Orthopedics Quick Review Anil Arora, Apurv Mehra, Thameem Saif
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FM1Orthopedics Quick Review
Fifth Edition
Conferred as ‘Magic Book of Orthopedics’ by Students
Apurv Mehra MBBS MAMC MS ORTHO (UCMS) DNB ORTHO DIP. SICOT, (BELGIUM) FELLOWSHIP COMPUTER NAVIGATION JOINT REPLACEMENT FROM GERMANY, AUSTRALIA AND MALAYSIA Consultant Orthopedic Surgeon Computer Navigation Joint Replacement and Arthroscopy Surgeon Edited by Anil Arora Thameem Saif Forewords SM Tuli Sudhir Kumar SKS Marya
FM2
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Orthopedics Quick Review
First Edition: 2012           Second Edition: 2013
Revised Reprint: 2014        Third Edition: 2015
Fourth Edition: 2016
Fifth Edition: 2017
9789386322432
FM3
Reach High, for Stars Lie Hidden in Your Soul.
Dream Deep, for Every Dream Precedes the Goal
My Mission
Aspiring to Serve Humanity
Dedicated to
My Daughter, Vrinda Mehra
My Patients & My Students who have helped me evolve as an Orthopedic Surgeon and a Teacher.
— Dr. Apurv MehraFM4
FM5FOREWORD
Despite the availability of more lucrative opportunities to the current generation in business and technology, the brightest of the young generation of any country opts for medicine as a career. Orthopedics happens to be one of the most sought-after clinical discipline, fully aware of the long years of arduous training involved for success in the profession. It is just natural that the best amongst the admission seekers would be able to enroll themselves for the limited seats available in Orthopedics in the teaching and training institute. To maintain objectivity and transparency, admissions based upon objective MCQ type of questions is the best of all assessment systems, granting that no assessment system is really “perfect”. This book is intended to help the student to quickly review the subject for MCQs examinations. The table of contents of the book covers the wide landscape of orthopedic discipline.
Dr Apurv Mehra over the last 9 years has been trying to analyze the system of MCQs type examinations, collate and organize the material for understanding at the graduate level. This book would help the prospective candidates to channelize their thinking process for the admission tests. The question-answer style of various sections would also help the prospective faculty (who compose the MCQs) to standardize the framed words for constructing the question with least ambiguity and for appropriate level of MBBS graduates. It is a laudable effort by Dr Apurv Mehra, and it is a must-read for the admission seekers.
SM Tuli
MBBS, MS, PhD, FAMS
Formerly: Director
Institute of Medical Sciences
Banaras Hindu University, Varanasi, India
Senior Consultant Spinal Disorder and Orthopedic
VIMHANS Hospital, Nehru Nagar, Delhi
FM6FOREWORD
Orthopedics today has become one of the most sought-after branches in medicine and similar is the representation of number of questions in PG entrance examinations. Clear concepts and crisp knowledge is often required to solve MCQs irrespective of the type and format of questions. Orthopedics Quick Review comes with a complete package for PG aspirants to have a concept based knowledge, important points to remember and recollect at the time of examination. Illustrative diagrams, images, flowcharts and summary have been made keeping in mind the need of students today. This book is not one for the shelf but is for the last minute revision specially with the chapter like Complete Summary of Orthopedics also having controversial questions frequently asked by the students.
Dr Apurv Mehra has carefully included questions and topics keeping in mind that the whole spectrum of Orthopedics is covered and retained by students.
Orthopedics Quick Review is a must-read book for Orthopedics MCQs.
Sudhir Kumar
Head of Department
Department of Orthopedics
University College of Medical Sciences and
GTB Hospital, Delhi
FM7FOREWORD
Dr Apurv Mehra has put forth a new edition for the aspiring postgraduates in orthopedic surgery. While there is an ocean of knowledge and texts available this edition comes from the heart of a young orthopedic surgeon who has himself faced the pleasures and difficulties of acquiring knowledge.
Many texts are available to the examinees and seekers of information and each has a flavor of its own. In this case Dr Mehra has a refreshing approach towards imparting information. The text comes with useful pictorial diagrams and X-rays to illustrate concepts. While putting forward a multiple choice question the author has given an elaborate reasoning for the best choice answer. He has classified the chapters with good deal of thought.
It makes a simple read for those revising for examinations and subtly adds information to the candidates knowledge bank. In fact, the edition will be an asset in the collection of all those who are learning and teaching the art of Orthopedic Surgery.
