ROTATION #2 - ORTHOPEDICS

ORTHOPEDICS

 Another rotation has ended. This one was a tiring rotation. It consisted of long hours and overnight call shifts.  

My drawing interpretation of the team. Me with a few tall dudes :)

TYPICAL DAY IN ORTHO

6:45 am – The ortho team meets up and discuss any new consults that had come overnight or any issues with current patients on the ward

7:00am – We start morning rounds

9:00am - The rest of the day is filled with either outpatient clinics or consults from emerge or in hospital wards.

For every consult and patient we saw in clinic we always checked if the patient was neurovascularly intact in the area that they had surgery or injury to. Here are the nerves that we tested

UPPER EXTERMITY (HAND)

NERVE	SENSORY	MOTOR
Radial	1st dorsal webspace	Wrist extension
Medial	Index finger	Thumb Abduction
Ulnar	Lateral of 5th finger	Finger Abduction
AIN (branch of median)	N/A	A okay sign
PIN (branch of radial)	N/A	Thumbs up

LOWER EXTERMITY (FOOT)

NERVE	SENSORY	MOTOR
Deep peroneal	1st dorsal webspace	Dorsiflexion
Superficial peroneal	Dorsal foot	Eversion
Tibial	Plantar surface	Plantar flexion
Sural	Lateral malleolus	N/A
Saphenous	Medial malleolus	N/A

 4:30pm – sign over to the overnight on-call ortho team.

ORTHO SURGERY

Similar x-rays I would see on outpatient clinics

I did have a chance to scrub into a few surgeries. Of course it was embarrassing not knowing all the rules in the OR but I was able to do some cauterization, suction and cutting sutures to help the surgeon. There was also a lot of holding limbs to get a proper angle to drill or screw. I do like the OR but I realized that I’m not a big fan of drills, hammers or screws. I guess that makes sense since I don’t like doing any of that at home :P

FIRST OVERNIGHT CALL SHIFT

my call room :S - took some time to get used to

After the day shift you stay the night at the hospital. As an intern you have a resident with you so you are not alone. 

4:30 to 11:30 pm – Sitting and waiting not knowing what I should do, if I should eat or go to the washroom. :P

12:00 am – got a consult

1:00am – found the on call room a dark gloomy room with a bed and no windows

3:00am – couldn’t sleep because I was freezing in bed

3:15am – got a call for a consult in emerge

4:30am – back to the on call room to get a nap in

6:00am – started morning rounds

9:30am – At home exhausted. Slept until 5:00pm

SUMMARY OF THE THINGS I DID/SAW

How to manage open fractures

Tibia/fibula fracture

Radial dislocations/fractures

Pelvic fractures

Reductions with hematoma blocks

Reductions with conscious sedation

Aspiration of a joint – I was able to do an aspiration on the wrist

Removal of a cast

Assisted in application of back slabs and casts

Post-operative follow ups

Removed staples / stitches

Wound care/management

Reading X-rays

Removal of a drain – hemivac

Overall Orthopedics was a fun rotation. I learned a lot on how the hospital as a whole functions and the basic concepts of orthopedics.