Pyrrhic victory

That is a new phrase added to my glossary thanks to the BBC. Yesterday I was super productive and indeed finished my presentation ( it was awesome; that feelings when you make your classmate awake and interested), mini assessment and a bedside discussion went smooth. I also did my first ortho on call. Simply amazing. I truly enjoyed it. We got to see loads of traumas and different fractures. Enough bragging. The price was me surrendering to my sinusitis induced headache ( sleeping when I was supposed to study). O and I should add I barely read/ prepare! The consultant said we don't need too. I swear.

I'm currently in my third week in ortho. And seriously considering it as a future specialty. My consultant also said it would suite me:) Well at least that is what he thought before I missed a basic question. (bye bye dear "remnant" ego. I am considering total face reconstruction once I graduate from medical school. Man, I need to shut my mouth and pretend I am thinking quite often).



Diabetes affect blood supply to nerves leading poor sensation and injury going unnoticed

In the ward I saw a lovely lady with Charcot foot (common in poorly controlled diabetes) who slipped in the bathroom and broke her ankle (grade C in Weber ankle classification.. umm..yes I know what that is). Because of her poorly controlled diabetes her wound got infected and the healing was delayed ( 2 months and the wound still swollen and not fused). Her motion at ankle was restricted in all directions. Sensation was almost normal. Joint position sense was not there! First time I test someone and they test positive! Needless to say her ankle was deformed. Much like the picture. There were many fracture cases with different correcting implants. And we got to know the name of different plates and screws used. We saw two cases of implant failure, one due to a combination of wearing off of the implants (estimated age of an implant is 15-20 years) and an advance osteoporosis. The other was due to infection. And after spending 2 hours teaching us about these stuff, the doctor conclude by saying that it is beyond what is expected from us! Hooray! Additionally we got to spent one day in the physiotherapy department!



In fractures (compared to joint replacement) implants is removed after one year, sometimes sooner!

Clinic wise; I saw many interesting cases in the wrist clinic ( I told you it is a highly specialized center). One was of an army fellow who managed to tear his TFCC ( help in forearm supination and pronation which were limited in our patient.) I also saw the classic scaphoid fracture. The patient main complain was pain in the anatomical snuff box ( yes, the area people used to put heroin to sniff it). I spent most of the time in the knee and spine clinic.

We learn loads of examinations to detect ligaments tears and impingementation and were introduced to different fracture classification system. I guess we are not expected to know them by heart ( or are we?) there is a classification system for almost each joint/bone. I guess I will learn the Ottawa one, because ankle injury is the commonest ( yeah, not because its super usefull and copys of it hanging from A & E walls).

In aside note, do students from other specialty share their experience over meal time or in trips? Because when I told my brother, who is a honor student , he said that is what nerds do!

Ok, I have boooooooooks to read. Wish me luck.