Mexican Ortho

@traumaticum @ImprezowyKotek @orthobullets @orthotraumamd I see why a DHS… has the compression option that not all nails have, and it’s easier to add antirrotation or extra fixation screw in case needed. Also may let you correct valgus using the implant instead of forcing you to have it reduced before nail insertion. I like it.

@ImprezowyKotek @orthobullets @orthotraumamd looks like it was trying to hang in there, even with broken hardware, and the head doesnt look necrotic, so agree it was worth a shot at refixing. could have gone another nail, but DHS also a valid option so not going to criticise :)

69 yo M, implant failure + nonunion 6m after CRIF. Now hardware removal, CRIF with DHS, augmented with tricortical graft from iliac crest. May heal or should I go with THA? @orthobullets @orthotraumamd @traumaticum #operativeINK #orthotwitter

@ImprezowyKotek @orthobullets @orthotraumamd @traumaticum A THA is much more predictable, calcar looks fairly healed so may even get away it primary implant (I would have revision stem ready just in case). And get it over with.

@sportsdoc2016 @InvictaOrtho @orthotraumamd @generalorthomd A great reduction and fixation here is better than a great THA. But if reduction isn´t great it can lead to shortening, loss of abductor power and /or limping which a 56 yo will hate. So to me it depends on reduction achieved.

Healthy 56 yo ski injury. Anyone fixing this? I’m thinking total hip. @InvictaOrtho @orthotraumamd @generalorthomd ##orthotwitter

Typical case for testing. Tell me what happenned with an image. Don´t give it away.

@NuelleSportsMD @LenMacPT What is a thick graft? 10? 9? patient specific? I stick to 9s... but QT graft and me are in a love / hate relationship right now.

@LenMacPT -Meniscus repair b/c of restricted postop ROM +/- NWB protocols for periods of time -⬆️QT graft size can lead to ⬆️ difficulty regaining extension & thus arthrofibrosis -Females it’s multifactorial but similar correlations have been shown in other studies Our 📊 coming soon…

Females, meniscus repair and QT graft increases chances of arthrofibrosis after ACL surgery...why? ~7% cyclops lesion rate overall. pubmed.ncbi.nlm.nih.gov/36585324/

@hjluks Lots of biases: financial conflict (conscious or unconscious), confirmation bias, and the “our kids didnt die in vain” phenomenon, which makes it difficult for us surgeons to admit that we have performed an unnecessary procedure on many patients so we cling to “success” cases.

A bone spur was blamed for causing lateral shoulder pain for decades. Remarkably, it still is in small pockets... Despite no evidence. It’s strange to me that we still blame it. Docs and such accept and know that we get tendinopathy throughout our body and bone spurs are never mentioned. Yet, tendon pain in the shoulder was blamed on a bone spur? Cmon. Tomorrow's post... stay tuned.

@DrNikhilMD Everything looks good, should feel better in a couple of days, you don´t need an MRI just yet.

Without naming your speciality, tell me something you say 100 times everyday at work.

Young patient with recurrent knee effusion. MRI inconclusive. Does this double line in condyle US make you think of CPPD? @GSERRANOB_MSK @northwoods1980 @sbmander @DrJN_SportsMed

@deln_ioann I hate this proximal fractures, I confess I am never comfortable with method to determine rotation. How do you determine rotation if non op?

11-years old Votes for surgery or beginning conservative ? Boy

@traumaticum @Davembmd True, context would help, some hospitals outside US literally have nothing more than a few K wires, sometimes no fluoro, or other limitations. But this really is hard to look at and needs one very justifying context to make it look better.

@Davembmd Needs context Whoever put in those wires knew what they were doing

@schulte_ss @HeartOTXHeartMD @X Full of distractors and promoted posts. It’s still my go to learning social media, but it`s not what it used to be. I would say year 1 and 2 after pandemics was it`s best moment for me.

@HeartOTXHeartMD @X Orthotwitter is >80% dead.

The tales of the demise of #MedTwitter are greatly exaggerated. There were some who left. Most of those who did are back on the @X platform. BlueSky was a dud…

@indian_pitta x.com/sortabonefixer…

Share a photo of a Reptile 🦎📷 📷 🐸

@hjluks 👏🏼 It all comes down to the basics move, sleep, have social life, eat well. Patients always want the best supplements they can take, their kitchens look like Vitamin World. But they smoke, are sedentary and sleep deprived. Health isn’t in a 💊.

@DrLongissimus So true.

Fuck around find out medicine version is ask for non-indicated imaging study get stuck managing incidentals

Some doctors have passed in the last months at my hospital. It`s amazing how quickly people (colleagues, coworkers and specially administration) turn the page. We really need to avoid pouring our whole life at work, we are so replaceable…

A specialist in "biomedicine" (yes, biomedicine, for whatever that means) just told this patient that she has severe patellar OA and requires PRP immediately. He wishes he had half of the health of this PF joint.

💥 Complete scaphoid-side tear of the dorsal and proximal membranous portions of the scapholunate interosseous ligament, beautifully demonstrated with dynamic stress ultrasound — highlighting the power and absolute need for real-time dynamic assessment to make the right diagnosis. 🎥 Which video shows the dorsal band rupture, and which one the proximal membranous tear? 🤔 And how can we tell which portion is which in these images? 👉 Hint: The song reveals the sequence… #MSKultrasound #ScapholunateLigament #DynamicUltrasound #WristInjury #SportsImaging #MSKradiology #UltrasoundEducation

La ventaja de que los implantes tarden en llegar a México mas que a la mayoría de los países en latinoamerica, es que nos va a dar tiempo para saber si esto va bien o es un desastre, como ha pasado con otros implantes. Gracias burocracia del gobierno 🙏.

@jointdocShields @InvictaOrtho @Davembmd @DrTauqeerNKhan @centerofhip @childortho @IhabFathiSulima @orthobullets @lisacannada @FractureDoc Plus, with shortening of neck a successful salvage wouldn’t (in my opinion) outperform an average THA. And failure of salvage may even complicate and otherwise straightforward replacement. I would totally get a THA. If I dont outlive it, well, revisions are successful too.

@InvictaOrtho @Davembmd @DrTauqeerNKhan @centerofhip @childortho @IhabFathiSulima @orthobullets @lisacannada @FractureDoc I would - I think current bearing surfaces will outlive a 40 year old

40M. 7 months old NOF lt fixation was done. Comments & further treatment plan @centerofhip @childortho @Davembmd @IhabFathiSulima @orthobullets #orthotwitter #hippelvis #MedTwitter

@DrTauqeerNKhan @centerofhip @childortho @Davembmd @IhabFathiSulima @orthobullets At 40? He will love a THR. I once revised a 22 year old replacement in a 50 year old patient (got it at age 28) and he said "this hip took me through the most productive and happy years of my life, no regrets at all". Since then... my THR threshold went down.