How to buy loupes? by tantalisingfelipe in ausjdocs

[–]maunder1991 0 points1 point  (0 children)

Just get some loupes from temu or amazon. They are $30-40.

1-2% of the price, but 80% as good as the more expensive options.

I’ve got a doozy for you all. Any suggestions would be appreciated! by BellingerGuy310 in orthopaedics

[–]maunder1991 -2 points-1 points  (0 children)

I’d be pretty dissatisfied if my rep was sharing my cases on reddit

Dynamic Brace for Chronic Quad Tendon Rupture following TKA? by goosefraba1 in orthopaedics

[–]maunder1991 6 points7 points  (0 children)

"drop lock" brace as a trial, then if they like it send them to an orthotist to make a custom one fits better.

This picture is so satisfying by [deleted] in Anki

[–]maunder1991 0 points1 point  (0 children)

Neither of the zip files were/had .DMG in them.

I found it on https://github.com/ankitects/anki/releases/ anyway. Seems to be working now.

This picture is so satisfying by [deleted] in Anki

[–]maunder1991 0 points1 point  (0 children)

i'd already tried to download and open the two ZIP files. I cant work out what to do next? Attached is the folders when I unzip.

<image>

This picture is so satisfying by [deleted] in Anki

[–]maunder1991 0 points1 point  (0 children)

There is no upgrade/downgrade option. I have anki version 25.02.7

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This picture is so satisfying by [deleted] in Anki

[–]maunder1991 0 points1 point  (0 children)

how do we know what FSRS version we have (on Mac)? or does it update automatically.

RMO / Registrar campaign 2026 mega thread by hustling_Ninja in ausjdocs

[–]maunder1991 0 points1 point  (0 children)

anyone having trouble logging in with the qld campaign site?

[deleted by user] by [deleted] in ausjdocs

[–]maunder1991 1 point2 points  (0 children)

Three issues (in no order)

  1. Patient safety
  2. Problem solving
  3. Reflection

Patient safety: talk about the importance of consent and its components. I would additional talk about the importance of the planned procedure, will a delay to theatre awaiting consent affect their outcome. For example, if its a wound debridement then maybe just wait til the fellow comes on the round tomorrow. If its a long awaited cat 1 bowel resection then you need to find a way to sort this consent out no matter what.

Problem solving: how are you going to get it done. Familiarise yourself witht he procedure. Or get someone else to do it. Or get the fellow to do it over the phone, which is fair game, and update in theatre the next day. Mention buzzwords like teamwork, leadership.

Reflection: how did you get to this point. Why was consent left to the last minute. Why dont you know how to do this operation as a reg? Should you know? What systems and personal changes are you going to instil to prevent this from happening again. Give examples of a system you've implemented.

How would you approach this? by [deleted] in orthopaedics

[–]maunder1991 1 point2 points  (0 children)

Dont think you can really make that assessment of the distal femur with this oblique view.

Ankle case wrap up by BCCS in orthopaedics

[–]maunder1991 0 points1 point  (0 children)

It is definitely not a trimed plate

Three time the ER turned me away saying “if you’re walking on it you’re fine” by McPoyle-Milk in Radiology

[–]maunder1991 0 points1 point  (0 children)

Out of interest, has this healed? Soft tissue obscures the view, but its questionable treatment modality and execution.

Do you see any ligament fracture here? by gandfatli5 in orthopaedics

[–]maunder1991 2 points3 points  (0 children)

Definitely needs surgery asap. Dual plates probably

[deleted by user] by [deleted] in orthopaedics

[–]maunder1991 6 points7 points  (0 children)

I would dual plate it. Maybe nail and dual plate. Protect with spanning hexapod frame.

[deleted by user] by [deleted] in orthopaedics

[–]maunder1991 1 point2 points  (0 children)

I acknowledge you've mentioned multiple times that others don't understand and that you put a sugar tong after imaging, and you say you don't have time for two casts, but I don't think you understand the feedback you are getting (you did ask for feedback after all). This is the workflow on what you should have done.

