Orthopedics

Fasting for Ramadan and being the on-call orthopedic trauma resident

Physician

June 20, 2019

A patient groans in agony lying atop a rigid spine board, carried by paramedics into the ER, his neck in a protective collar. The paramedics shout a summary of the accident. Monitors are attached to the man, flashing and beeping the cadence of vital signs. Nurses and physicians swarm. Gloved hands comb through brown hair for bumps or lacerations. They remove his clothes, feeling for pulses in the neck and …

The inspiring story of a female orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

June 10, 2019

As a female orthopaedic surgeon, I am often asked how I ended up in this field. Although seeing women in orthopaedic surgery is becoming more common, we are still makeup only 6 percent of the orthopaedic surgeons in the U.S.

I actually had no idea what orthopedic surgery was before medical school. In fact, I started medical school thinking I would be an internist, but it really didn’t take me very …

The journey from hand surgeon to entrepreneur

Eric George, MD

Physician

June 7, 2019

An excerpt from We: Ditch the Me Mindset and Change the World.

We use them to greet friends, congratulate acquaintances, and embrace loved ones.

To lay bricks, perform surgeries, and sculpt artwork.

Everyone uses them thousands of times a day in a variety of different ways.

It took me years to recognize …

The journey from a low GPA to an orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

May 27, 2019

I’m an orthopaedic surgeon, but if you told me I’d be here when I graduated from college, I’d be laughing at you. When I got started in college, I thought I was going to be pre-med and apply to medical school. It was not a well-thought-out decision. I thought that this was what good Chinese-American children do: Grow up to become doctors. It became clear that this goal was parent-driven …

An orthopedic surgeon’s guide to tennis elbow

Nancy Yen Shipley, MD

Conditions

March 15, 2019

As a sports medicine orthopaedic surgeon, I often see patients with complaints at their elbow. One of the more common diagnoses is tennis elbow, otherwise known as lateral epicondylitis. Surprisingly, most of my patients with this condition don’t even play tennis! Many types of repetitive arm movement can lead to tennis elbow. It all has to do with the tendons in our arms.

Tendons are the structures that hold muscle to …

An orthopedic surgeon’s bone broth journey

Roy A. Meals, MD

Physician

January 19, 2019

Many cooks traditionally use broth derived from simmered bones of fish, fowl, or four-footed critters to flavor soups and sauces. Recently, bone-broth bars have popped up around the country and serve a non-caffeinated, nutritious alternative to tea or coffee. In some of these health-conscious establishments, the owners claim that these drinks also have filling, cleansing, and detoxing capabilities.

I decided to see if a daily cup of bone broth should be …

ACL injuries in middle-age athletes

Nancy Yen Shipley, MD

Conditions

October 10, 2018

Over the last 20 years, physical fitness as a means to improve overall health has increased among the over-40 set. This is great, right? Yes, absolutely. Athletes who remain active as they age do a better job than non-athletes in retaining lean muscle mass. They also show improved bone density, bone structure and bone strength. However, what physicians are seeing are injuries related to the increased level of activity.

One area …

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ACL injuries in middle-age athletes

How many bones in the human body? It’s not what you think.

Roy A. Meals, MD

Conditions

August 28, 2018

If somebody asks you how many bones there are in a human body, please do not blurt out, “206.” The correct answer is nuanced. To respond accurately to the query, you have to address five questions. Who? What? When? Where? Why?

Consider first that humans vary from one another in facial features, hair color, height, and shoe size. Unknown to nearly everybody except …

The human hand: not really that good for anything

Roy A. Meals, MD

Conditions

August 6, 2018

Long ago primitive sharks had ridges running down their sides from gill to tail. Later, muscles grew into the folds, and eventually, the central portion of each ridge receded while the ends enlarged to form fins both fore and aft. All was well.

Then one day several hundred million years ago, a fish was swimming blissfully in a shallow pool. The tide went out …

Who named our bones? And what were they thinking?

Roy A. Meals, MD

Conditions

July 21, 2018

All of our 200+ bones have names, which facilitates describing them when we cannot actually hold them or point directly at them. It might be easier to remember the names if they were familiar ones like Robert, Sally, and Kevin, but no such luck. Latin was the original language of science, so the bones received Latin names. Some of those were derived …

How to match into a fellowship

Faton Bytyci, MD

Education

April 27, 2018

Residency training is an opportunity to get a good feeling of the specialty that interested you when thinking about what to pursue in the future. You may think that after applying for premed college, medical school and residency, applying for fellowship would be a piece of cake for you. Let me tell you: applying for fellowship is probably the hardest one among all other applications you went through so far. …

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How to match into a fellowship

Learn about Salter-Harris fractures with a Medcomic

Jorge Muniz, PA-C

Conditions

January 13, 2018

Pediatric physeal fractures have traditionally been described by the five-part Salter-Harris classification system.

Type I fractures occur through the growth plate. These injuries may present with normal radiographs, and the diagnosis is often made clinically when tenderness is palpated over the growth plate.

Type II fractures occur through the growth plate and metaphysis. Type II injuries are the most common physeal fractures.

Type III fractures occur through the …

Is assembly line surgery better for the patient?

Thomas D. Guastavino, MD

Physician

November 3, 2017

A friend of mine recently underwent a total knee replacement. Although he did well and was pain-free, he did say that he felt he was on an assembly line. I asked him what he meant. As he was talking, I flashed back 30 years, back to a time when by today’s standards I would be considered a “good old country orthopedist.”

Thirty years ago, I moved to a small community to …

9 reasons the “golden age of medicine” was golden

Thomas D. Guastavino, MD

Physician

August 29, 2017

To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.” We purposely keep our patients in pain, or we addict them to …

This resident’s childhood friend inspired him to help other children as a physician

Admin

Video

August 24, 2017

“You find joy that people are doing better because of what you did for them.” #BornToHeal

Courtesy of the American Medical Association (AMA).

This resident’s childhood friend inspired him to help other children as a physician

Beware of worthless procedures and epidural steroids for your back pain

Cathryn Jakobson Ramin

Conditions

April 29, 2017

An excerpt from Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery.

Near my office, there’s a breakfast-and-lunch joint where strangers sit down at shared tables. When Joseph, an attorney …

MKSAP: 79-year-old man with right hip pain

mksap

Conditions

April 8, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 79-year-old man is evaluated for a 3-month history of right hip pain. He points to the center of his right buttock when asked to identify the location of the pain. He has no radicular symptoms. He reports no focal trauma but believes his symptoms began after he stepped off a curb that …

How duty hour restrictions are hurting residency training

Anonymous

Education

April 10, 2016

As I get near the completion of an intense 5-year orthopedic surgery residency program, I had an interesting interaction with our hospitals sub-committee specifically tasked to address duty hour and resident fatigue issues.

As they gave examples from other departments about changes made to their programs regarding duty hours, a clear-as-mud connection was continually made. They spoke of “improvements” made as the result of residents stepping up to serve as whistleblowers …

What surgeons aren’t saying about sex after hip replacement

Troy A. Miles, MD

Conditions

April 2, 2016

As far as follow-up appointments go, this one was routine. My 65-year-old patient had undergone hip replacement surgery two weeks prior, and we discussed her pain level, progress with physical therapy, and eagerness to return to everyday activities. But as she stood up to leave the exam room, I could tell there was something left unsaid. She stepped out the door then stopped, turned around, and leaned in close to …

An emergency physician goes to the ER, and is shocked at the care she receives

Karen Shackelford, MD

Physician

November 2, 2015

I have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services.

Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a …

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