Trauma call stories from an ortho at a level 1 center - I fixed a thing

Jan 14, 2017 2:29 PM

arccola

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34597

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1277

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47

Consulted on hand v. mill equipment. No fractures or dislocations, ok cool.

Next step check neurovascular status and tendon function at DIPs, PIPs, and MCPs. He was good on both.

Numbed the wound with lido/bupivocaine, washed him out with irrisept, explored wound, prepped and draped, closed with 3-0 nylon in simple interrupted manner, volar splint for muscle rest, follow up in hand clinic. Dude was a pleasure to help, joking around the whole time, Received verbal consent to post. Always hard telling ppl that dorsal hand degloving injuries don't always take, even with quick intervention.

9 years ago | Likes 2 Dislikes 0

For a whole minute , I thought they amputated 3 fingers and I didn't understand :/

9 years ago | Likes 1 Dislikes 0

Posts chastising me for no warning got dv'd, ❤️you Imgur. On the real though sorry folks, would it really have stopped you sick fucks? ;)

9 years ago | Likes 2 Dislikes 1

#1 What's wrong with that, looks fine to me. #2 Jesus!

9 years ago | Likes 2 Dislikes 0

9 years ago | Likes 2 Dislikes 0

I admire your ability to keep calm when faced with this -- I sure as hell couldn't do it

9 years ago | Likes 2 Dislikes 0

What did he do hand feed a chainsaw shark?

9 years ago | Likes 2 Dislikes 0

Looking at the before photo I’m amazed his extensor tendons made a narrow escape!

8 years ago | Likes 1 Dislikes 0

Wow this went from interesting to cringe in the space of one pic.

9 years ago | Likes 3 Dislikes 1

Op is Dr. Frankenstein

9 years ago | Likes 2 Dislikes 0

How? Yessss i love medical stuff

9 years ago | Likes 1 Dislikes 0

9 years ago | Likes 19 Dislikes 0

Ok honestly wasn't expecting that. Imgur really needs an nsfw tag

9 years ago | Likes 36 Dislikes 10

Isnt this more like NSFL?

9 years ago | Likes 1 Dislikes 0

Mature is the tag, technically.

9 years ago | Likes 9 Dislikes 0

Imgur, where even non-sexualized images of breasts are unacceptable, but gore is great for all ages!

9 years ago | Likes 3 Dislikes 1

There is one. It's mostly used on the science side. I think this would be more a NSFL tag that we would need here?

9 years ago | Likes 3 Dislikes 1

Maybe a hamburger hand tag?

9 years ago | Likes 2 Dislikes 0

9 years ago | Likes 4 Dislikes 0

"Degloving"

9 years ago | Likes 3 Dislikes 0

Hope this dude's girlfriend heals fast. Must have been hard for him to go through that with her.

9 years ago | Likes 223 Dislikes 4

Oh my. It took me much longer to realize what you meant than I'd like to admit. I thought I was missing the story or something.

9 years ago | Likes 11 Dislikes 0

No she is Franken-girlfriend

9 years ago | Likes 5 Dislikes 0

I heard he was seeing someone on the side..

9 years ago | Likes 3 Dislikes 0

And she is no longer wiping his ass. The struggle is real!!

9 years ago | Likes 1 Dislikes 0

I hear he's a lefty.

9 years ago | Likes 1 Dislikes 0

Dextral male????

9 years ago | Likes 1 Dislikes 0

Hello stranger my old friend.

9 years ago | Likes 2 Dislikes 0

If there's ever been a time for this guy to become ambidextrous, it's now

9 years ago | Likes 1 Dislikes 0

As a medic i loved this

9 years ago | Likes 1 Dislikes 0

I dont think this needs a NSFW warning. I think people need to grow up. *insert Confession Bear Meme*

9 years ago | Likes 9 Dislikes 1

Depends where you work really. Probably not the best idea for a kindergarden teacher to get caught looking at this in front of kiddos

9 years ago | Likes 2 Dislikes 1

Kindergarten teachers should NOT be on imgur during work hours, this place is no places for very young kids eyes.

9 years ago | Likes 2 Dislikes 1

Not necessarily, that's why we have a mature content filter.

9 years ago | Likes 2 Dislikes 1

I bet it smells like a freshly opened a can of Dinty Moore beef stew…

9 years ago | Likes 2 Dislikes 0

What did that to his hand?

9 years ago | Likes 1 Dislikes 0

9 years ago | Likes 2 Dislikes 0

"don't always take" - What does this mean exactly?

9 years ago | Likes 1 Dislikes 0

So what happens if it doesn't "take?"

9 years ago | Likes 2 Dislikes 0

If I'm not mistaken, the damaged flesh will be rejected, die, and it will try to scab over. Will probably need a graft.

9 years ago | Likes 1 Dislikes 0

X-ray looks alright. I wonder why this is post... Holy shit!

