Had a 15yo female patient with no TFO on AP and mortise. No fracture, normal MCS. Tenderness over AITFL, but squeeze and ER test negative. Her injury had an external rotation mechanism, it happened the day before and she was able to ambulate since then.

What's your opinion?

Hello! I am so excited to be an ortho resident but I also want to prepare myself as good as possible.

Is there anything in your day to day or in your bag that you couldn't live without??
(A specific type of shears or a go-to protein snack)

Thank you!!

EDIT: I'm not from the US but amazon, etc are still available for me.

Hand surgeon. Need a headlight for in-office minor procedures (triggers, carpals, small lumps and bumps). Rather than dropping yet another grand on one of the many loupes companies’ headlight offerings, does anyone have experience with using a camping headlight from say Amazon ($30-50) for a similar purpose? (Not intending this for OR / big surgeries, I have a different set up for that).

Looking at the Black Diamond spot 350, for $45, for example.

Probably gonna try something, worst case it’s not ideal, but figured I’d ask and see if it’s even reasonable.

Have to appeal they said

Hi, I’m currently a UK medical student. 2 years ago I broke the 3rd and 4th metacarpals of my right (dominant) hand, requiring internal fixation. I am interested in a career in trauma and orthopaedics, but I’m worried my hand could limit me in the future (development of OA etc). Currently, I have complete functionality of my hand and it feels fine. Do any surgeons have any advice for me? Thanks

I have shadowed plenty of doctors and am very keen on ortho. I’m well aware of the competitiveness of matching into ortho, but would love some advice on how to set myself up for success. Of course there’s hurdles getting there but any help from you guys would be awesome! Thank you in advance 🙏

Hello I'm a resident interested in an in-depth resource for shoulder arthritis and shoulder arthroplasty. We use Delee and Drez for Sports but this book doesn't cover arthritis of the shoulder and elbow nor arthroplasty in great detail. Would appreciate any recommendations on this

Mainly asking about what we’re closing open carpal tunnels with, I don’t know why I’m having a brain fart and cannot remember what we close with after a brief hiatus from doing them (fellowship)

Hi everyone,

I’m an orthopedic surgeon working in a limited-resource setting where titanium interference screws are the only option for ACL reconstruction. Recently, I encountered a challenging case where the titanium screw damaged the graft(Hamstring graft) during insertion into the femoral tunnel. This happened when I put using IN-OUT method which ultimately led to the graft being compromised.

I would greatly appreciate any tips or advice on: 1. Techniques to avoid graft damage when using titanium interference screws. 2. Whether adjusting the screw IN-OUT method is a common risk factor for this complication, Should I change to OUT-IN method? 3. Any specific guide on choosing the size of titanium screw in compare with the graft 4. Should I put many stitches as possible on the graft to avoid graft lacerated from interference screw 5. Should I change to quad graft or BPTB graft? Feel free to adjust it if you need me to include additional details!

Can someone suggest good journals with no APC or a minimum APC, that would accept expert consensus documents - the consensus is on osteoarthritis and the role of upcoming therapies

I am looking into obtaining additional training on point of care ultrasound and would like to hear if anyone has recommendations on courses that were helpful and oriented more for ortho.

Before or after taxes. And how about from collections vs ancillary vs surgery center etc? What specialty?

Hi r/orthopedics. I was looking into shoulder replacement options for situations for young active patients with near complete chondral loss. Are there newer options for the humeral head prothesis surface? And are there any experimental procedures such has RECLAIM for the knee?

Hi everyone! Thanks so much for all the helpful info in this subreddit. I’m currently in an adult recon fellowship and will be starting a private practice job this fall.

I’m curious if there are any specific skills, courses (ie coding), outreach opportunities, or practice site visits you’d recommend tackling before the grind begins. I was considering building a landing page, but unfortunately that isn't allowed.

Would love to hear your thoughts on setting yourself up for success!

Thank you!!

OMS4 here in the midst of interviews. As I’m constructing my rank list, I’m struggling with whether I want to prioritize my personal fit with a program or the operative quality of the program. I’ve been to programs with a culture and people that I’ve absolutely loved but with weaker operative experience. And I’ve been to programs with people that I just get along with but their training is miles better.

It seems like a ridiculous question to ask a bunch of surgeons whether I should strive for better training or not. But residency’s a non-insignificant amount of time and intensity and I’d obviously prefer to go through it in a place with people I enjoy being with. Not to belabor this point but I’m a minority and it’s definitely been noticeable in some places more than others. How did y’all make the decision on your rank list?

