@OmahaSportsDoc
Occurs weekly and way too often these days!!! 😡🤬
Of note, found out recently that an “approval” for surgery does not guarantee that the insurance company will pay you for said procedure. WTF?!??
@hjluks
I’d guesstimate over 24 years, ~80% of my practice is non-op based.
And I’d also say that majority of my new pt. consults are talking them out of a surgery they were told they “needed.”
Give the human body a chance. You might be surprised.
#WeekendThoughts
Please don’t let these ankle fx/dislocations ever leave your ERD, looking like this. Their “reduction.”
Call Ortho. We’ll be very happy to assist.
The bone sets the tone, but the TISSUE is always the issue.
#orthotwitter
#SundayThoughts
Classic example of why we always X-ray deformities b4 attempting a reduction.
This will not reduce like an ankle fx/dislocation. Different animal entirely.
Always X-ray b4 you attempt a reduction. A 5’ wait causes zero harm.
#orthotwitter
#NoWorkFridays
Love doing Gluteus Medius/Minimus repairs. One of my favorite cases( I do open generally) Patients are so happy. This was done yesterday, and today was out on the course…
35-40▶️75 # IYKYK 💪💪
#Orthotwitter
#TuesdayVibe
I have to thank
@JanetConwayy
every time I put on a Robert Jones dressing for a LE injury. Actually “tweeked” her egg rate idea w/a “throwaway” foam from a neuro set-up. Works great! One of my favorite steals from our wonderful
#orthotwitter
forum.
I love quotes. These three continue to resonated w/me.
“Don’t practice until you get it right, practice until you can’t get it wrong.”
“There’s a difference between knowing your shit, and knowing you’re shit.”
“Is the juice worth the squeeze.”
What’s yours?
#orthotwitter
Young active 60yo, fell down a few stairs. Presents w/this X-ray, w/isolated left hip pain. Infrequent hip b4 fall.
What is your plan/treatment?
#orthotwitter
Hip abductor tears(med/min) are often referred to me for recalcitrant hip bursitis. Often present w/a Trendelenburg gait/pain. Eval & MR➡️diagnosis can be confirmed. When repaired, these patients are some of the happiest. Here is an open repair of a larger tear.
#orthotwitter
How much varus can be tolerated when nailing a SubT fx?
Difficult case in that pt was in critical condition(cerebral/cardiac/hemodynamic). Pt coded during this procedure, so best I could do quickly.
Pt returns 1 year later, healed, ambulatory/& happy.
#lucky
🙏
#orthotwitter
This letter is from a female college student who shadowed me recently. Knowing that I had such a positive impact on her now wanting to become an Orthopedic Surgeon, makes everything that I do so much more worth while.
#womenofortho
#BeaPositiveRoleModel
#BestJobintheWorld
#TuesdayBlessings
Last day of call….EVER!
(7/1/93-9/22/24)
Always enjoyed trauma and its challenges. Won’t miss being awaken in the middle of the night 😵💫. Appreciate
@ChipRoutt
&
@ortho_ut
for always being there if I ever called 🙏
Now, a nice stick to celebrate☺️
🤘🤘🤘
1st year in practice to PGY-29.
Wow! That has gone by super fast! Hopefully the guy on the right is a little bit wiser through the years.
#BestJobintheWorld
#orthotwitter
The importance of pie-crusting(PC)the MCL to see EVERYTHING medially cannot be overstated.Protect the cartilage!
1st pic shows what appears to be a simple tear.After PC, you see the entirety of a complex posterior MMT, then repair.
#orthotwitter
#piecrusting
#savethemeniscus
Radial tear/root variant tears, to me, are very difficult. I did side-to-side x 2 & a stabilizing hey bale to the medial fragment. Been happier with this fixation than TOT, as far as”more” anatomic/hoop stress. How do others approach these?
@ChrisTuckerMD
@MDMillerMDUVA
First day as an attending, and after 23 years.
The guy on the left came out “guns ablazing<sic>” and knew it all!
The guy on the right just “really knows better.”