SKS Marya
Vice Chairman
Max Healthcare, New Delhi
Chairman
Orthopedics Department, Max Healthcare
FM8ABOUT THE EDITORS
Anil Arora
Dr (Prof) Anil Arora holds an experience of more than 20 years in Orthopedics. He has been Senior Orthopedic Surgeon and Professor of Orthopedics at University College of Medical Sciences, Delhi. He is an Internationally known figure in Orthopedics. He is a Joint Replacement Surgeon and is at present the Head of the Department of Orthopedics at Max Superspeciality Hospital and Institute of Joint Replacement, Patparganj, Delhi. He is known for his brilliant clinical skills and knowledge.
He has many International and National Achievements and Awards to his credit like:
SIROT Award in USA (First Indian to win this award from a body of 85 countries)
Weller Gold Medal
AA Mehta Gold Medal of Indian Orthopedic Association
“Silver Jubilee Oration” Award of Indian Orthopedic Association
He has also delivered White Paper of Indian Orthopedic Association
He has published about 50 research papers in various International, National and Regional Journals
He has about 20 Chapters in International and National Orthopedic Textbooks
Prof Anil Arora has carefully edited the contents of this book and has given valuable feedback in the making of this book.
Thameem Saif
Dr Thameem Saif, MD (Medicine), is a renowned teacher held in very high regard by medicos both in India and the US. He is an intellect of high order with brilliant teaching skills. His inputs have been found to be very valuable by his students across the country and he has helped lots of students to achieve their dreams of clearing the tough Indian entrance exams and the USMLE. Most of the toppers in the country today thank him in their heart for playing an important role in their success. He is well-known for solving MCQs by an organized approach to reach towards the answer. He has carefully gone through the book and his suggestion has given birth to a chapter on Complete Summary of Orthopedics for students to revise in last minutes.
FM9PREFACE
OrthoPedics Quick Review (OPQR) is much in demand and is the Best Selling book of Orthopedics for PG Preparation in the whole of South East Asia and is fast gaining recognition in other countries across the globe. Nationally and Internationally appreciated, OPQR is now being adopted by all PG Institutes as the No. 1 book to read for Orthopedics.
OPQR is a demand based supply and is channelized according to student needs communicated to me during my teaching classes. In OPQR, each chapter sequence is according to the importance of topics in entrance exams and is very well explained with the help of neat diagrams and clear images, followed by flowcharts and mnemonics to further help understand the concepts. At the end of each topic all the questions asked in all major Entrance Exams (AIPG/AIIMS/PGI/DNB/JIPMER and Different State Exams) have been arranged from recent to backwards (i.e. from Jan 2016 backwards). The last chapter, Complete Summary of Orthopedics is for quick revision in last 3 weeks just before the exams. This chapter also includes controversial and doubtful questions that have been frequently asked by the students.
The success of OPQR goes to all the Toppers who have achieved great ranks and owe their success to this book. They are the ones who strongly recommend reading OPQR, being the most authentic, concise, comprehensive and easily retainable book available in the market. (Read Topper's Reviews on the Back Page).
“Complete Summary of Orthopedics”, the last chapter of OPQR, is another reason why students appreciate this book, as the summary helps them to revise the whole of Orthopedics in just FIVE HOURS.
The success of OPQR is further enhanced when students writing the entrance exams claim that most of the questions asked in their exams came directly from the content of the book.
OPQR rests its fundamental principle on the idea of providing the students with a complete book which is not just easy to read and understand, but at the same time helps to retain and memorize in just FIVE Days, with a target of 60 pages per day and that should complete it in FIVE Days…which is the least possible time….!!!
Because of all the above reasons, OPQR has been named as “The Magic Book of Orthopedics” by the students.
OPQR 2017—Fifth Edition
Biggest strength is in its simplicity and concepts.
  • It is more concise, more compact and more comprehensive for easy understanding
  • It has more illustrated diagrams and new images for better retention
  • It includes new flowcharts and new mnemonics for easier recall during examinations
  • It has new topics added as per the latest guidelines and trends in exams.
— Apurv Mehra
FM10GOOD THINGS TAKE TIME …
Q. 1. Why I did not achieve a rank when I worked so hard…?
My Answer: I would like to share with you, what most of you do not know that when most of my friends qualified in the first attempt and I didn't, it was a heartbreak and quite unbelievable. That is when I realized that our so called failure in entrance exams is not a failure but is the inability to plan a strategy and identify our areas of lacunae.
I analysed my lacunae and came to this conclusion:
A good player of cricket is the one who needs to be a good runner but if his running is weak then he will be run out, so he needs to work on his running as well at the same time he needs to keep practicing his batting skills too.
Through this I wish to convey that you should keep revising your strengths otherwise they become your short comings.