Hi all, I'm doing my due diligence double checking MRI safety of an implant for a research technologist gig I do on the side. I'm typically not concerned with scanning passive orthopedic implants of any kind, and in a clinical setting would likely have a million prior xrays of a patient's various parts and hardware to confirm nothing looks out of the ordinary. In the research setting, I don't have access to this participant's films or prior records and am unfamiliar with this brand, and my Google-fu is failing me.

Just wanted to poke the hive mind and see if there's anything special about this one, like it's loaded with magnetic buckshot (kidding) or those magnetic expandable components. I'm pretty sure it's just a benign, passive rod but I'd appreciate any insight on this if not. Thank you :)

Hi,

I am currently contemplating residency rank list and was curious how much exposure to certain niche fields during residency matters for long term career goals.

For example if you ultimately wanted to focus on peds spine deformity would it be a mistake to go to a more desired residency program that doesn't do this vs one that has high volume but you don't love the overall program as much?

Additionally, for things like hand... Should you prioritize a program that does more complex hand cases and microsurgery?

Can these differences be overcome during fellowship or does seeing/assisting in these cases during residency make a huge difference?

Thanks!

Hey all, I'm interested in starting to perform reverse total shoulders for geriatric 4 part fractures. My exposure to total shoulders have always been in the beach chair position, but I've heard of some surgeons especially on the west coast performing their rTSAs supine on a flat top radiolucent table. I've tried to search for articles, chapters, and techniques on how to do it in the supine position but haven't had any luck. Can someone point me in the right direction? Thanks!

Can any of the attendings here speak a little bit about your experience working for a private practice vs an employed position? I am looking for jobs as a current fellow and considering private practice in an ideal location vs an employed position in a less ideal location.

These are the things I am weighing and would appreciate advice on:

1. income stability/security: having very little income initially in PP and essentially paying my partners to be there until I bring in sufficient business. what if covid happens again or some other natural disaster threatens the practice? vs employed position with a salary and benefits.
2. parental leave: paying for my overhead if we have a kid/kids in PP vs an employed position that has paid leave
3. student loans: pay off myself in PP vs potential PSLF as an employee (unless the new admin does away with this anyways)
4. competition: building up my name and competing against well established surgeons in a competitive area in PP (imposter syndrome and self doubt is real . . . )
5. Flexible schedule: is the potential future income growth and flexibility in PP worth the unknowns in the first few years? Also what if PE comes in and buys the place out?
6. Location: we would be much happier in the location with a PP in terms of activities outside of work. My partner has been forced to follow me around for enough years that they deserve to get to pick where we should live for once . . . but will I be too busy and stressed out to enjoy it?

Anyone work for an HCA hospital? I’m negotiating with them but the contract seems a little predatory and they’re not willing to budge on much of anything. No one ever has anything good to say about them but I’m not sure I’ve ever talked to anyone that does work for them. Is that in itself a big enough red flag to walk?

A while ago I had a friend who was a PT who disclosed to me after some drinks that he believed the majority of his patients were faking it. Wrist pain, foot pain, knee pain, etc. He said there of course are patients who are injured or have disabling pain (I know nothing about this field) that he helps too but gave the number of 50 percent for those he thinks are faking it at least in one way or another.

The kicker is, he doesn't even think they are faking it for financial reasons. Many of them pay out of pocket to be there. Wrist braces give some people the attention they need, I guess.

I talked to this friend again recently and it got me curious. Does anyone else in this field feel the same way?

Is it possible to have a good work life balance as a pediatric orthopod? I love pediatric ortho but I wish to have a little more free time and residency hours are kicking my butt. If not, what is the best option for an ortho subspecialty with good hours?

A few days ago a colleague of mine showed me the cori simulator website, a webpage where you can exercise on knee balancement cuts via your pc. Unfortunately to access the website you need to have an account provided by smith&nephew. I was wondering if any of you guys know something similar available for free to anyone, thank you!!

Just got word from billing and coding that total shoulders and open biceps tenodesis are being bundled by all insurers. Anyone else hear this?

Hi all, as the title suggests I’m a US MD student at a strong program that just got back a 246 on step 2. Like everyone else applying ortho I was hoping for a stronger result.

I have 20+ presentations+publications, most first or second author. I’m currently doing a research year at my home program. I honored surgery during clerkship year with strong feedback on all of my rotations. My school doesn’t do AOA or rank. If it helps, I’m a normal / broey personality type of guy (lol).

It’s about time to plan away rotations. What kind of programs should I be looking at? I live in a major city and most local programs are competitive. Should I even apply ortho? Will I need to dual apply gen surg / IM?

Any feedback would be appreciated, seems like the average step 2 for ortho now is a 256. Thanks in advance.

Not a joint guy but I was wondering if anybody has tried melting a poly for a ski base repair instead of ptex?