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DNB Orthopaedics Previous Year Questions

These are the DNB Orthopaedics theory questions asked by NBEMS in the December 2025 and June 2025 exams, listed paper by paper as they appeared. The Prep DNB app has all 25 DNB sessions from June 2014 to December 2025 — 1,000 questions in total — with repeat-question tracking, examiner keywords and MCQs.

Jump to: December 2025 · June 2025 · Important topics · Older papers

DNB Orthopaedics December 2025 Question Paper

Paper 1

  1. Describe articular cartilage in relation to: a) Structural anatomy & histology. [5] b) Mechanical property and functioning. [5]
  2. Bone-brain axis: a) Role in bone health. [5] b) Role in fracture healing. [5]
  3. RED-S in male sports person: a) Pathophysiology and clinical presentation. [5] b) Biomechanical markers and management. [5]
  4. Describe endosteal and periosteal blood supply of proximal humerus fracture. [10]
  5. Knee biomechanics: a) What is pivoting point in the knee? [5] b) How alignment of lower extremity affects the strain while pivoting activity? [5]
  6. What is spinopelvic harmony? Describe various parameters in evaluating patients with adult spinal deformity. [10]
  7. Describe holistic care for patients with fracture neck femur in geriatric population. [10]
  8. Tendon transfer: a) What is non-phasic tendon transfer? [5] b) Workflow of training muscle after non-phasic transfer. [5]
  9. Fracture non-union: a) Classify the types of non-union. [5] b) How ultrasonic therapy stimulates fracture healing? [5]
  10. a) How to define a trial comparing the outcome of two types of interventions in patients with ACL injury allocated randomly into two groups? [5] I. Group-1 ACL reconstruction + LET II. Group-2 ACL + ALL reconstruction b) How will you ensure blinding in such group of patients? [5]

Paper 2

  1. Surgical principles and rationale for articular and non-articular fractures management. [10]
  2. Hallux valgus: a) Clinical and radiological criteria for surgical intervention. [5] b) Soft tissue and bony procedure to correct hallux valgus. [5]
  3. Sprengel shoulder: a) Classification. [3] b) Pathogenesis. [3] c) Treatment options. [4]
  4. Retroperitoneal approach for lumbar spine: a) Indications and rationale. [3] b) Anatomy and surgical steps. [4] c) Pros and cons of approach. [3]
  5. Management of a case of carcinoma lung with pathological fracture at subtrochanteric level: a) Management rationale and options. [5] b) What is the role of histopathology and/or immunohistochemistry in decision making? [5]
  6. Anterior shoulder instability: a) Highlight various surgical techniques according to cause. [5] b) Laterjet procedure. [5]
  7. Fracture scapula: a) Coles criteria. [5] b) Modified Judet approach. [5]
  8. Malunion of supracondylar fracture humerus: a) What is Yamamoto test? [5] b) What is its role in decision making? [5]
  9. PCL avulsion fracture - diagnosis and management. [10]
  10. Describe direct anterior approach for hip arthroplasty, indications and contraindications, and how to perform it. [10]

Paper 3

  1. AO principle and rationale of fracture classification: a) How to understand the severity of trauma using AO classification? [3] b) How to understand the possible mechanism of fracture using AO classification? [3] c) How severity of trauma and mechanism of trauma affect the strain and fracture fixation strategy? [4]
  2. Proximal femoral osteotomy in pediatrics: a) Indications. [5] b) Rationale and principles. [5]
  3. What is CPAK classification and its role in knee surgery? [10]
  4. Acetabular fractures: a) Radiographic evaluation. [3] b) Classification. [3] c) Describe the anterior intra-pelvic approach. [4]
  5. Lumbar spine injury with paraparesis: a) How to assess clinically and radiologically? [5] b) Management rationale and options. [5]
  6. a) Intraoperative strategy to limit radiation hazards to patient and treating team while doing C-arm guided osteosynthesis of fracture. [5] b) Role of TLD badge to limit long-term radiation hazard to orthopedic surgeon. [5]
  7. Describe differences between Buttress vs Antiglide plating. [10]
  8. Fracture of V metatarsal: a) Classification. [5] b) Management rationale and principles. [5]
  9. Total hip replacement in patient with ankylosing spondylitis: a) Clinical and radiological workflow to assess surgical difficulties. [5] b) Their role to mandate surgical modification. [5]
  10. Radiation synovectomy: a) Indications and contraindications. [3] b) Mechanism of action. [4] c) Pros and cons. [3]

Paper 4

  1. a) What is SIRS and CARS? [2] b) What are their clinical, soluble and non-soluble markers? [4] c) How these could affect the short term outcome in fracture care? [4]
  2. Describe kinematic, restricted kinematic, inverse kinematic and mechanical alignment in TKA? [10]
  3. What is PHAGES in osteoarticular infections treatment? [10]
  4. Trochleoplasty in patellofemoral instability: a) Indications and principles. [5] b) Techniques & complications. [5]
  5. Progressive cubitus varus deformity: a) Etiopathogenesis. [5] b) Management. [5]
  6. Discuss evolution of radial head replacement: a) Implant design. [5] b) Surgical technique. [5]
  7. What are the different technique for incorporating Vitamin E to the poly used in TKA? [10]
  8. a) Metabolic syndrome and orthopaedics. [2] b) How to develop multimodal therapeutic approach? [4] c) Role of HbA1c in surgical decision making. [4]
  9. Subtalar arthroereisis: a) Biomechanical rationale. [6] b) Surgical techniques. [4]
  10. Augmented reality in relation to orthopedics. [10]

