I admit to have less Orthopedics exposure during my clerkship (it was incorporated in our Surgery rotation and we have very minimal cases) so it seems as if I'm starting from scratch on this rotation. Two weeks allotted is very scarce to learn about the broad subject. To make things uncomplicated, I narrowed my goals into two:
a. learn the upper extremities' anatomy by heart
b. learn the lower extremities' anatomy by heart
So far, I had only four OR assists: ilizarov application and fibulectomy, quadriplasty (left), ulnar pinning and debridement (right) and just this morning I had partial hip arthroplasty (left). This one's interesting for I am contemplating on convincing my Dad to undergo knee arthroplasty to stop his chronic knee pain on the left. :'( I miss my Dad so much. He called me up last night to tell me that my Mom and him are coming sometime in October to pay me some visit. Yay! I can't wait for October then. By the way, I have some geeky stuff to share about arthroplasty which I stole from wikipedia. Here:
Arthroplasty (literally "surgical repair of joint") is an operative procedure of orthopedic surgery performed, in which the arthritic or dysfunctional joint surface is replaced with something better or by remodeling or realigning the joint by osteotomy or some other procedure.
Background
Previously, a popular form of arthroplasty was interpositional arthroplasty with interposition of some other tissue like skin, muscle ortendon to keep inflammatory surfaces apart or excisional arthroplasty in which the joint surface and bone was removed leaving scar tissue to fill in the gap. Other forms of arthroplasty include resection(al) arthroplasty, resurfacing arthroplasty, mold arthroplasty, cup arthroplasty, silicone replacement arthroplasty, etc. Osteotomy to restore or modify joint congruity is also an arthroplasty.
For the last 45 years the most successful and common form of arthroplasty is the surgical replacement of arthritic or destructive or necrotic joint or joint surface with prosthesis. For example a hip joint that is affected by osteoarthritis may be replaced entirely (total hip arthroplasty) with a prosthetic hip. This would involve replacing both the acetabulum (hip socket) and the head and neck of the femur. The purpose of this procedure is to relieve pain, to restore range of motion and to improve walking ability, thus leading to the improvement of muscle strength.
Indications for Arthroplasty
- osteoarthritis (OA)
- rheumatoid arthritis (RA)
- avascular necrosis (AVN) or osteonecrosis (ON)
- congenital dislocation of the hip joint (CDH) Hip dysplasia (human)
- acetabular dysplasia (shallow hip socket)
- frozen shoulder, loose shoulder
- traumatized and malaligned joint
- joint stiffness
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| Googled photo. |
Our patient this morning is a 70+ woman with a posterior dislocation of her left femoral head so after the surgery, hip radiography would look like the one above. :)
We made a segue to FMAB (Faculty of Medical Arts Building) after our small group discussion with Dr. Tanbonliong, a hand surgeon, to refresh with Bubbatealicious. Crystal was sipping her Royal Milk Tea when she exclaimed: "Shit, hindi ko ma-suck ang balls!! Puro fluids lang nasa-suck ko!!!" Well, it's up to you what to think! But it made us LOL!
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