Ortho Conditioning

🦴 Ortho Surgery Education, Mentorship, & Community (check pinned ⬇️)

[Ortho Conditioning @orthocondition]

Check out our ortho community, drop in and ask questions!

Whether it is on matching strategies, away rotations, interviewing, or ortho in general, we are happy to help!

https://t.co/tHphN8aMCs

[Drew Albert @DrewAlbertMD]

Our community @orthocondition has had a few awesome contributors cataloging ortho research positions in the United States, if you have a research position to add let us know!

https://t.co/0kN9fetjoI

[Drew Albert @DrewAlbertMD]

Med student that I have been mentoring (early and active contributor to @orthocondition):

99th percentile Step 2 score
Honored all clinical rotations/shelf exams
Doing great on away rotations
Winning research awards

"I just want to match somewhere."

[Drew Albert @DrewAlbertMD]

What advice would you give us fellows looking for a job in the context of these stats:

~50% of ortho surgeons leave their first job within 5 years.

Why?
- financial reasons (34%)
- practice not as advertised (31%)
- minimal training in selecting a job (53%)
- most ortho grads feel inadequately prepared for the business side of orthopedics (88%)

https://t.co/6tzs7Hf3Dl

[Drew Albert @DrewAlbertMD]

What are OR efficiency consultants saying these days about spine getting two rooms?

Do they just lump them into the typical "Surgey must be <90min. to qualify?

It seems like ~2 hour surgeries with 30min overlap between the two rooms, getting 4-5 cases done seems reasonable (and is done at some institutions).

[Ortho and Spine Jobs @orthoandspine_]

Ever wonder why at least 50% of new surgeons leave their jobs after 2 years? We think it may be related to understanding practice economics.

One of our goals is to empower surgeons with data to make the best choices they can. https://t.co/2bndNEcfzQ

[Ortho and Spine Jobs @orthoandspine_]

Where are all the efficient ortho and spine hospitals and ASCs? If you love where you do your cases, please fill out the survey.

It is time we had a surgeon focused ranking for hospitals: https://t.co/tjnA29PC5m

[Ortho and Spine Jobs @orthoandspine_]

“The best advice is to find a group with partners that will support you and help you with cases initially. Don’t try to be a hero and do what you are comfortable with in first 1-2 yrs.”

- Sports Surgeon in Texas

[Ortho Conditioning @orthocondition]

Open fractures

Associated neurovascular or tendon injury

High-energy polytraumas

Acute carpal tunnel syndrome (emergent)

Volar Bartons (unless specified by attending, some are sent home)

[Ortho Conditioning @orthocondition]

For Medical Students Learning Ortho, What are some common Operative Indications for Distal Radius Fractures?

[Ortho Conditioning @orthocondition]

Hematoma blocks are when you inject lidocaine or another nerve-blocking derivative into the fracture hematoma.

[Ortho Conditioning @orthocondition]

For Medical Students Learning Ortho, What is a Hematoma Block?

[Ortho Conditioning @orthocondition]

Rules on Reading X-rays
- Verify the patient, date of birth, and date of x-ray.
-Are there similar prior x-rays to use as a comparison?
-Look at the whole image and identify the obvious findings.
-Then move on to a deep systematic analysis.

[Ortho Conditioning @orthocondition]

Assessing the quality of AP Wrist X-rays: Key Points

Assess Proximal to distal;
Image centered at the (DRUJ);
The third metacarpal, capitate, and radius should fall in a straight line indicating the wrist was in a neutral position;
The pisiform and triquetrum should overlap.

[Ortho and Spine Jobs @orthoandspine_]

We are building a map of surgeon-friendly states with anonymous compensation and asset ownership data.

Ortho and spine surgeons, please fill out the survey to see the results: https://t.co/MmwOWmgdEr

[Ortho Conditioning @orthocondition]

Have a System for Reading Wrist Xrays:

Verify the patient, laterality, and quality of xrays -

AP, Lateral, and Oblique Views
Skeletally mature or immature?
Obvious injuries?

After establishing the obvious, go back and systematically through each image.

[Ortho Conditioning @orthocondition]

Periprosthetic fractures:

Use the term “periprosthetic” any time there is a prosthesis and fracture in the same bone, even if there is a distal femur fracture with proximal hardware like a total hip.

[Ortho Conditioning @orthocondition]

Fracture Angulation:

Valgus = the distal bone is angled away from the midline of the body
Varus = the distal bone is angled towards the midline of the body

[Ortho Conditioning @orthocondition]

Format for Describing Fracture Displacement:

Displaced - If there has been movement of fracture pieces.

Nondisplaced - No movement between bone fragments.

Minimally displaced - When not much movement has occurred, this is a subjective description.

[Ortho Conditioning @orthocondition]

When Describing Orthopedic Fractures, make sure not to miss these important points:

Describe the displacement, Fracture morphology, Fracture location, and any Unique Scenarios, such as Periprosthetic fractures (hardware present) or
Joint involvement.

[Ortho Conditioning @orthocondition]

Describe the fracture in the most straightforward way possible.

Don’t get bogged down in the details.

Say the most accurate and elegant fracture description in the fewest words possible.

Say it with confidence (even if you are not).

[Ortho Conditioning @orthocondition]

Format For Describing Fractures:

Say the x-ray views you are seeing and the laterality, if you are unsure of the view, say 1 or 2-view of a left or right “blank”.

[Ortho Conditioning @orthocondition]

Look for open physes to say, “skeletally mature or immature individual”.

Starting out, this a good practice, when you are a resident it may not be necessary in your residency program