DNB Orthopaedics June 2025 Question Paper

Paper 1

  1. a) Blood supply of head of femur in an adult. [4] b) Enumerate causes of avascular necrosis (AVN) of femoral head. [3] c) Classify AVN of femoral head. [3]
  2. a) Relevant surgical anatomy of anterior cruciate ligament (ACL)'. [5] b) Different options for grafts in ACL reconstruction. [5]
  3. a) Types of cartilage. [4] b) Classify cartilage defects. [3] c) Management of cartilage defects. [3]
  4. a) Functions of hand. [5] b) Opponensplasty. [5]
  5. Discuss the pathophysiology and management of neurogenic shock in a 23-year-old patient with traumatic knee dislocation. [5+5]
  6. Describe initial assessment and resuscitation of trauma patient. [10]
  7. a) Staging in musculoskeletal tumors. [6] b) Role of PET scanning in musculoskeletal tumors. [4]
  8. Describe wound healing and factors affecting wound healing. [5+5]
  9. a) Seronegative inflammatory arthropathies. [4] b) Management of ankylosing spondyloarthropathy. [6]
  10. a) Describe the anatomy of brachial plexus with illustration. [5] b) Management of a suspected case of brachial plexus injury following a road traffic accident. [5]

Paper 2

  1. A 26-year-old male presented with low back pain radiating to back of left thigh. a) Discuss the indications of getting an MRI of spine in this patient. [3] b) What instructions will you give to the patient regarding the management, if you suspect this to be a case of discogenic origin? [4] c) What instructions should be given to the patient to report early in emergency care (Red Flag Signs)? [3]
  2. A 34-year obese female patient presents to your OPD with gradually increasing medial side knee pain, especially during walking, for the last 8 months. a) Discuss aetiopathogenesis and diagnostic work-up. [6] b) How would you treat a case of primary knee osteoarthrosis? [4]
  3. A 22-year male presented with wrist drop due to stab injury to arm one year back. a) How would you manage this case? [4] b) Classify nerve injuries. [3] c) Discuss the principle of tendon transfer. [3]
  4. Parents bring their 3-year-old child to the OPD, apprehensive regarding the bow legs. a) Discuss normal physiological angular variation in the growing child. [3] b) How would you evaluate the deformity clinically and radiologically? [4] c) Discuss the treatment of Rickets. [3]
  5. Write briefly on: a) Post polio residual paralysis. [3] b) Gouty arthritis. [4] c) Joint fluid analysis. [3]
  6. A young patient presents to your emergency with badly crushed leg. a) Discuss the principles/factors which help in decision making for managing this case by amputation or salvaging. [6] b) Describe any scoring system for crushed extremities. [4]
  7. a) Classify posterior dislocation of hip in adults. [5] b) How would you manage a case of posterior dislocation of hip in a 20-year-old patient following a road traffic accident? [5]
  8. A 68-year-old female fell on the ground and fractured her hip. X-ray shows it to be an intertrochanteric fracture. a) How do you classify this injury? [4] b) Discuss various management options. [6]
  9. A 69-year old patient presented to the emergency with a compression fracture D12 vertebrae without any neurologic deficit following insignificant trauma. a) How would you investigate (diagnostic workup) this case? [6] b) What are the common tumours which metastasize to spine in this age group? [4]
  10. a) Carpal tunnel syndrome. [4] b) Pirani score. [3] c) Enchondroma. [3]

Paper 3

  1. You are suspecting tuberculous infection of the hip joint in a 12-year-old male: a) Discuss clinico-radiological classification. [5] b) How do you investigate this case? [5]
  2. A 32-year-old male presented to the emergency after an accident with a potential 'Chance fracture'' at D10 vertebra: a) Outline the components of proper evaluation and assessment. [5] b) Discuss the management options. [5]
  3. a) Types of cerebral palsy. [3] b) Gross Motor Function Classification system (GMFCS). [4] c) The vulpius procedure for equinus deformity. [3]
  4. a) Treatment options for Kienbock's Disease (AVN Lunate) with carpal height and alignment preserved. [3] b) Triceps-reflecting anconeus pedicle flap (TRAP) approach to elbow. [3] c) Caries sicca. [4]
  5. A 42-year-old female presenting to your OPD with symmetrical small joint arthritis: a) Discuss the differential diagnosis. [4] b) What investigations will help in confirming the diagnosis? [3] c) What deformities are likely in the wrist and hand of a rheumatoid arthritis patient? [3]
  6. In a case of recurrent anterior shoulder (gleno-humeral joint) instability following trauma in a young adult: a) How would you evaluate clinically and what relevant investigations would you ask for? [5] b) Discuss various treatment options. [5]
  7. Describe Kumar and Tulissclassification for TB spine. How will you manage a case of TB D9-10 vertebrae with grade 4 paraplegia in a 20-year-old adult? [3+7]
  8. a) Symes amputation. [4] b) Surgical site infection. [3] c) Antibiotic loaded cement in orthopaedic practice. [3]
  9. A young motorist injured his leg in an accident, presented to you in emergency with severe swelling of the proximal leg. Radiographs show an intraarticular fracture of the proximal tibia: a) Classify proximal tibial fractures. [5] b) How would you manage this patient? [5]
  10. Enumerate use of artificial intelligence in orthopaedics. Discuss advantages and disadvantages of robotic total knee replacement. [5+5]