**Lesson: Be humble, work hard and keep learning daily.
#OrthoTwitter
#MedTwitter
#MedStudentTwitter
I’ve certainly learned a trick or two from the outstanding
#orthotwitter
crew. This one from
@JanetConwayy
w/incorporating an egg crate under and around the heel w/a Robert Jones, is GOLD
Multiple co-morbidities w/ hospice placement. Too sick for ortho x2 days( TSFO). I CT essentially all hip/subt fx’s, as this is an excellent example on why. Sub-t/BC w/ sag coronal extension into the mid-neck. Plain X-ray here
Watch this. Powerful.
“I have a get to job, not a got to job.”
#OrthpaedicSurgery
the BEST job in the world. I “get to” do it every single day. Blessed 🙏
#orthotwitter
70+ yo active male; extremely low KL; nl alignment. Presents w/MJLP after 1 month of sx.
Plain WB X-ray/ intra-op PHRT. MR extrusion ~4mm. ▶️OR w/G2 unipolar MFC CM.
I repaired him. Giving him a chance.
**Plz never “treat” pt’s just by chronological age**
#orthotwitter
Octagenarian w/adv. dementia. Vancouver 3+++. Prox. femur▶️smoked( no intra-op pics 😒). Overkill of cerclage? Perhaps. But, felt necessary here. Added a pm strut w/a Reclaim revision 190cm stem.
Open to critiques/comments on what others may done here.
#orthotwitter
Ladies & gentlemen of
#orthotwitter
,my 2021 is officially over today 🎉Last 2 months were brutal trying to get everyone taken care of.
Off to SLCx3 weeks for R&R, & maybe a little ⛷.
Remember,it’s imperative to put you and your family above your work.
#WorkHardPlayHarder
#SundayThoughts
Be more concerned with your character than your reputation. Your character is who you REALLY are, while your reputation is merely what others THINK you are.
#orthotwitter
#MedTwitter
Pedi SCH fx’s get my full attention, immediately when on-call, especially type 4’s. Had to open ulnarly.
OS residents: which transient nerve injury is associated with these type 4’s?
#orthotwitter
“Be more concerned about your character than your reputation. Your character is who you REALLY are, while your reputation is what others THINK you are. “
Have tx’d quite a few variations of these injuries, CR & ORIF. But, this was quite the exception. Plz see these when called.
Type III/IV w/CS▶️fasciotomies. No meniscal or ACL injury.
Healed nicely w/o sequelae 🙏
#orthotwitter
#orthoX
*w/permission
@mattjlange
Despite 3 TO’s and behind 24-6, w/3+ minutes left in the game, Texas had the ball in their end trailing 24-21. Two late TO’s make the final score a blowout. If you watched, it wasn’t
At full staff, Texas wins this game. Almost did it w/a frosh taking over after the 2nd series.
@TGowdySC
Once a huge fan of
@TGowdySC
, but once you removed consideration for AG position, I suspected something was up.
Such a beast as Chair of House Oversight. So much promise to do right.
But now? You’re nothing more than, “all bark,zero bite!”
Such an utter disappointment!
Ladies & Gentlemen of
#orthotwitter
#BonesBourbonBrisket
and all of those that follow…..
HAPPY NEW YEAR!!!
May 2022 bring us all true blessings & happiness
At time of sx, ST envelope looked good. Bone? Not so much. Hook plate was necessary. PM reduced nicely, ran out of real estate w/SS. Sorry, not a great mortise view after the fact.
#WeekendThoughts
Please don’t let these ankle fx/dislocations ever leave your ERD, looking like this. Their “reduction.”
Call Ortho. We’ll be very happy to assist.
The bone sets the tone, but the TISSUE is always the issue.
#orthotwitter
Respond with something that you accomplished that you really didn’t think was possible.
For me, running a full marathon. Never ever ran for distances while playing sports, so this was/still a shocker for me.
#orthotwitter
#medtwitter
@JJcolemanMD
I think every physician endures mom or dad guilt. I certainly did. Of all the things that money can buy, time isn’t one of them.
What a great reflection of your new community to come through like that! We need more of these “feel good” stories. Thank you for sharing.
#FridayMotivation
I did thIs BTB ACLR in 2005 w/the then standard TT fashion. Now in late 40’s, stated he never had issues. Lives a very active life. Seen for another issue.
