Orthopaedic surgery

Last week I scrubbed in for surgery with the orthopaedic consultant and his registrars.  It was the first time I’d scrubbed in a long time, and I had a hard time getting into my gown and gloves.  Still, I remained sterile the whole time so it was merely embarrassing.  X-Rays were being done throughout all the procedures, so I had to wear a heavy lead gown and thyroid shield under my scrubs too.  By the end of the morning my back and knees felt ready to snap and I could see myself on the operating table.

The morning list was paediatric cases, which is the first time I’ve ever deal with kids in a clinical setting.  We started by removing K-wires from a 16 year old girls tibia.  Nothing too complicated; just grip them with the pliers and yank them out.  I got to do 3, and have to say I felt a little queasy doing it.  Next up was a boy with some malformation of his left lower leg, the name of which I forget.  The basic idea was that his medial femoral epiphysis (the bit of the bone that does the growing) needed to be held back as he grew to give the lateral side time to ‘catch up’ and correct his valgum deformity (knock-knees).  This was done by screwing an 8 plate, a small plate in the shape of a figure of 8 funnily enough, into the bone above and below the epiphysis so that the bone couldn’t lengthen.

I’ve helpfully drawn a diagram below for your viewing pleasure:

The last case of the day was a boy who’d come in the previous night having been knocked down by a car.  Amazing, his only injury was a transverse compound fracture of his femur.  This would be fixed with elastic wires.  Going into details about this would take too long and probably another diagram (the one above took longer than you think), so it’ll suffice to say that I was allowed to hammer one of the rods into his femur.

The surgeon asked me if I knew what a kitten pawing at a toy looked like.