Paper 4

  1. a) What are the newer drugs available in the treatment of tuberculosis? [5] b) Discuss BPaL (Bedaquiline, Pretomanid and Linezolid) regimen in the treatment of drug resistance tuberculosis. [5]
  2. a) Role of biologicals in the treatment of inflammatory arthritis. [4] b) Bone morphogenic proteins (BMP). [3] c) Stem cell therapy. [3]
  3. How do you grade quality of evidence for making clinical practice recommendations? [10]
  4. What is the principle of Ilizarov fixator? Discuss the various indications and complications with its use in clinical practice. [2+8]
  5. Short notes on following technological advancements: a) Patient specific instrumentation. [4] b) Growth rods in early onset scoliosis. [3] c) Smart sensors in orthopaedic implants. [3]
  6. a) Intra-operative neural monitoring. [3] b) Botulinum therapy. [3] c) Bone banking. [4]
  7. Discuss the management of multiple ligament injuries to the knee of a young patient. [10]
  8. Enumerate different methods of fixation in ACL reconstruction and discuss advantages of each. [5+5]
  9. a) Gait lab. [5] b) Immunofluorescence microscopy. [5]
  10. a) What are the principles in wound coverage in acute injuries? [5] b) How would you manage the skin defect in extremities? [5]

High-Yield DNB Orthopaedics Topics

A selection of 30 of the 48 important topics curated in the app from repeated DNB Orthopaedics questions.

Trauma — highest yield in orthopaedics

  • Fracture healing: stages, factors affecting, primary vs secondary bone healing
  • Open fractures: Gustilo-Anderson classification, management of Grade II/III tibia, fix-and-close
  • Polytrauma: ATLS, damage control orthopaedics vs early total care, trauma triad of death

Upper limb trauma and hand

  • Shoulder dislocation: Bankart, Hill-Sachs, Latarjet, Remplissage, reverse TSA
  • Rotator cuff tears: clinical tests, imaging, management, reverse TSA indications
  • Elbow: terrible triad, radial head fractures, intercondylar humerus fracture

Spine — very high yield

  • Pott's spine: middle path regimen, indications for surgery, paradoxical reaction, MDR-TB
  • Spinal cord injury: ASIA classification, neurogenic vs spinal shock, incomplete syndromes
  • Cervical spine trauma: subaxial classification, odontoid fracture, Hangman's fracture

Hip and femur

  • Hip anatomy: blood supply to femoral head, AVN risk after fracture/dislocation
  • Intracapsular femoral neck fracture: Garden classification, management in young vs elderly
  • Intertrochanteric fracture: AO/OTA classification, DHS vs PFN, cut-out complications

Knee and leg

  • Tibial plateau fractures: Schatzker classification, management principles
  • Knee ligament injuries: ACL, PCL, MCL, LCL — clinical tests, MRI, management outline
  • Meniscal tears: McMurray test, repair vs meniscectomy

Foot and ankle

  • Ankle fractures: Weber classification, syndesmosis injury, management
  • Calcaneal and talus fractures; Lisfranc injury
  • Achilles tendon rupture; clubfoot (Ponseti method)

Paediatric orthopaedics

  • Physeal injuries: Salter-Harris classification, growth arrest complications
  • DDH: Barlow/Ortolani, Pavlik harness, indications for surgery
  • CTEV/clubfoot, congenital vertical talus; SCFE and Perthes disease

Bone tumours and metabolic bone disease

  • Osteosarcoma and Ewing sarcoma: presentation, staging, management outline
  • Giant cell tumour: Campanacci grading, curettage vs resection
  • Metastatic bone disease: Mirels score, prophylactic fixation; pathological fracture

Nerve injuries and reconstruction

  • Peripheral nerve injury: Sunderland classification, Wallerian degeneration, EMG/NCV
  • Brachial plexus injury: pre-ganglionic vs post-ganglionic, Erb's/Klumpke's
  • Radial, ulnar, median, common peroneal nerve palsy — tendon transfer principles

Joint replacement and arthroscopy

  • THR: approaches, bearing surfaces, complications (dislocation, infection, leg length)
  • TKR: indications, alignment principles, complications (stiffness, infection, loosening)
  • Arthroscopy: knee (meniscus, ACL), shoulder (rotator cuff, instability)

Older DNB Orthopaedics Question Papers

The remaining 23 papers are available in the Prep DNB app, organized paper-wise with repeat-question tracking.

Get all 25 papers in the app

Previous Year Questions for Other DNB Subjects