Angelos Assiotis

Ortho Consultant/Upper Limb tribe🦴 🇬🇧🇨🇾

[Angelos Assiotis @AngelosAssiotis]

@UMY_35 First attempt; malreduced and distracted. Second attempt; not enough contact, plate not suitable. Basic principles type of scenario: Contact/Alignment/Stability/Stimulation (biology). Plan: Exclude infection, re ORIF, shorten bone and compress, graft.

[Angelos Assiotis @AngelosAssiotis]

@northwoods1980 Three issues:
1. Fracture was never reduced and it needs to be anatomical at the proximal ulnar
2. Screw missing in the proximal fragment (plate design issue? Surgeon issue?)
3. I tension band suture all of these and then plate on top. Zero escaped fragments

[Angelos Assiotis @AngelosAssiotis]

@DrLoizos

[Angelos Assiotis @AngelosAssiotis]

@Xeon4f145d96s1

[Angelos Assiotis @AngelosAssiotis]

@VirtueOfNothing What is of even more concern, than this ‘news article’ and its purpose, is Steeting’s response in that very article. I find it difficult to believe what he just articulated.

[Angelos Assiotis @AngelosAssiotis]

@ATRightMovies M
No

[North West Thames Orthopaedic Rotation @NWTOrtho]

A huge thank you to our faculty who made this event such a success!
@ADLiddle @ortho_london @KLogishetty @AngelosAssiotis Miss Waterman, Mr Strachan, Miss Li, Mr Stammers, Mr Sabharwal.

[Angelos Assiotis @AngelosAssiotis]

@VoltCyprus Ποιες οι επιλογές του Volt για τις υποψηφιότητες των Προέδρων των Επαρχιακών Οργανισμών Αυτοδιοίκησης;

[Angelos Assiotis @AngelosAssiotis]

The @NWTOrtho Annual Lipmann Kessel Annual Scientific Meeting was a fantastic opportunity to catch up with friends, old and new!
North West Thames Ortho, all the way!

[Angelos Assiotis @AngelosAssiotis]

@fuzzylonglegs1 @sainsburys @Tesco Same problem here; purchased from Sainsbury’s, several packets present the same problem. Not suitable for use when the tablet disintegrates on attempting to release it.
@sainsburys need to consider a different supplier
#galpharm

[Angelos Assiotis @AngelosAssiotis]

@PicturesFoIder 80s/90s vibes….

[Angelos Assiotis @AngelosAssiotis]

@pratikorho They can be challenging, especially when lots of small fragments. Two key points I like trainees to take away:
1. Leave as much soft tissue attached to these fragments as possible, when reducing.
2. Don’t ‘pepperpot’ the clavicle with the drill.

[Angelos Assiotis @AngelosAssiotis]

@themskarchive 2 things:
1. Subchondral collapse of humeral head, could be indicative of AVN but it doesn’t explain the second point;
2. Glenoid blunting and callus/fragmentation.
Most likely diagnosis; severe instability Arthropathy

[Angelos Assiotis @AngelosAssiotis]

@Doced95 @orji_ck @aqueipot @InvictaOrtho Because a cephalomedullary nail is more expensive than a DHS and evidence does not support its use in this type of fractures, over a DHS.

[Angelos Assiotis @AngelosAssiotis]

@orthobullets @OrthoShah @BannerHealth @RachelFrankMD @EauClaireOrtho @AnthonyRomeoMD @OrthoStrelzow @kburnsmd @DrRobHartzler @rish_parmar @PaulSethiMD Fun case!
1. Seizure free for 6 months after Neuro review.
2. Must’ve stopped smoking if smoker. 3. Arthroscopic procedure: remplissage and then bone block (distal clavicle), through rotator interval. This respects suscap in case of future Arthroplasty.

[Angelos Assiotis @AngelosAssiotis]

@NoContextHumans @OzzyManReviews

[Angelos Assiotis @AngelosAssiotis]

@pratikorho ⬆️ seen one of these when the stem handle and the version rod were used, right side for a left shoulder 😬

[Angelos Assiotis @AngelosAssiotis]

@pratikorho Likely will heal as there’s an extensive fracture surface area. Braces/splints don’t offer much benefit in available literature (happy to be corrected if I missed anything). Old saying: ‘best way to stop clavicle healing is to operate on it’ (not entirely true but I like it!)

[Angelos Assiotis @AngelosAssiotis]

@DrGoblin3

[Angelos Assiotis @AngelosAssiotis]

@traumaticum If there’s a delay to theatre, more than few days, I find the shaft stuck medially and I release pec major tendon (partially) without hesitation, to get the shaft to move. Also, the shaft (or head, in fracture/dislocations) has a nasty habit of sticking on the artery, if allowed