Monday, February 25, 2013

Give yourself a hand

Watched hand surgeries for about eight hours recently. Mostly carpal tunnel and trigger finger releases that only take about 15-20 minutes once the patient is on the table. However, one of the surgeries was a four corner fusion and scaphoid removal.  Basically the surgeon flayed the skin on the dorsal aspect of the man’s hand, and then removed the scaphoid bone with something that looked like an oversized tool the dentist would use to pull a molar. OK, it was a lot more complicated than that, because it took almost three hours. Previously I knew knee and hip surgery was brutal and required tools that look like they came from Home Depot. But I’m finding that most orthopedic surgery is not a gentle or delicate thing when you’re trying to manipulate bone.
 
(Scaphoid is on the left above the radius and below the thumb)
 
Truthfully, eighteen months ago I never expected that I would like orthopedics or even thought about looking for work in that area after graduation. My previous experience only comes as a float nurse and remembering the knee and hip replacements with lots of pain control. Even during the past year of school and primary assessment skills, I thought no way. Why would I want to learn the 206 bones in the adult body, along with all the tendons, ligaments and muscles that control them. I have enough problems with the lobes of the liver and parts of the heart.
Now I’m thinking different, this is an area that truly interests me. It has helped to have a good preceptor who has shown me how different clinical orthopedic patients are from the hospital orthopedic patient. 

5 comments:

Nighthawke said...

That would be pretty interesting to watch. What kind of recovery is involved for a procedure like that? What about PT?

NP Odyssey said...

Like a broken bone. Weeks in a cast and then a couple more in a brace, followed by lot of Occupational therapy. Everybody heals differently

NPs Save Lives said...

I really didn't enjoy Ortho but I do like disease process. You asked on my site if you could listen to the show on 96.5 and if you click on the tab Retro Replay. The link is on the page. Let me know what you think!

A Doc 2 Be said...

I'm sorry to post this (not really, or I wouldn't!) Buttttt...

when I see hand bones? All I can think about - and giggle loudly about - is Rachel on FRIENDS yelling "there's something about phalanges on the plane, is that dangerous?" and everyone running off thinking phalanges are bad...

:D still makes me giggle.

Hope you like ortho - I'd never thought I'd like it either...

A Doc 2 Be said...

I should also clarify, I though phalanges were in the hand, not metacarpals... which makes sense since carpal tunnel is in the wrist, not the foot.