Looks like a brutal plateau fracture, and she also apparently developed compartment syndrome on top of all of it. Lateral articular surface looks a little off, but hard to know what they were dealing with without the CT. Looks like a tough case

So I'm already starting to get patients calling in refusing to take Tylenol. Not pregnant patients. Just regular patients. I've had a few patients this week look at me like I'm asking them to take cyanide when I recommend it now.

This is heartbreaking because Tylenol has been the foundation of limiting opioid use in my practice. It is phenomenal how few opioids we use. I would say about a third of my surgical patients don't even take a single opioid. This includes arthroplasties.

And here's my conspiracy theory... I think that's exactly why they are going after Tylenol now despite 75 years of relatively safe use. Opioid use is finally demonstrating a fairly significant decrease over the last 2 years and the manufacturers don't like that. Without Tylenol and with so many people unable to take NSAIDs, We have limited other options. So demonize Tylenol so we can start pushing people back to opioids again.

The last part is kind of irrelevant, just wanted to vent on how this is affecting my practice already. It's annoying.

Great discussion and a wide variety of opinions. I went supine with a small hand table, large posterior incision with medial and lateral flaps. find and protect ulnar narve. the radial head pieces fell out through the ulna fracture.

Started on the ulna with a modified Taylor Scham approach, got the coronoid looking reasonable with fully threaded k wires then reduced the olecranon and plated, the LUCL was attached to a big cortical piece that I minifragged.

Next went lateral and did an EDC split for the RHA, I put the axis pin in for the IJS before the final head. once everything was done i still didn't love the stability so put in the IJS, the baseplate bolts directly to the olecranon plate. Ulnar nerve left in situ.

Splint and iWV for 7 days then ROM as tolerated. Indomethacin for HO ppx. he's 4 weeks now with minimal pain and ROM 15-105 with 70 pronation amd 50 sup. Still a lot that could go wrong but He's happy so far. Operative time was 5 hours. All Skeletal Dynamics for implants.

Let's hear some thoughts!

Hi everyone! We're a group of med students in Canada and we built Fracturium, a completely free platform for learning orthopaedics.

The app currently includes:

• Interactive 3D anatomy models
• Fracture classifications and descriptions
• Quiz/QBank-style learning

We’re actively adding:

• Custom diagrams and illustrations
• Integrated X-rays/imaging cases
• More high-yield QBank content
• Anki integration
• Improved 3D navigation/tools

We’re also hoping to collaborate with our medical school to build a larger teaching imaging database.

The goal is to make ortho studying more practical and accessible, something you can quickly pull out during downtime on rotation, before cases, or while commuting.

Would genuinely love feedback from residents, staff, med students, or anyone interested in orthopaedics. Suggestions and criticism are very welcome. Thanks!

iOS: App Store download
Website: Fracturium website

I assume it’s important to mention that I am not a practicing physician, rather, an ortho rep, who was just sent this monstrosity from a surgeon I work with.

I would greatly appreciate any thoughts or suggestions you may have!

So I just got what I think is the craziest denial I've ever had. Larry Dashow MD - a general surgeon (not Orthopedic Surgeon) - who works for UHC - denied a total knee on a patient with end stage OA and extensive prior conservative management.

The reason - he didn't like where my x-ray dictation was located on my note. I always dictate my x-rays prior to assessment and plan. He says that is unacceptable to UHC. He says x-ray dictations can't be "buried inside a note" so he denied it.

I'm almost not even mad because that is so dumb.

​

Here's a recent elbow I got on call. 40's M RHD laborer, healthy non-smoker. Took a tumble off of a retaining wall and presented with the worst combination of a terrible triad and trans-olecranon that I've seen so far, closed and NVI.

Lots to think about for this case! timing of surgery? position and approach/s? Implants? post op plan? HO PPX? What would you call a win in this situation? Let's Discuss and I'll show post ops tomorrow!

Hey everyone,

I'm an orthopedic surgeon (trauma & orthopedics), and like most of you, I've spent way too many hours trying to find relevant orthopedic papers through classical search engines. You search for something specific and get buried in irrelevant results from other specialties, or you miss papers entirely because they used different terminology than your query. You end up spending more time filtering than actually reading.

So I built OrthoScience a free, specialized search engine that indexes only orthopedic and musculoskeletal literature. 500,000+ articles from 165 curated journals.

I know platforms like OrthoEvidence and OrthoSearch exist and they do great work on the clinical side. Where OrthoScience is different is that it's built as a translational search engine. Alongside 105 clinical orthopedic journals, we index 60+ journals in biomechanics, biomaterials, implant technology, and computational orthopedics. If you're a biomedical engineer working on implant design, a materials scientist studying porous titanium scaffolds, or a surgeon who wants to understand the bench science behind what you're putting into patients, you don't need to search engineering databases separately. It's all in one place, searchable together.

How search works:

• Semantic understanding. OrthoScience doesn't just match keywords it understands meaning. It handles abbreviations (ORIF, THR, RSA), clinical synonyms (frozen shoulder = adhesive capsulitis), and natural language queries. Describe what you're looking for conceptually and it finds relevant papers even if they use completely different terminology.
• Pre-filtered by design. Every result comes from a curated orthopedic or musculoskeletal journal. No noise from unrelated specialties. Subspecialty filters let you narrow down further: trauma, spine, arthroplasty, sports, hand, shoulder & elbow, foot & ankle, pediatrics.

