best ortho procedures

www.or-live.com has some surgeries that you can watch. Doesnt answer any of your questions, but I figured it would be interesting to you.

trapperjohn said:

i heard orthopods do the coolest (in my opinion), most physically demanding surgical procedures of all the surgical specialties. if you guys wouldnt mind, what are some of the most exillerating procedures to do and what about them makes it exciting? also, a big turnoff to neurosurgery is the relative "poor" outcome of trauma cases they recieve. i know ortho gets a ton of trauma. typically, how well do your trauma patients recover after ortho procedures are successfully performed. thanks.

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Although not trauma, I have heard a couple of orthos say that the labral repair in shoulder is a "neat" surgery that requires some intellect as opposed to others which are more routine and can be done by a trained chimp.

Trauma in ortho is some of the best surgery. Long bones typically do very well, but can be complicated, especailly with open fractures - infections, non-unions, malunions being some of the hardest to deal with. Periarticular fractures are a fun challenge, and many do reasonably well. Early post-traumatic arthritis can be a real problem.

Though a "trained chimp" (please refer to pot-hole's insight above) could probably figure out how to assemble a scope, or how to put together the modular pieces of a major total joint - the real fun of these cases is found in the subtle differences each case offers. I suppose that any trained monkey would agree that all total knee replacements are the same; right?

Fianlly, it is true that orthopedists do the coolest procedures. Get into a good general practice, and your day in the OR could consist of scoping a few shoulders or knees, replacing a joint or two, fix a fracture, release a carpal tunnel or trigger finger, and still be home early in the day. Sure beats sewing valves and vessels into sick hearts, or looking at the poop-shoot from the inside through the back door...

In what other speciality could you do something like this, implant this, or use one of these, and someone's dumb enough to pay you for it?

Trauma surgery is awesome. There are programs that are doing some really cool things.

I love these cases, because you see instant results through fluro and you get to shoot pins just distal to the tibial plateau, then saw along your pins, followed by hammering a wedge into your opening then securing your plate with titanium screws!!! If that isn't freakin awesome I don't know what is??!!! Total shoulders are cool too, but usually bloody as all get out!!!

dobonedoc said:

Though a "trained chimp" (please refer to pot-hole's insight above) could probably figure out how to assemble a scope, or how to put together the modular pieces of a major total joint - the real fun of these cases is found in the subtle differences each case offers. I suppose that any trained monkey would agree that all total knee replacements are the same; right?

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Dude, relax, man! Very little of ALL medicine requires much of a brain. I've said that 95% of any job in medicine - ANY - could be done by a machine or a tech. What we are for is that 5% of the time (which is randomly distributed) when someone with more precise knowledge and training is required.

Surgery is straightforward - precision and coordination are needed, but surprises are rare. Medicine has all sorts of arcanum, but remembering the trivial disease is the biggest challenge - even with the most complex issues, going around the block once is enough to get it straight in your head. Even the nephrologists - who some people will say are the smartest of the smart (and I am not a renal doc, nor associated with any, nor have no desire to be) - could have a person just reading off a chart and calculating all sorts of numbers.

I appreciate - wholeheartedly - the job that OrthoSx does. However, even brain surgery isn't all it's cracked up to be (remember the neurosurgeon in the '80s who offered to trade NSx lessons with Eddie Van Halen for guitar lessons?) - just more precision. The hands are as important as the mind - or even more so. However, to claim that it is intellectually challenging is slightly disingenuous. I know several orthopaedic surgeons that are proud to compare themselves to carpenters - true artisans that see each job they do as a piece of work that is unique, even if it is using the same raw materials as other jobs. It is the acquired skill - in conjunction with the natural ability - that makes the bone doc what he is. Perfect reduction in an ORIF or getting the bone ends planed just the right way for a TKR is all DOING - no matter how much you think about it, it has to get to the hands. That satisfaction of the macro results - when the patient says, "I can walk again" or "my arm isn't numb anymore" - that's where the joy is (as far as I know from my colleagues).

RxnMan said:

In what other speciality could you do something like this, implant this, or use one of these, and someone's dumb enough to pay you for it?

Trauma surgery is awesome. There are programs that are doing some really cool things.

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Wow.

I have never seen a vertical expandable prosthetic titanium rib procedure done. I don’t think that is part of the required curriculum for orthopaedic residents....

Until your post, I had never even heard of it.

Learn something new every day…

trapperjohn said:

i heard orthopods do the coolest (in my opinion), most physically demanding surgical procedures of all the surgical specialties. if you guys wouldnt mind, what are some of the most exillerating procedures to do and what about them makes it exciting? also, a big turnoff to neurosurgery is the relative "poor" outcome of trauma cases they recieve. i know ortho gets a ton of trauma. typically, how well do your trauma patients recover after ortho procedures are successfully performed. thanks.

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Doing total joints (knees and hips) is pretty cool. If you’re the kind of guy that likes things all clean and neat, TKR, THR is awesome. You start with a gnarly, diseased, crooked hip/knee and finish with a straight and shiny new joint.

Then the patient loves you for the next 10 years because they can go back to golf/tennis/walking and think that you are the best doctor ever.

That part is pretty cool—and this is the result that 90% of these patients get.

Nothing in neurosurgery really compares to the exhilaration that you can get from a good total joint.

moquito_17 said:

Wow.

I have never seen a vertical expandable prosthetic titanium rib procedure done. I don’t think that is part of the required curriculum for orthopaedic residents....

Until your post, I had never even heard of it.

Learn something new every day…

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I have not seen one done either, but I met with the medical device guys at a conference. Very cool. Ortho guys & gals get the best toys.

sign me up for Orthopaedic Surgery!