Memes of Podiatry
Started by GreenHousePub
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Tried to use AI to make to make an MIS joke, but it has trouble placing the screws...
Still better fixation than half the cases on Reddit.
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Third world X-rays tbh. Ur not far off
They provide the highest patient satisfaction.
It’s ok visit plus procedure..
BeaverBlade
Quadruple board certified
It's to hang on your fridge........right?
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Ha. Xerox proved that being a gripey biotch gets you free stuff. I didn't even ask for it and they caved and overnighted me free yellow toner to make the printer work again. Course I'd already bought replacement toner elsewhere, but I'll likely send it back and just replace it with black.
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I got a CT head as a kid and my parents managed to get the actual film copies. If they could find them, I’d frame them and put them on my wall so my wife can’t argue about if I have a brain
"Honey, what good is putting this picture up here if you're not using it?"- our wives
So - I have a patient who had a botched cheilectomy performed elsewhere. She developed a wound complication that a WHC had to manage. She had continuous chronic pain once it closed. I saw her - she has severe 1st MPJ arthritis but it just looked wrong. MRI shows T1, T2 change with this very guarded weird note. I call the radiologist to hammer it down and he's like - yes, its osteomyelitis. Patient is young as hell. We biopsy and it comes back acute and chronic osteomyelitis. To screw with my life - nothing grows and I sampled the heck out of it. Doesn't want amputation which would suck. We've been trying to manage since, infectious disease, pain management, etc.
She comes in and has the other doctor's complete note set. The notes are trash.
Me: Is this for a disability claim?
Patient: ...something like that.
I've had 4 patients like this.
3 wanted FMLA
1 wanted a second opinion but you could tell the non union was because of them doing everything the other pod told them not to do
Reached out to the other pod and gave them a heads up. Sent them back.
Its always FMLA or disability
Symptoms are vague + previous surgery from somewhere else + patient is just dodgy AF when you give them multiple treatment options + they straight up just ask for disability and have their paperwork ready for you.
Even worse- the ones that tell you "I ain't responsible for that, you need to figure that out with my work place" when you ask them what kind of paperwork they are needing filled out
Still seething thinking about it. Fired them from my office.
Bro, those things were like the size of a cabinet door. Basically modern art. Assuming there wasn’t too much residual early 90s radiation, I could probably sell them for a decent bag
BeaverBlade
Quadruple board certified
gah. how do you botch a cheilectomy btw? I did have a wound on one myself once, younger patient. Was very frustrating but I did get it to heal. Was pretty surprised his incision didn’t heal. Just proves sometimes **** happens in surgery
Simple: by performing them.
...but yeah, for hallux rigidus do diclofenac gel and ice and injects and Morton extension... then do MPJ fusions. They can "ride it til the wheels fall off," but don't do surgery that doesn't work.
I have fused so many cheilectomies done by other DPMs that failed within a year or two or three that it's not even funny (if you were the patient, absoutely not funny).
BeaverBlade
Quadruple board certified
Some people just have bump pain. I’ve seen large spurs in young patients with good rom that I’m not fusing.Simple: by performing them.
...but yeah, do diclofenac gel and ice and injects and Morton extension... then do MPJ fusions.
I have fused so many cheilectomies done by other DPMs that failed within a year or two or three that it's not even funny (if you were the patient, absoutely not funny).
They will go on to have trouble, more surgery... it's OA of all of it (dorsal MPJ, central, plantar, sesamoids).
Why do you think they formed said large spur?
BeaverBlade
Quadruple board certified
🤷♂️ . It’s tough to fuse a joint that is normal intraop and with normal rom preop in a young patient. I think cheilectomies have a place just have to discuss with patient it might come back and you might need a fusion later.
When there’s obvious limited rom and arthritis though I tell patients no you’re not getting just the spur off
BeaverBlade
Quadruple board certified
I actually don’t do cheilectomies or fusions. I just scope them
I appreciate you sharing your in-depth knowledge on the subject with us.
I’ll send you this shirt out of principle Beaver
Some people, especially patients on the younger side, don’t want a fusion. Cheilectomy, decompression osteotomy, etc. are fine as long as you tell them it’s likely a stop-gap, not a definitive procedure, and they understand it may end in a fusion at some point.
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I love chillectomies.
I always tell patients straight up it’s just a temporary measure and they may need a fusion down the line. That’s the nice thing about them, if it fails you can always fuse it. I’ve had a ton of them do great because the main complaint is always just bump pain generally or dorsal spur pain.
Big Hardware hates chielectomies though..
I always tell patients straight up it’s just a temporary measure and they may need a fusion down the line. That’s the nice thing about them, if it fails you can always fuse it. I’ve had a ton of them do great because the main complaint is always just bump pain generally or dorsal spur pain.
Big Hardware hates chielectomies though..
Chielectomy and irrigation with bulb syringe > MTPJ scope.
I do Maximally Invasive Surgery as well
