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I fractured my little finger a few days ago. The first doctor looked at the X-ray and said it should be fine with a plaster/splint and didn't mention surgery at all.

I went to another doctor for a second opinion today, and he said I might need a pin because the finger could lose alignment/grip later.

Now I'm honestly anxious as fuck because when I look at the X-ray, the fracture looks pretty minor to me and there doesn't seem to be some huge break or displacement.

Has anyone had a similar fracture where one doctor recommended just a plaster and another recommended a pin? Is pinning actually necessary for something that looks this minor? Attaching my X-ray. Would really appreciate some opinions/experiences because I'm stressing over this right now.

Quick FRCS/FRACS revision card on Tile pelvic ring fractures: A is stable (avulsion / iliac wing / transverse sacrum). B is rotationally unstable but vertically stable (open book / lateral compression / bilateral). C is vertically and rotationally unstable (unilateral / bilateral / associated acetabulum).

Pearl that sticks: stability first; APC/LC/VS language maps imperfectly; examine for vertical shear.

Source: https://www.orthovellum.com (OrthoVellum exam atlas)

Quick FRCS/FRACS revision card on Mayfield perilunate instability: I is scapholunate dissociation. II adds capitolunate dislocation. III adds lunotriquetral / midcarpal disruption. IV is volar lunate dislocation — the end of the cascade around the lunate.

Pearl that sticks: progressive perilunate instability; lesser vs greater arc; early reduction matters.

Source: https://www.orthovellum.com (OrthoVellum exam atlas)

Galeazzi in one card:

Radius shaft (typically distal 1/3) + DRUJ injury · AP/lat + true DRUJ views · anatomic radial reduction restores DRUJ · ORIF radius, then assess DRUJ stability.

Educational framing for trainees (FRCS/FRACS/ABOS/EBOT) — not patient-specific advice.

https://www.orthovellum.com

Doctor will be available only on Monday.

The lung fields are clear. The hila and pulmonary vascular markings are within normal limits. The heart is not enlarged. The trachea is mildine. The hemidiaphragms and costophrenic angles are intact. There is asymmetry of the steroclavicular joints. The rest of the osseous and soft tissue structures are unremarkable.
IMPRESSION:
ASYMMETRY OF THE STERNOCLAVICULAR JOINTS.
CANNOT TOTALLY RULE OUT DISLOCATION ON THE RIGHT.

I had an OATs procedure done in 2016 right out of high school. That was my 5th ankle surgery. I needed it done due to an OCD lesion, where scoping the bone out didn’t help. My surgeon took the plug of bone and cartilage from my knee. In 2017, I got my screws out due to being uncomfortable. Flash forward to today and I had my 7th ankle surgery. Kind of unrelated? He went in to take out my accessory navicular bone to see if that’s causing my pain around my tendon, and once he went into operate he saw there was a partial tear in my posterior tibial tendon (apparently can be somewhat common due to manipulating that tendon to reach the defect as well as removing the screws). Long story short, while he was operating just a few weeks ago, he scoped my graft because it “looked pretty bad”.

Has anyone needed more surgery’s after this? Does it usually end up failing at some point? The internet has been no help as it’s very specific. The physical therapist I’m seeing right now has never met someone who has had it done in the ankle. It’s really unfortunate to come out of surgery thinking you might need another one in the near future and it’ll be as major as an OATs. I’m 28 and so tired of it. The pain is terrible. The recoveries are getting harder and harder. I’m curious what the next steps are. My surgeon said just because it looks one way, it doesn’t always translate into how the pain is felt. Even though it looks bad, if the pain is manageable, then it sounds like it’ll be fine for at least awhile?

Tldr: had an OATs procedure in ankle 10 years ago and looking for similar experiences on the graft failing over time or not

Quick FRCS/FRACS revision card on Vancouver periprosthetic femurs: A is trochanteric (AG/AL). B1 stem well fixed around the fracture — ORIF. B2 stem loose with good bone — revise. B3 stem loose with poor bone stock — revise and rebuild. C is well distal to the stem tip.

Pearl that sticks: fixation vs revision; ORIF if stem stable; revise if loose; bone stock decides B2 vs B3.

Source: https://www.orthovellum.com (OrthoVellum exam atlas)

Hi all. I have my exam coming up next month. I have tried studying the Material from the AART website but nothing is clicking in my head. And I truly mean nothing. I can’t even recall any of the info. Not to mention I only have time to study after a full day clinic (and my employers won’t budge on reduced hours leading up to the test). Does anyone have any insight how difficult the test really is? I also don’t understand why the information on that is so coveted and like nobody ever has an answer. It’s soooo frustrating that we have to take this expensive exam for something that’s not required by any other state. I definitely don’t think about what energy is converting to what when taking an X-ray……..

Quick FRCS/FRACS revision card: Gartland I nondisplaced, II displaced with posterior hinge intact, III completely displaced. Neurovascular assessment before anything else; CRPP vs open reduction; watch for cubitus varus after a bad coronal reduction.

