Ortho Rotation reccs

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Orthojoe

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Ive had a lot of students doing ortho audition rotations this upcoming year ask for advice on what they need to know. Here is a rehash of a previous post to answer that questions. Also if anyone is rotating in Modesto this year PM me for a good overview.

#1 obviously anatomy - get hoppenfelds surgical approaches. must have book
#2 hand book of fractures, if you dont have it, get it. below is a list of the highlights to know cold
#3 learn how to read an xray appropriately. ie 2 views of "anatomic part" of a "skeletally mature/imature"; demonstrating a "desribe fracture oblique, transverse, comminuted" fracture then add in angulation and displacement if needed.
#4 work hard and dont expect to sleep much, always be willing to stay late.. its 4 weeks of no sleep that will make or break the rest of your life.
#5 be nice to everyone, most importantly the nursing staff, office staff and residency staff.

Handbook of fractures
1. Section I: General Considerations - most of it is not very high yield; focus on following points
a. Open Fractures
i. Table 3.2
b. Muscle Viability
i. Table 3.4
2. Section 2: Axial Skeleton Fractures - again, not very high yield for ortho auditions
a. Chance, Compression, Burst, and Jefferson fractures
b. know diagram on p. 137
3. Section 3: Upper Extremity Fractures and Dislocations
a. Allman classification (p. 145)
i. Look at Tarascon's for Neer modification
b. AC joint (p. 154)
i. Table 12.1 and Figure 12.3
c. Hill-Sachs, HAGL, and Bankart lesions (p. 174)
d. Proximal humerus fractures (p. 194)
i. displacing forces (figure 15.1)
e. Holstein Lewis type fractures (p. 211)
f. Tolerances of humeral shaft fractures (p. 206)
g. Circle of Hori (p. 232-233)
h. Terrible triad of elbow - radial head fx, coronoid fx, and elbow dislocation
i. Radial Head - Mason classification (p. 250-252)
j. Bado classification (Figure 21.2)
k. Galiazzi and Monteggia (p. 267)
l. Frykman (p. 273)
m. Smith/Barton's (p. 274)
n. Scaphoid fx
i. blood supply of scaphoid (p. 288-289)
o. Triquetrum fx - classically seen on lateral xray as a fleck on dorsum of hand
p. "Terry Thomas sign" (p. 302)
q. Boxer's fx (5th metacarpal neck)
r. Bennet, Rolando (p. 312-313)
s. Stener lesion (Figure 24.9)
4. Section 4: Lower Extremity Fractures and Dislocations
a. Young and Burgess (Figure 25.6)
b. Vascular supply of femoral head (Figure 27.3)
c. Femoral neck fractures - Pauwel and Garden (p. 381-383)
d. Evans intertrochanteric fx (Figure 30.1)
e. Patellar fractures (p. 441)
f. Patellar radiographic lines (p. 446)
g. Schatzker classification (Figure 36.1)
h. Danis-Weber classification (Figure 38.8)
i. Lauge-Hansen (p. 485)
j. Ruedi and Allgower (p. 493, Figure 38.10)
k. Pilon fx (p. 495)
l. Calcaneal fx
i. radiographic lines/angles (Figures 39.1 and 39.2)
ii. Sander's (p. 513-514)
m. Hawkin's classes and sign (p. 522)
n. Lisfranc injury (p. 541-548)
o. Jones fx, (p. 551)
i. know what a true zone 2 is
5. Section 5: Pediatric Fractures and Dislocations
a. Salter-Harris type I - V (p. 567)
b. Gartland (p. 605-606)
c. Physeal fractures of lateral condyle (p. 609)
d. Juvenile Tillaux fx (Figure 51.3)

note: credit to many students that contributed to this list as I asked other fellow ortho students what they frequently were asked at each ortho audition.

any other questions feel free to ask. good luck and congrats to those who just matched.

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Thanks for this info!

My primary source so far (M2 involved in ortho) has been Netter's Concise Ortho Anatomy, do you have opinion on this book?
 
Thanks for this info!

My primary source so far (M2 involved in ortho) has been Netter's Concise Ortho Anatomy, do you have opinion on this book?

That's a great book that was highly recommended by the residents I've spoken to. Although, I believe your main focus should be on your Step 1
 
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That's a great book that was highly recommended by the residents I've spoken to. Although, I believe your main focus should be on your Step 1

I'm not really interested in ortho but I have a question. Is step 1 the most important thing for matching into this field? Because for EM, it's LORs and clerkship grades. Step1 is used more of as a screening tool. I was wondering if it's different for ortho and surgical fields in general.
 
in the DO world, its about boards AND doing well on rotations. Most programs look for "fit" over boards.

At my program, if you are put on our make-shift "maybe" interview list and it comes down to a few people for the remaining spot, we'll go to boards to pick the person. Also, if you didn't make a great or bad impression on your rotation and no one can really recall if to give you an interview or not; having high boards will get you bumped to a maybe vs low boards will just be a no.

When I say low, I mean like low 500s or lower.
 
Bone smashed, me fix with big tool, me cash check.
 
Anybody know of programs that interview as late as january?
 
Heard that many DO students are able to arrange several weeks of rotations at some of these ortho sites and arrange visits with people at these sites during their third year so once they get to the audition rotation they have already spent a significant amount of time at the hospital and know everyone there, making it hard for students who get their 4 week audition and nothing else. Today was the first I had heard of this happening. Anyone else heard about this or know if it is common?
 
Heard that many DO students are able to arrange several weeks of rotations at some of these ortho sites and arrange visits with people at these sites during their third year so once they get to the audition rotation they have already spent a significant amount of time at the hospital and know everyone there, making it hard for students who get their 4 week audition and nothing else. Today was the first I had heard of this happening. Anyone else heard about this or know if it is common?

I met or heard of numerous people who rotated at programs their 3rd year and were back for auditions. It can help you if you do what you should while there or hurt you if you don't. Double edged sword. If I could do it over again I would have done as many at programs I was interested in as possible my third year and absolutely work my tail off.

On another note to this topic I would just like to give my two cents on this process as I just went through it. The OP could not be more spot on with regards to what is expected of you on these auditions (work ethic wise, knowledge wise, and generally not being a d-bag wise). But honestly these are just the bare minimums these days because just about everyone out there on the trail did all those things, and did them very well. So many hard-working, smart, friendly students didn't end up with a spot when the dust settled. There is a mountain of annoyances I had with this whole process that I was going to go into but I've decided not to because in the end I matched and want to move on from this ridiculously horrid portion of my life.

To those about to enter the suck. Good luck.
 
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I have an open slot in January of 4th year. Obviously, this doesn't really work as an "audition" because it is well after interviews. But seeing as it would be before the match/rank lists, would it benefit me to schedule it at a place I did an actual audition (and hopefully received an interview) as like a Hey I'm really interested in you rotation? Probably would be contingent on my original audition and the (hopefully) interview going well.

I was also thinking about scheduling it at a place I got an interview but wasn't able to audition? (Which I realize is pretty uncommon, but I hope to get 1 or 2) I doubt that it would count as a true audition but maybe it could help out.

I appreciate the feedback, I just wish that elective was 3 months earlier.
 
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