Orthopedic Surgery I

I had three days in the operating room which was good exposure to surgeries for orthopedics. The first surgery I saw was a humeral prosthesis. It was a long open surgery and the most eye-opening part was when they pulled out fragments of bone from a broken humeral head due to trauma. I also got to feel the glenoid cavity of the arm from the inside, which is a pretty unique experience. Last Friday, we did two arthroscopic ACL reconstructions using cadaver graft. I really appreciated doing two of the same surgery on the same day; it not only reinforced my learning by getting a better understanding of all the steps in the procedure, but it also helped me see the variability that could happen in the surgery (the first patient bled a lot preventing easy visualization; the second patient had a huge PCL). Arthroscopic procedures are really impressive; they're technically difficult, requiring a good knowledge of surface anatomy, manipulation of the joint, and manual dexterity to orient the camera and tools. It also requires a ton of patience. On Monday, we did an Achilles tendon rupture repair which is an open surgery. It was really cool to see a careful dissection: exposing the ruptured tendon ("frayed paint-brush ends"), isolating the sural nerve, finding the plantaris muscle (it's tiny). The suture-work to re-appose the ends of the ruptured tendon is also quite impressive. Lastly, I saw an arthroscopic rotator cuff repair, a long arduous procedure that requires an amazing technical ability to throw sutures within the joint using tools from the outside. It's difficult to describe, but very, very cool to see. It can be incredibly frustrating too when you worry about tangling sutures, unexpected knots, and difficulty manipulating the tools.

Image from aclsolutions.com