Q. 2. Why do we keep forgetting what we learn…?
My Answer: I always advise to make 2 schedules:
  1. Main schedule for preparation for the whole day.
  2. Revision schedule in which you have 90 mins each day to revise volatile subjects, for example for me - Pharma was one such subject.
Q. 3. Why do we lag behind in our schedule…?
My Answer: Read each subject in the order of priority of the topics so that in case you exceed your time allotted to each subject, then you move on to the next subject but do not miss on vital thing. You need to move to next subject because we can never complete 100% of any subject. But we can cover important topics and our aim is to do so in all 19 subjects. But if you till the end do not follow this advice of sticking with your schedule, you will end up with a catastrophe - a catastrophe of leaving a subject which no one can never compensate.
Also keep practicing MCQs every day, preferably in the morning hours, at the same time when the exams are conducted, so your internal clock is tuned.
Q. 4. Negative Thoughts—What if I study properly and still do not make it this time then what…???
My Answer: There is a self belief which tells you to take chances. I agree there will be doubts but you must at the same time realise that even Rank 1 of any exam, will have doubts but even then the power to conquer the fears is more. So the basic thing you can do to counter this is - to develop a habit of surrounding yourself with positivity and positive human beings and to my brain, they are your parents-talk to them, they will always show you the positive aspect.
Q. 5. Sir, when will my time come…?
My Answer: This is a big question and I can just tell you one simple thing. Your time will never come, you have to create it. God will write your destiny according to your efforts, and only hard work can beat any talent and I know it surely will.
My batchmates in MAMC were very talented and intelligent but I always had this habit, a habit called as hard work, which I gradually realized is the biggest asset which if nurtured and fed well can take you everywhere. Those who can work hard can do good not only with themselves but also to lots of people around. Just as I have learnt from my grandmother, ‘To live like a king, we need to work like a slave.’
So to summarise:
FM11FOR MY PATRIOTS
A MESSAGE FROM MY HEART…
Draw a plan for the next day before you sleep so that by the time you get up for the day you already have a target. (This small change has done miracles in many lives)
Minimum requirement to clear entrance exam…
6 hours per day without mobile phone around you, for a period of six months non stop…
The selections in entrance are not based upon intelligence and knowledge but is based on revision of recent topics and proper planning… so keep revising…
Do not count the days make the days count!
FM12FEW VALUABLE PEARLS BEFORE EXAMINATIONS
Every time we would go to write an exam our seniors (at MAMC) would tell to us….
  1. Sleep on time and sleep well a night before.
  2. Before sleeping preferably speak to your closest family member or your wise friend and do promise that you will give your best and keep a positive attitude.
  3. Reading few jokes from a joke book has been found as a stress reliever by some.
  4. On the morning of the exam, never go empty stomach never eat too much, take a balanced fruit, a sandwich and a cup of coffee/tea is preferred by most.
  5. Always get ready on time and wear your most comfortable clothes and shoes. Trying out a new footwear is not advisable.
  6. Most prefer some music in morning hours to de-stress themselves.
  7. Leave early from house for the center and avoid driving at any cost.
  8. Make sure to carry your Photo Identity proof, Admit card and Stationary.
  9. At the center preferably involve yourself in some meditation or stay with your family or friend accompanying you. Avoid mingling with groups.
  10. Please do all the formalities before the exam on time to avoid any last minute panic.
  11. Follow instructions of the examiners or invigilators at the center dare not involve in any of them.
During the exams…
  1. Start the paper and read the question very carefully.
  2. ONE liners should be read 3 times and message should be very clear what the examiner is asking and then read all 4 choices.
  3. One-by-one try to rule out options so that you have more probability of getting the answers correct, e.g., If you select one answer out of 4 then your success probability is 25% but if you rule out one then your success probability is 33% and if you are able to rule out 2 options then you have to mark from the remaining 2 choices thus your success probability is 50%.
  4. Do not make a mistake of marking the first answer without reading all 4 choices. Most of the examiners set 3 to 4% questions on the principle that student marks the first answer on reflex. This makes a total of about 10 to 12 questions in your exam thus can make a huge difference.
  5. Please do not try to find mistakes in questions for all practical reason try to answer questions taking them as correctly framed.
  6. Multiple lines or clinical questions should be answered on remembering the following point:
    1. Age of the patient may help you decide the answer.
    2. Unilateral or bilateral may help you rule out few choices
    3. Normal feature mentioned helps rule out few choices
    4. Please make a note of important radiological findings.
    5. Give very high importance to histopathological or biopsy features to arrive at diagnosis and always give tissue diagnosis more importance than radiological findings because radiological finding can be non-specific
    6. Always make a note whether most common finding is asked or most characteristic finding is asked
    7. Similarly observe that whether investigation of choice is asked or gold standard investigation is asked
    If you look at questions investigation of choice refers to next investigation and gold standard refer to best investigation usually.
