Robert Dunbar, MD

Orthopaedic Trauma Surgeon @ Harborview Medical Center

[Robert Dunbar, MD @FractureDoc]

Mini-fragment applications for lower extremity long bone fractures: A … https://t.co/VLOlK56Bwc

Check out this review of different applications for mini-fragment fixation as part of fracture fixation constructs in lower extremity long bones!

[Robert Dunbar, MD @FractureDoc]

@Davembmd Whoa!

[Robert Dunbar, MD @FractureDoc]

@Davembmd Ah, the Jif wasn’t that stale.

[Robert Dunbar, MD @FractureDoc]

@orthotraumamd @orthobullets @FollowMercy @rkh_md @itius @jamesablairMD @DrFraneNicholas @Walt_IUOrtho @bonesmith_ @PaulSethiMD @H2O_SportsMD @schulte_ss I personally hate the term “provisional reduction” - it’s a malapropism of reduction and provisional fixation (reduction is only provisional if it sucks) but it may apply here: we often build dist to prox & temporarily reduce the olecranon fragment to determine radial head needs.

[Robert Dunbar, MD @FractureDoc]

@Davembmd That has delusions of being suboptimal; it aspires to suboptimality

[Robert Dunbar, MD @FractureDoc]

@Davembmd *snowglobe

[Robert Dunbar, MD @FractureDoc]

@Davembmd I don’t even think of it as boredom. The down time just lets all the chaos in my head sift down like the snow in a snoglobe

[Robert Dunbar, MD @FractureDoc]

@Davembmd Who knew there were homes right on the rim?

[Robert Dunbar, MD @FractureDoc]

@orthotraumamd @orthobullets @bethisraellahey @dr_a_s_prasad @drsebheaven @stevemchale @jamesablairMD @shaunpat1 @itius @rkh_md @DrFraneNicholas @jointdocShields @traumaticum Like for 4.5s the pitch may vary from 1.75 mm to 2.0 mm depending on company

[Robert Dunbar, MD @FractureDoc]

@orthotraumamd @orthobullets @bethisraellahey @dr_a_s_prasad @drsebheaven @stevemchale @jamesablairMD @shaunpat1 @itius @rkh_md @DrFraneNicholas @jointdocShields @traumaticum Our soon to be AI overlords say that a typical 2.7 mm screw actually has a 1.0 mm pitch — and that the 2.4’s do also — had thought that maybe these were just switched — but again, this likely does not carry across all companies’ offerings

[Robert Dunbar, MD @FractureDoc]

@orthotraumamd @orthobullets @bethisraellahey @dr_a_s_prasad @drsebheaven @stevemchale @jamesablairMD @shaunpat1 @itius @rkh_md @DrFraneNicholas @jointdocShields @traumaticum In fact, it seems incongruous that the 2.7s have a finer pitch than 2.4s - let me check on that

[Idara @Idarabasimi]

I've genuinely watched this 15 times 🙁😒🙁😒🙁😟🙁

[Robert Dunbar, MD @FractureDoc]

@InvictaOrtho @jnrybt @Traumatisch @traumaticum @IMNailR @Drlyndonmason This is not my specific focus, but if it’s a met, then yes, a long IM nail that protects the full length of the affected bone is preferred. If it’s a primary bone tumor, it may need excision & either a limb sparing tumor type arthroplasty or may need an amputation.

[Robert Dunbar, MD @FractureDoc]

@InvictaOrtho @jnrybt @Traumatisch @traumaticum @IMNailR @Drlyndonmason CXR, CT Chest, Abdomen pelvis. CBC, Metabolic panel, liver labs; urinalysis incl urine SPEP/UPEP, Bence Jones proteins — then as Dr Bodan says. Chances are good this is a met, but get heme/onc involved

[Robert Dunbar, MD @FractureDoc]

@Davembmd “Omnimpotent” all unpowerful

[Robert Dunbar, MD @FractureDoc]

@Davembmd Me neither

[Robert Dunbar, MD @FractureDoc]

@Davembmd Is there another way?