The dreaded European heat wave finally came upon us. No matter how high we turned our fans, opened our windows, or fanned ourselves with our notebooks, it was sweltering: 100 degrees Fahrenheit, 38 degrees Celcius, and a whole lotta degrees humid.
De’Ryonne wasn’t feeling well because of the intense heat so I went to the hospital alone on Wednesday. I would be shadowing Dr. Nacho, however it wasn’t the Dr. Nacho I remembered. This Dr. Nacho was young: he looked like he was about 30 years old, and he was tall with dark hair and a 15 o’clock shadow (in Spain time). He was very serious and spoke very softly so I had to lean in to listen to him, but he spoke very fluent English which was great.
We walked down to the OR to start our first surgery: a knee repair. The patient was a young female in her 40s who suffered from a fracture in the distal femur. Dr. Nacho 2.0 told me that there are two types of repair for this type of injury. The first one is putting in a nail. The second is a plate. In this surgery, he would be choosing the second option.
He took a CT scan of the knee and entered on the lateral left knee with the scalpel. After putting in the plate and 8 screws, all while the patient was snoring very loudly, he did two layers of a non-continuous cruciate suture to sew up the skin. Finally, he stapled the skin closed and put a large bandage over the area.
The second surgery was a distal clavicular fracture. Dr. Nacho 2.0 told me he would be repairing it using a plate with a tiny rope attached that would tie to the coracoid process to stabilize the clavicle. Dr. Nacho said he had never used this tiny rope device before, but he was ready to try it out.
The patient was put under complete anesthesia because it is impossible to give local anesthesia to the clavicular area (according to Dr. Nacho 2.0). He used a cauterizer to cut the skin open and then used a hand-held screwdriver to drill holes into the clavicle where the plate attached. The surgery was incredibly fast for being his first time, but he kept having to take CT scans to make sure everything was lined up inside. At the end, he asked me if I had any questions, and then we said a formal goodbye and I scurried home.
Orthopedics seems a little repetitive with the things they repair, but each case is completely different from the next. Plus, each specialty probably seems repetitive to people like me who only observe for 4 days at a time. It makes me want to learn their entire scope of practice: What other bones can they repair? What’s the strangest case they’ve had? What kinds of complications come with bone repair? I’ll let you know after the next blog post! Ciao!
Anna-phylactic Shock 