  7. Each question is highly valuable and do not take any question lightly how much confident you are.
  8. It is very strange that students try to save time on the questions that they have knowledge about and give more time to questions they are not aware of. Actually you must focus strongly on topics you know and answer their questions carefully rather than giving more time to topics you are unaware of. Most toppers get the repeat topics correct as compared to scoring high on new topics.FM13
Keeping the recent trend in mind to prepare for all entrance exams….(AIPG NEET/AIIMS/PGI/DNB) It would be practically impossible to separate your preparation. Hence, a combined approach is suggested:
  1. It would be a good option to write DNB exam as the same body is conducting NEET exams although they can turn out to be totally different at end.
  2. It is advisable to go through last 3 to 4 DNB papers.
  3. It is good to do last 2–3 PGI papers
  4. Last 7 years AIIMS papers would be important.
  5. Memorize last 5 years All India questions.
  6. Revise your notes you have made and also course notes if you had joined any coaching institute.
  7. This is no time to waste on finding answers to controversial questions just decide an answer.
  8. Day of writing the exam actually does not matter, go ahead with the slot available.
  9. Your knowledge will be more important than any strategy.
  10. Make use of every single day.
  11. Keep a positive attitude throughout.
  12. All the best… Go crack it…
If you feel miracles do not take place this one is for you
ALBERT EINSTEIN: Most of us take Einstein's name as synonymous with genius, but he did not show such promise.
Einstein did not speak until he was four and did not read until he was seven, causing his teachers and parents to think he was mentally handicapped, slow and anti-social. Eventually, he was expelled from school and was refused admission to the Zurich Polytechnic School. It might have taken him a bit longer, but most people would agree that he caught on pretty well in the end, winning the Nobel Prize and changing the face of modern physics.
If he could, you too can…
Always remember, to believe in your self… it really works.
Being a student of science, I sincerely apologize for any mistake you come across as it is inadvertently made.
However, your feedback is extremely valuable. Please feel free to mail me any suggestion or error you come across in the content to orthopedicsquickreview@gmail.com.
My Grandmother always used to recite these Lines from Guru Granth Sahib ……… which I often read out to all My students.
“Teri kismat da likha
Tere toh koi kho nahin sakda”
Tu shram (Karam) kara chal bande…
“Je usdi meher hove ta tenu o v mil jauga jo tera ho nahin sakda”
Go Chase Your Dreams, I Pray To Almighty To Grant It…!!!
— Dr Apurv Mehra
ORTHO DHOOM DHADAKA (ODD)
India's Leading Orthopedic Lecture by Dr Apurv Mehra
Ortho Dhoom Dhadaka (ODD), India's leading Lecture on Orthopedics is a highly successful program conducted by Dr Apurv Mehra. Ortho Dhoom Dhadaka (ODD) is not just about Orthopedics but goes beyond that, as Dr Apurv Mehra believes that education should be fun as well as inspiring.
Born on 14th August, 2014, ODD is a dream come true and is a landmark in history. Standing true to its name, Ortho Dhoom Dhadaka (dhoom dhadaka means a gala event) within three months achieved grand success, not only by going house full in all the cities it was organized, but more importantly by the recognition, its name has received, is one of its kind in the world of Medical Education.
Ortho Dhoom Dhadaka is a humble initiative by Dr Apurv Mehra to strengthen his bond with his students & help them achieve their goals. Inspired from his lectures, students not only ‘learn’ but actually follow Dr Apurv Mehra & also implement his advice & guidance in their day-to-day lives.
Dr Apurv Mehra provides the vision and high content resources needed to take students to the next level. Thousands of students have benefitted from his dynamic lectures.
(To know more about Ortho Dhoom Dhadaka, visit www.drapurv.com)
DR APURV MEHRA–THE ORTHOPEDIC SURGEON
Dr Apurv Mehra is an Internationally Trained & Experienced Computer Navigation Joint Replacement & Arthroscopy Surgeon & is a Consultant at Max Institute of Bone & Joint Care At Patparganj, Delhi & Noida. He is the Founder & Director of Vidya Jeevan Ortho Pedics Centre & is recognized as the Most Trusted Orthopedician of Delhi because of his ethical principles.
He has exceptional academic skills and his clear and logical thoughts and approach to complex knee issues makes him a standout in Knee Arthroscopy & Ligament Reconstructions, thereby helping his patients to return back to sports activities. His clinical skills are exemplary, he achieves good outcomes, and his patients love him.