A medical student suggested to harvest the bladder stone and screw it on the needle-like head. #trunnion #orthopaedics #aorecon #pincushion #avascularnecrosis
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A medical student suggested to harvest the bladder stone and screw it on the needle-like head. #trunnion #orthopaedics #aorecon #pincushion #avascularnecrosis
A 79 year-old woman had a total hip replacement in 2004 revised in 2008. In 2015, she complained of a knee mass at the level of Gerdy's tubercle on the same side of previous surgeries (left: thigh AP, right: knee lateral). That lesion turns out to be the stem tip. Shortening is 8 cms. Draining sinus present on lateral midthigh. #lastpatientoftheday #toink #goodnight #aorecon #preoperativeplanning #template
Finally got to finish the planned multiple-stage surgeries for a strong 82 year-old woman with cardiac morbidities. Her hip broke 3 years ago and it was replaced with a cemented Thompson prosthesis which we removed months back due to infection (left top and bottom). After debridement, curettage and sequestrectomy, a customized Vancomycin cement spacer (right top) was inserted. She responded well to long duration culture-guided treatment and with clear infection parameters, the spacer was removed (middle) and definitive total hip replacement done with a hybrid cementless cup and cemented calcar replacing stem (right bottom). She's sitting up with her legs dangling at bedside cracking jokes one day after surgery. Very glad for a medical, anesthesia, physiatry, psychiatric and orthopaedic team working together for a common patient endpoint. #orthopaedics #aorecon #calcar #ilovewhatido #easiersaidthandone #multidisciplinary
16 degrees varus deformity of a 19 year-old woman, with a malunited AO 42-A2 IC 1 injury from eight months prior. From left (all AP): Full weight-bearing bow legged, intraoperative fluoroscopy with intended line of bony resection, osteotomies of the tibia and fibula performed. For antegrade reamed interlocked intramedullary nail fixation with bone grafting. Although the tibia may be forgiving in terms of acceptable angulation, excessive malunion changes lower extremity kinematics and places abnormal stresses on the ankle, knee, hip, and low back. Principles dictate restoration of length, axis, and rotation with relative stability. The fibula absorbs up to 16% of load during activity, and may be left alone. #aorecon #sign #aotrauma #orthopaedics