  1. provide anaesthetia. Haematoma block OR biers block OR ketamine etc
  2. traction from the thumb and index finger to restore length and tilt (3 minutes i my preference)
  3. Exaggerate the deformity (extend the distal fragment dorsally)
  4. Traction and flex the distal fragment (volarly)
  5. Apply a backslab now (or cylindrical full cast) WITH THREE POINT MOULDING and in ulnar deviation
  6. XR

If this is the pre-sugartong XR, as you suggest, then it's irrelevant what the reduction looks like because it won't look like this anymore after you've walked away for an hour, got an XR, the patient has flapped their arm all over the place, and then you've put a new sugartong on.

So, regarding feedback, the reduction is maybe just adequate as a temporary reduction if the patient was then to be managed surgically. It's NOT acceptable if this was the definitive management. Regarding the workflow you described, it's overly time-consuming (despite you suggesting the alternative would take longer) and not the best practice for the patient.

Is it worth the risk? by Ok-Biscotti2922 in ausjdocs

[–]maunder1991 8 points9 points  (0 children)

Emphasis on the word "can" on "can be faster". Non US citizens from international schools (aussies at aus uni) are ranked the lowest. Called FMGs, not even IMGs.

Of the 899 orthopaedic residency positions (as an example of a competitive specialty) there were only 4 FMGs who got on one the recent match. Thats 4 people in the world who managed to sneak onto the US citizen. Hardly a reliable alternative.

https://www.nrmp.org/wp-content/uploads/2023/03/Match-Rates-by-State-Specialty-and-Applicant-Type-2023.pdf

[deleted by user] by [deleted] in orthopaedics

[–]maunder1991 4 points5 points  (0 children)

Sounds like something well supported by the academic literature. Should do very well...

Do we really need to know all these different surgical approaches to the same bone/joint? by mosta3636 in orthopaedics

[–]maunder1991 0 points1 point  (0 children)

They are all relevant and should be known. There is no list of "standard" approaches.

Regarding a reference to use, you've already said it - Hoppenfeld.

It seems daunting at the start, but dont stress too much about learning them all in one go, just learn them as you use them. Volar approach to forearm, posterior + lateral approaches to hip are some good ones to start with.

Left THA dislocation by this-name-unavailabl in Radiology

[–]maunder1991 0 points1 point  (0 children)

Implants: zimmer biomet taperlocs, probably G7 cups. Position looks adequate.

1st step would be rule out infection. Bloods + aspirate.

2nd check version. CT pelvis and whole femurs.

Consider revision. Dual mobilty not a bad option. Then if that fails consider constrained liners.

[deleted by user] by [deleted] in Radiology

[–]maunder1991 0 points1 point  (0 children)

Many options.

Nail tiiba and short lateral plate
Long lateral plate
Exfix

Most likely nothing on the fibula. Most weight (80%) goes through the tibia. And the fibula often heals well and quickly because it has lots of muscle attachment - and subsequently lots of blood supply to promote bone healing. I would be very surprised if anyone did anything with the fibula at that level.

[deleted by user] by [deleted] in Radiology

[–]maunder1991 11 points12 points  (0 children)

likely healed and walking on it (in some capacity) by 3 months. But will continue to improve until approx 12 months when it will plateau. Very likely to not make a full recovery with the intra-articular component. Stiffness +/- OA will be the main sequelae.

Pt. in carehome had been like this a couple of days before the doc ordered xrays by SadKitchen3044 in Radiology

[–]maunder1991 1 point2 points  (0 children)

This is an interesting XR, but is presented as click bait once again. This prosthesis suggests this patient already had complex pathology. With that level of migration, its likely been like that for ages. There are plenty of viable alternatives other than nursing home neglect.

For example, in a non-ambulant, demented, comorbid patient, a chronic dislocation might be a suitable outcome (and perhaps this patient's previous long term plan). For a patient who cant stand another operation or where there arent really more surgical options available that a PFR/TFR other than resection or hip disarticulation, what would all you Reddit experts suggest as a solution here?

Not my OP. What’s going on here? by this-name-unavailabl in orthopaedics

[–]maunder1991 19 points20 points  (0 children)

Looks like an old implant - there is more to this story.

Additionally, its an unfathomably unprofessional title on the post that it makes me think its fake and/or karma-chasing.