femur. Which ligament normally provides the principal restraint against this movement?

   1. A.Posterior cruciate ligament
   2. B.Medial collateral ligament
   3. C.Lateral collateral ligament
   4. D.Anterior cruciate ligamentCorrect answer: D

   Explanation: AAOS states that the ACL "prevents the tibia from sliding out in front of the femur". The posterior cruciate ligament restrains posterior translation; the collateral ligaments primarily control side-to-side stability rather than provide the principal anterior restraint.

   Reference: AAOS: Anterior Cruciate Ligament Injuries — Anatomy — Cruciate ligaments

7. 7An infant's idiopathic clubfoot has been corrected by Ponseti casting. The team now prescribes footwear connected by a bar to maintain correction and reduce recurrence. Which orthosis fits this prescription?

   1. A.A knee-ankle-foot orthosis
   2. B.A ground-reaction orthosis
   3. C.A patellar-tendon-bearing brace
   4. D.A foot abduction braceCorrect answer: D

   Explanation: AAOS describes the "foot abduction brace" and explains, "The brace keeps the foot at the proper angle to maintain the correction." This is the boots-and-bar device used after clubfoot correction. The other orthoses provide different forms of limb support rather than this prescribed abduction arrangement.

   Reference: AAOS: Clubfoot — Nonsurgical Treatment — Bracing and Markell brace caption

8. 8Following a tibial fracture, an adult is diagnosed with acute compartment syndrome of the leg. Which operation directly treats the raised myofascial compartment pressure and is required urgently?

   1. A.Vascular embolectomy
   2. B.Open fasciotomyCorrect answer: B
   3. C.Fracture osteoclasis
   4. D.External fixation

   Explanation: BOAST states, "Immediate surgical decompression should follow a diagnosis of compartment syndrome" and requires open decompression of all involved compartments. Fasciotomy provides that decompression; the other operations do not release the restrictive compartment fascia.

   Reference: BOAST: Compartment Syndrome of the Extremities — Standards for Practice, 9–10

9. 9An insertional Achilles tendon avulsion is to be repaired with bone anchors. Into which bone is the tendon normally reattached at its native insertion?

   1. A.CalcaneusCorrect answer: A
   2. B.Navicular
   3. C.Talus
   4. D.Cuboid

   Explanation: AAOS states, "It attaches at the back of the calcaneus (heel bone)." The repair restores the Achilles insertion on the calcaneus. The other named tarsal bones are not its native attachment.

   Reference: AAOS: Achilles Tendon Rupture — Anatomy

10. 10An adult with rheumatoid arthritis is discussing conventional, nonbiologic disease-modifying treatment with the rheumatology team. Which medicine belongs to this treatment category?

    1. A.MethotrexateCorrect answer: A
    2. B.Naproxen
    3. C.Prednisone
    4. D.Codeine

    Explanation: AAOS introduces its list with "The most commonly used nonbiologic DMARDs are:" and includes "Methotrexate". Methotrexate is the conventional DMARD in this group. Naproxen is an NSAID, prednisone a corticosteroid and codeine an opioid analgesic; their classifications are distinct from conventional DMARDs.

    Reference: AAOS: Rheumatoid Arthritis — Treatment — Nonbiologic DMARDs, list