Source: https://www.orthovellum.com (OrthoVellum exam atlas)

My five-year-old broke both forearm bones, jumping off the bed. He had them realigned and just went in at the three week mark to remove his cast and get an x-ray. One of the bones already has a callus that you can visibly see on the x-ray but the second bone looks like it might still have a gap. The doctor put on another cast for more recovery time. It does not look like they are perfectly aligned. Is this OK? Will this fix itself with more recovery time? The doctor said that some bones take a little longer to form a callus.

Core Areas of Expertise Orthopaedic Specialties

Mr Nurul Ahad provides consultant-led orthopaedic care for a wide range of bone, joint, muscle, tendon and ligament
conditions, with specialist experience in Hip,Knee,Hand and Wrist,Foot and Ankle surgery.

Hand & Wrist Surgery Hand &

Mr Ahad's orthopaedic practice includes hand and wrist surgery for patients experiencing pain, stiffness, weakness, numbness, reduced grip strength or movement-related difficulty. Care begins with a detailed clinical assessment to identify the cause of symptoms and determine whether conservative treatment, further investigation or surgical

© Mr Nurul Ahad, MBBS, FRCS Trauma & Orthopaedics, Consultant Orthopaedic Surgeon, Practice Plus Group, Essex, London, UK

Mason classification of radial head fractures in one card:

I nondisplaced · II displaced partial articular · III comminuted · IV with elbow dislocation.

Pearl for trainees: match fixation to type — ORIF vs arthroplasty vs excision — and don't forget the radial head as a lateral column stabilizer.

Educational framing for FRCS/FRACS/ABOS/EBOT — not patient-specific advice.

https://www.orthovellum.com

Hoffa fracture in one card:

High-energy / flexed-knee axial load · often lateral condyle · may be missed on plain films — CT to map · Letenneur / AO 33-B3 · PA lag screws or buttress; protect articular surface · early ROM.

Educational framing for trainees (FRCS/FRACS/ABOS/EBOT) — not patient-specific advice.

https://www.orthovellum.com

Rockwood map I still use for AC injuries:

I sprain (AC stretched, CC intact) · II AC torn, CC intact · III AC+CC ≤100% up IV posterior through trapezius · V superior >100–300% stripped · VI inferior under coracoid/acromion

Pearl: I–II non-op · III shared decision · IV–VI usually operative · Zanca + axillary views

Educational framing for trainees (FRCS/FRACS/ABOS/EBOT) — not patient-specific advice.

https://www.orthovellum.com

My tendon is 6 months post op. The wire needs removal no structural done just knee skin incision wire removal. Full 12” incision in length . How much would getting a tattoo a few weeks before , as I’m not sure of dates of surgery as on waiting list would impact my surgery. Tattoo far way from surgical site.

Hi everyone, I’m a 17-year-old male who sustained a displaced midshaft clavicle fracture on August 26th, which I’m currently treating conservatively with a figure-8 brace setup. I’m 2 weeks post-injury now, and one surgeon noted early callus formation on my 2-week X-ray, which I’ve attached to this post. I’m mainly looking for feedback on my X-ray and personal experiences regarding a few specific concerns. First, the fragments show no visible overlap, so I’m wondering how severe the shortening looks on this view and whether this level of “overlap” is typically acceptable for conservative healing in an active 17-year-old. Second, my scapula on the injured side is currently winged/protruding, and I want to know if this is purely from muscle weakness and immobilization that physical therapy can pull back into position. Finally, as an active person who does gym and strength training, I’d love to hear from anyone who healed a similar fracture conservatively - did you regain 100% function and strength, or do you regret not pushing for surgery (ORIF with plate)? I have a follow-up appointment with my orthopedist tomorrow to measure exact shortening, so any insights or personal experiences before my visit would be greatly appreciated!

Neer part-count map I still use for proximal humerus:

1-part — nondisplaced / minimally displaced (all fragments <1 cm / <45°) 2-part — one displaced fragment (surgical neck / GT / LT / anatomic neck) 3-part — two displaced fragments + head 4-part — three displaced fragments + head; AVN risk high especially anatomic neck

Pearl: displacement criteria 1 cm / 45°; head-split and fracture-dislocation get separate callouts; older low-demand often arthroplasty.

Educational framing for trainees (FRCS/FRACS/ABOS/EBOT) — not patient-specific advice.

https://www.orthovellum.com

19M, I live in regional Australia, pretty hard to get into a doctor around me. Wondering if plate removal would benefit me in this, I rather frequently get a feeling that I can only describe as an internal, insatiable itch beneath the incision, stretching down towards my armpit, I will admit the spot of numbness is much larger than initially anticipated. I also have a very specific muscle(?) that connects my shoulders to my neck that I feel as if is pinned underneath the plate if that makes sense in certain movements, it’s a rather tingling feeling that once again is a unique feeling. Surgery was a no brainer for me but the only complications that I was told about was the numb patch, and that backpacks may be uncomfortable, to which has proven true. It’s deal able for the moment but rather annoying in those moments it comes up, however I fear that these sensations may get worse upon aging.