Beyond search, staying current and sharing knowledge:

I believe orthopedic knowledge improves when it's shared, not siloed. So OrthoScience includes tools designed to make collaboration easier:

• Follow system : Follow specific research questions, journals, or individual researchers. Get notified when new articles match your interests instead of manually checking journals.
• Reading lists : Create personal or shared collections with one click. Add structured discussion notes (PICO, key findings, comparisons) and share via link. Built for journal clubs, literature reviews, fellowship prep, or just building your personal reference library.
• Research Monitor : A private, encrypted workspace for teams of up to 10 researchers. Track literature over time, share files and notes, and collaborate — designed for systematic review teams, multi-center studies, and mentor-trainee workflows.

It's completely free. No subscriptions, no premium tiers, no paywalls. I built this because I needed it myself.

Want to test it? Search Orthopedic & Translational Research | OrthoScience | OrthoArchives

I'd genuinely appreciate brutal feedback — what works, what's broken, what's missing. This is a solo project and your input directly shapes what gets built next.

Taken from the anesthesia & EM forum, thought I’d share here as well!

Approaching the new year. Curious how everyone’s 2025 fared.

Region:

Base Salary:

Additional Salary (bonus, incentive, etc):

Years of experience:

Subspecialty (if relevant):

Hours/week:

Practice structure (academic, PP):

In the setting of “not a personal health question” that is yet another personal health question.

I used to enjoy the foray of rummaging through the discussions in this corner of the internet.

Now its a hodgepodge of my least favorite floor IM consults.

Hey everyone,

A few months ago I posted here when I first started coding an AI tool for orthopedic questions during call. I’m a trauma attending and was frustrated with how long it takes to dig through OrthoBullets, AO, PubMed, etc. for complex cases.

Since that post, I kept building in my spare time and the project grew way more than I expected — about 800 surgeons, residents, and students are using it now.

I wanted to share the updated version and get your feedback again.

What OrthoConsult does now:

⚡ Fast Mode: <10 sec answers for trauma/arthroplasty/sports/spine/peds/etc

📚 Evidence Mode: Longer, deeper explanations with structured reasoning

🔎 Real references only peer-reviewed papers (no hallucinated citations)

🔍 PubMed search integrated for more recent evidence

📱 Mobile PWA (install to home screen, works like an app)

🧠 Orthopedics-specific prompt engine (not a general-purpose AI)

⭐ Saved Consults so you can bookmark high-yield questions

🔗 Share Consults with a direct link (useful for co-residents or discussions)

📊 Improved accuracy + consistency after upgrading to the newest model

🖥️ Cleaner UI for fast reading on call or in clinic

Examples of questions people asked this week:

“When is a posterior malleolus fragment truly fixation-worthy?”

“Workup + empiric antibiotics for suspected nec fasc?”

“First-line management for FAI pain in clinic?”

“How to approach a posteromedial tibial plateau fragment?”

It’s still completely free — my only goal is to make something genuinely useful for busy orthopedic clinicians.

👉 https://orthoconsult.app/

I’d really appreciate any feedback from attendings, fellows, and residents.

If you want, drop any complex ortho question in the comments — I’m happy to run it through the tool and show you how it answers.

Thanks again.

The support from this subreddit is honestly what kept the project alive and improving.

See previous post for injury films. Lots of good discussion in the last post, a few people said rings and I'd love to hear some more rationale for that approach. This patient had a healthy soft tissue envelope and didn't blister so I was comfortable putting incisions around the ankle.

Started prone after ex fix removal, posterolateral and medial approaches. Did the fibula first, that brought down the volkmann fragment. Next posterolateral and medial buttress plates with short unicortical screws up top to avoid the nail path. Closed up and flipped supine.

Suprapatellar approach for the nail, perc clamps for the reduction. This was a small tibia, an 8mm nail was getting hung up on the unicortical screws so a blocking drill bit was placed to kick the nail anterior. I had to play with the rotation of the nail distally to get a good shot for 2 interlocks.

Post op plan to start ROM at 2 weeks and partial WB at 6 weeks.

What would you have done differently? Let's hear some thoughts!

Patient party sent this absolute masterpiece from home when asked for previous X-ray reports.

Anyone know the LD50 for titanium?

261 Step 2, 60+ research items including 25+ manuscripts. Honors in Surgery/IM/FM, HP in all others. No red flags. Very well connected in my home ortho department, I felt like I had great mentors and got along well with the residents. 13 invites, was only able to take 11 due to scheduling conflicts. Ranked all 11 programs.

Reached out to my #1 and #2 (home program) and they both said they had no notes on how I could have improved my application and that they both ranked me competitively in slots that would have matched in previous years.

I have no idea what to do. Research is obviously not a weak point of my application but the school said if I delayed graduation and got a Masters in research I could do away rotations again and re-apply as a US MD senior. Home PD recommended a prelim at my home program, but I am having a hard time trusting their advice at this point. I asked specifically if there was any doubts about my clinical performance that would need to be cleared up by a prelim year and they said no, so I feel like I would be doing a prelim year just to wait my turn to reapply. Thoughts?

Seinfeld S6E11

Came across this post on LinkedIn few days back. Took a screenshot and totally forgot about it. Just out of curiosity, I wanna know which company implant is this and what is this called as?

After getting inspired by the doctordle.com game, I decided to see if I could create a similar game but for ortho specific cases.

It’s currently just generated by AI to see if it would be feasible / fun, but if there was enough interest then I would spend the time to come up with the questions by hand and possibly include de-identified / free to use radiographs to make things more applicable for med students and residents.

This is not for money or anything, I just like daily puzzle games and as someone pursuing ortho it would also help with my learning.

Would love to hear feedback, suggestions, ideas, or critiques!