Ortho. Surg. & life threatening sitations

[N-transition]

Do orthopedic surgeon deal with life threatening sitations? Critical Care? I am considering ortho b/c I like working with my hands especially in Adullt Reconstruction. I like the idea of doing implants (knee, pelvis etc...) But on the other hand I really enjoyed the life threatening situations in EM , Surgery and Gas. So, I was wondering if ortho deals with critical situations were the patients life is in the balance. I really don't kow which path to choose. Anybody with advice for me?

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[Cassidy61]

most people except ortho (maybe some ortho too) poop their pants when a massive pelvic fracture rolls into the ED. so, to answer your question, we do see some life threatening emergencies like an open book pelvis. overall, we are there to pick up the scraps when gen surg is done "saving lives"!! turns out that when these trauma patients wake up they are more concerned that their leg is back on straight than what an awesome job someone did sewing up their liver!! overall, ortho trauma is very enjoyable in that you are truly a consult to the main event. you get all of the adrenaline of helping to save someone's life without having to take care of all of their orders and scut like rolling them to the CT scanner!!

 

[N-transition]

most people except ortho (maybe some ortho too) poop their pants when a massive pelvic fracture rolls into the ED. so, to answer your question, we do see some life threatening emergencies like an open book pelvis. overall, we are there to pick up the scraps when gen surg is done "saving lives"!! turns out that when these trauma patients wake up they are more concerned that their leg is back on straight than what an awesome job someone did sewing up their liver!! overall, ortho trauma is very enjoyable in that you are truly a consult to the main event. you get all of the adrenaline of helping to save someone's life without having to take care of all of their orders and scut like rolling them to the CT scanner!!

Cassidy61,

thank you for your insight. I was wondering...these "open book pelvis" fractures....are they mostly in elderly patients? Do you get a wide range of patients (ped, adults and elderly) in serious, life threatening ortho trauma.

 

[Cassidy61]

first of all, you don't see many of the more severe ortho traumas unless you are at a major level 1 receiving (harborview, shock, etc..). most of the wicked injuries happen in younger adults due to their reckless nature! we do see a wide age range of trauma from the very young to very old, however, most of the trauma is NOT life or death. i was trying to point out that it can be very satisfying to be part of the team that reconstructs a trauma while not actually being the one to cross clamp the aorta. believe me, after a few years you get a little bored no matter what the situation. so, the best advice i can give is to pick the field in which you can stand the day to day crap to get to the occasional adrenaline filled moments.

 

[skb21]

The orthopod I've worked with for the past two years trained at Campbell Clinic in Memphis. While at the MED, he says they averaged about 80 acetabular fractures a year during his 5 years there. That's a wicked amount for a case that will take anywhere from 2-10 hours to do.

 

[soudes]

i just got off my first intern month (on ortho), and just on my nights on call, we had two open tib/fibs, one open femur, open book pelvis and an open knee.

can't wait til winter

btw, it was at elmhurst hospital in queens (mt sinai program)

 

[skb21]

i just got off my first intern month (on ortho), and just on my nights on call, we had two open tib/fibs, one open femur, open book pelvis and an open knee.

can't wait til winter

btw, it was at elmhurst hospital in queens (mt sinai program)

That's cool man! You got a good bit of trauma experience early on.

 

[ortho2003]

Since we are sharing stories...this past weekend, I had an open-book pelvis, a C2 fx and a cervical occiput dissociation all role in over the course of 12 hours. You can get plenty of life threatening injuries in ortho. They may not be as bloody as an aortic rupture, but they are life and death injuries.

 

[thenavysurgeon]

i think the answer to the OPs question is this: ortho, although very smart docs, don't manage, and don't want to manage critically ill patients. Where I trained, and this is almost universally the case, Gen Surg does the initial stabilization, 'owns' the patient in the ICU, and when its safe for the patient. allows ortho to do their thing...

when i was a resident, the ortho guys were in the trauma rooms with us, placing traction pins, doing some joint disloc. reductions...so they got the thrill of a chaotic trauma room...but 99% or orthopaedic interventions occur after the patient is stabilized...

if you want adrenaline, General Surgery with a practice in trauma is a great place to be. It gets old, however. I've been in practice for 3 years now...I would very much not like to do trauma ever again...it keeps you up late at night, and in on the weekends. that's no way to live...

 

[Kilgorian]

I think thenavysurgeon said it best: "don't manage, and don't want to manage critically ill patients."

Critical care/trauma surgery is painful. Most don't enjoy it. Many of the trauma surgeons where I work don't enjoy it at all. It does keep you up at night, screws up your life with its unpredictabiliy, and, like I said, is just generally painful. We are involved in trauma patient's care (often playing a key role), but not ultimately responsible for most aspects of acute resuscitions. We stabilize the orthopaedic injuries in one way or another, and try to communicate the nature/necessity of emergency treatment of life-threatening orthopaedic injuries.

I think you'll have to experience it for yourself and make your own decision. If you don't work at a Level 1 trauma center, do an away rotation and get the taste in your mouth. I think navysurgeon would agree with me: it's sour. Not even bittersweet, just plain sour.