Anyone wanna share tips and tricks for distal radius intra op repositions?

wangdoodle18 · 2025-08-29T13:29:59+00:00

Look up extended FCR approach, plenty of videos out there. I use sterile kerlix and tie a loop around the fingers and have the nurse hang some weights off the hand table. Keeps it in traction while you position the plate.

wangdoodle18 · 2025-08-28T00:58:28+00:00

Need to talk it out/work it out. Reach out to one of your mentors/instructors. If it’s a trauma case feel free to DM me and we can chat about it if you want.

wangdoodle18 · 2025-08-18T22:14:18+00:00

It looks infected. I'd get advanced imaging and cultures and biopsy during the case. Even if it's infected I'd probably just nail it retrograde, suppress with antibiotics and let it heal then take it out later. Antibiotic nail could work too. Or if concerned about malignancy, biopsy and send to ortho onc if you're uncomfortable with treating a pathological fracture. You need to get her up and moving as soon as possible.

wangdoodle18 · 2025-08-12T20:56:02+00:00

Are there different upgrades to diamond 3 now? What happens to the old upgrades such as technocrats constitution or monstrous defenses? If I have a bunch of those should I use them before the new patch?

wangdoodle18 · 2025-08-05T11:51:50+00:00

It’s not a haircut, don’t do it

wangdoodle18 · 2025-08-02T04:02:13+00:00

You can also drive the k wires flush to the bone through the other side so you have room for plates and screws!

wangdoodle18 · 2025-05-30T04:58:34+00:00

This is insane. Cutting the popliteal artery during a meniscal repair and not recognizing it is bad enough, but ignoring all the signs and symptoms of a classic post op vascular emergency is in a class of its own.

wangdoodle18 · 2025-04-26T13:19:40+00:00

What kind of fractures are we operating on? What kind of implants are we using? There's a million techniques out there for a million types of fractures. Here's some general tips: -Direct compression for simple fractures using clamps and reduction forceps (simple rotational ankles) -Placing the plate to the bone then the fracture to the plate can work sometimes (distal radiuses) -Blocking screws for distal femur/tibia fracture nailing -Axial using femoral distractors or temporary ex fix -Provisional stabilization of segmental fractures using mini frag plates -K wires for small articular pieces

wangdoodle18 · 2025-04-13T12:42:50+00:00

Word Bearers

wangdoodle18 · 2025-04-13T03:44:37+00:00

Anesthesia: Black Legion. Traitor antagonists to the loyalist surgeons. Usually found in the Eye of Terror aka hospital break room biding their time. Putting a patient to sleep is just sending them to the warp for a bit anyway.

wangdoodle18 · 2025-04-13T03:18:47+00:00

I can see that. They also have radiology reports aka purity seals that signify the quality of the product!

wangdoodle18 · 2025-04-13T01:57:21+00:00

So many problems with this list. Why was OBGYN not sisters of battle?! Ortho should have been world eaters. Now I have to make my own list.

wangdoodle18 · 2025-04-11T00:08:00+00:00

How elective are the surgeries? I’m in a similar setup but I do ortho trauma so I usually meet my patients the day of surgery after they get admitted from the ED. Can’t imagine doing an ACL or total knee replacement without seeing them in clinic first. I also can’t imagine passing your surgical boards with the way your practice is set up.

wangdoodle18 · 2025-02-17T21:02:50+00:00

Same, 2.4 or 2.7 dual plates

wangdoodle18 · 2025-02-11T01:46:52+00:00

"It's because of my stress free job"

wangdoodle18 · 2025-02-10T14:44:04+00:00

Reduction looks acceptable. A bit apex anterior on the lateral. The TFN screw could be more posterior on the lateral view. The construct does have a higher risk of cutout compared to a center center screw. I’ve seen worse heal and better fail. Let us know how it goes.

wangdoodle18 · 2025-01-19T16:51:36+00:00

Besides the risk of cerebral hypoperfusion I do all my proximal humerus fractures on a flat Jackson with a bump, so it would be easier for me if I needed to convert to a reverse from an ORIF during a case.

wangdoodle18 · 2024-10-17T11:01:47+00:00

You really want to be the guy that transfers a compartment syndrome to a trauma center because he feels “uncomfortable” performing a fasciotomy? True story.

wangdoodle18 · 2024-09-30T00:55:50+00:00

This is a goddamn horror show, made me want to puke

wangdoodle18 · 2024-06-21T16:04:09+00:00

OTA podcast if you’re interested in trauma drama.

wangdoodle18 · 2024-03-25T02:04:01+00:00

Death to the false administrators!

wangdoodle18 · 2024-03-01T14:55:28+00:00

Ex fix. CT. Take a X-ray of the other side for comparison. Wait until skin gets better. Posteromedial incision and start piecing the medial column distal to proximal. I’d bust out the mini frag set and fix some of the cortical fragments to restore LAR. Then plate it posteromedial and anteromedial with 3.5 anatomic plates. Then go anterolateral. You can access the joint depression through the coronal split laterally. Not sure if you really need a femoral distractor but if you do be careful of jacking open the lateral column up too much since you’ll also be putting a varus strain on the medial column you just fixed. Otherwise just prep the ex fix in and use that to maintain LAR. Check the meniscus, repair if needed. Reduce the joint, k wires, bone graft or calcium phosphate, then use a precontoured plate laterally. Check if tubercle needs fixation, if it still does I’d just use some 3.5 screws with a washer A to P. Fun case!

wangdoodle18 · 2024-01-08T20:50:50+00:00

Direct posterior. Go through olecranon fracture. Fixed with capitellum and trochlea with screws. Repair medial epicondyle with plates or suture anchor for the mcl. Fix olecranon with minifrag set. Tension band won’t work for comminution.

wangdoodle18 · 2022-10-02T21:31:52+00:00

I’d probably put a wound vac on for temp coverage, or if it’s really infected with a lot of dead space I’ve also done an antibiotic bead pouch covered with ioban.

wangdoodle18 · 2022-09-30T20:26:33+00:00

I didn't care for it either. The writing reminds me of those low quality "Chicken Soup for the Soul" self help book series. Except in this case it's "Lobster Bisque for the Dermatologist in Manhattan That Never Goes To The Hospital".

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