(Current X-rays below. )
Vertical graft but KL 0/1 & stable exam. Go figure 👍💪
#orthotwitter
Always special to see one of our athletes return to their previous level/sport, coupled with their huge infectious smile & appreciation.
Orthopedic Surgery-best job in the world!
#BTBACLR
#orthotwitter
#angelinacollegeathletics
60ish male, ND side, seen as 2nd opinion & was given only surgical options. I recommended non-op; coapt▶️functional brace▶️early Codman’s. Healed w/o pain, back to work in 14 weeks.
#orthotwitter
@freddie_V88
Those ripping you for heckling have likely never been to CBB game. Trash-talking is at all levels of the game.
As for TF’s gesture? That’s a class act, pure & simple.
To all my colleagues, please watch this video. PP sustainability is on life-support. W/o PP as the main competitor to hospital employment and ultimate health control, every doctor will eventually see their respective FMV’s⬇️⬇️⬇️
#WakeUp
#OrthoX
#OrthoTwitter
#medtwitter
Physicians, who see Medicare patients, struggle to keep their doors open because of debilitating reimbursement cuts each year.
Congress must step up and protect America’s doctors and patients.
My bill, the Preserving Seniors’ Access to Physicians Act, will get the job done.
Going to be extremely hard leaving here…….3 weeks has flown by. Won’t miss the snow plowing( actually it was really quite fun). So happy that I made the move here. Gorgeous!!
#orthotwitter
A slight mishap this afternoon.
Apparently someone mistakenly thought that one of our clinics had a “Drive-Thru” Orthopaedic service. 🤔
Thankfully no one was hurt.
#orthotwitter
This patient of mine in now 2 yrs out from bilat. TKA’s. He takes a 30+ hour bus ride outside of Mexico City, each way. Although he loves his new knees, I think he loves bringing me new “chanclas” each visit.
Moments like this make my day, and reinforce why I love what I do.
Always looking for ways to burn that dreaded, turn-over time. Today, between cases I was working on my breaking ball.
#orthortwitter
Whatcha think
@RyanHessMD
Ok, how many of my
#orthotwitter
colleagues/ Twitter peeps work on their BDay?
I always have. But, after today’s clinic, I am thinking that I need to reassess my options going fwd. 😂😁
@orthotraumamd
There’s a lot of “worse” things to say, but the absolute “best” thing to say in the middle of an operation is….
“I read how to do this on an
#orthotwitter
thread last night.”
👍💪
@txsportsdoc
Healthcare is the current model is unsustainable.
Physician cost to the >$3billion dollar tab has been consistent to equate to 7-8% of the total cost. Yet, the gov’t/media has blamed the doctors for this problem.
Hence, reduce doctors, bring in the mid-levels. Brilliant 🤡🤡
X-ray on the (L)is a student/athlete w/a pivot shift injury➡️ACL & LMT
*MR denied
X-ray on the (R)is a person w/o acute injury&chronic pain.
*MR in hand
This is a recurring problem🤬.Plz, if you’re considering an ortho ref. let us eval b4 u order any other studies
#orthotwitter
@generalorthomd
@Humana
Buckle up! Unless paid doctors quit helping insurance companies make MORE money & deny necessary treatment(s), just going to get worse.
P2P, pre-auth’s & THEN deny payment/ask for refund after surgery or tx is complete, is what drove me to retirement plans & def. won’t miss
Daddy-daughter Cowtown 1/2 Marathon in 2013. 9 years ago, today. Seems like yesterday.
I remember being overcome w/emotions crossing the finish line along side her.
Special day, unforgettable memories.
@DrChadKrueger
I believe we(physicians) comprise~6-7% of total healthcare costs/yearly.Yet, q 2yrs I receive a letter from my personal insurance comp. that my premiums will be ⬆️due to the“increasing cost of medical care by physicians & hospitals.”
FYI-I haven’t had 1 reimbursement ⬆️in 20yrs
@Super70sSports
Jack eagles 15 to pull w/i 2 shots of Seve. Then Jack nearly jars his tee ball on 16. Sinks the birdie, now w/i 1 shot. Roar causes Seve to step away from his 2nd shot into 15. Then pulls it in the pond, bogeys. Now tied w/Jack. Jack birdies 17 w/Verne’s “Yes sir!!”call. Wow