9 years ago | Likes 470 Dislikes 2

v

9 years ago | Likes 4 Dislikes 0

9 years ago | Likes 1 Dislikes 0

Better reaction.

9 years ago | Likes 2 Dislikes 0

I was trying to figure out what would bloat a hand like that. I guessed epic bruise, not flaying

9 years ago | Likes 12 Dislikes 0

I knew something was wrong because you can see that there is a large amount of swelling and fluid in the hand based on the opaqueness of it.

9 years ago | Likes 2 Dislikes 0

My reaction as well

9 years ago | Likes 8 Dislikes 0

basically my exact reaction

9 years ago | Likes 1 Dislikes 0

Hahaha! My exact reaction.

9 years ago | Likes 28 Dislikes 0

9 years ago | Likes 2 Dislikes 0

orto here! Great job

9 years ago | Likes 1 Dislikes 0

So that's why they call it degloving... I will never fuck with heavy machinery so long as I live.

9 years ago | Likes 2 Dislikes 0

That will buff right out.

9 years ago | Likes 8 Dislikes 0

Rub Arnica cream on it

9 years ago | Likes 0 Dislikes 0

Rub Arnica cream on it

9 years ago | Likes 1 Dislikes 1

Rub Arnica cream on it

9 years ago | Likes 1 Dislikes 1

Rub Arnica cream on it

9 years ago | Likes 1 Dislikes 1

Rub Arnica cream on it

9 years ago | Likes 1 Dislikes 1

Rub Arnica cream on it

9 years ago | Likes 1 Dislikes 0

Is it me or do those MCPs look really short? turner syndrome or am i just being dumb?

9 years ago | Likes 1 Dislikes 0

Can we have a follow up in the future. Curious to see if it takes.

9 years ago | Likes 28 Dislikes 0

I'm a joint replacement guy, so he'll follow up with hands, but I'll see what I can do

9 years ago | Likes 17 Dislikes 0

Cheers :)

9 years ago | Likes 1 Dislikes 0

If it doesn't take will need to have it amputated?

9 years ago | Likes 5 Dislikes 0

If there's interest, I'll walk through some hip and knee replacement info and stories. We do a lot of very difficult revisions too.

9 years ago | Likes 278 Dislikes 5

Yes please. The more graphic it is, the better. Someone I know watches r/watchpeopledie. So I've got a strong stomach.

9 years ago | Likes 1 Dislikes 1

yesssss

9 years ago | Likes 1 Dislikes 0

He'll yesh

9 years ago | Likes 1 Dislikes 0

As a nursing student, yes please

9 years ago | Likes 1 Dislikes 0

As an RN that works on an ortho/neuro floor, yes! Very interested.

9 years ago | Likes 2 Dislikes 0

Please and thank you!

9 years ago | Likes 1 Dislikes 0

Foot stuff would be pretty rad, too. Pod student here.

9 years ago | Likes 1 Dislikes 0

Certainly interested here

9 years ago | Likes 1 Dislikes 0

Ermergerd yas

9 years ago | Likes 1 Dislikes 0

As a nursing student, yes please

9 years ago | Likes 2 Dislikes 0

Clean job my man! As an ER guy, I would have sent them straight upstairs!

9 years ago | Likes 1 Dislikes 0

That is a damn good suture job!

9 years ago | Likes 1 Dislikes 0

Yeah I think a lot of us have some kind of background/exposure to this, it's actually informative.

9 years ago | Likes 1 Dislikes 0

Do it. Now.

9 years ago | Likes 1 Dislikes 0

Yes please

9 years ago | Likes 1 Dislikes 0

Please post.

9 years ago | Likes 1 Dislikes 0

There is interest! Also in follow up on whether this guy's recovery went well

9 years ago | Likes 1 Dislikes 0

You're doing one of my dream jobs, you have peaked my interest here

9 years ago | Likes 1 Dislikes 0

Keep at it! See you at the conference;)

9 years ago | Likes 1 Dislikes 0

I'm up for some stories about revisions

9 years ago | Likes 1 Dislikes 0

Yes please good sir. This is pretty interesting!

9 years ago | Likes 1 Dislikes 0

more, please

9 years ago | Likes 1 Dislikes 0

Oh yes please.

9 years ago | Likes 1 Dislikes 0

Maybe a warning block saying there's a fucking gory ripped up hand heading our way next time

9 years ago | Likes 12 Dislikes 6

Yes please. The more graphic it is, the better. Someone I know watches r/watchpeopledie. So I've got a strong stomach.

9 years ago | Likes 1 Dislikes 1

Go on...

9 years ago | Likes 1 Dislikes 0

.

9 years ago | Likes 1 Dislikes 0

Please! Yes! Do eeet!

9 years ago | Likes 1 Dislikes 0

There is interest.

9 years ago | Likes 40 Dislikes 0

So much interest

9 years ago | Likes 0 Dislikes 0

So much interest

9 years ago | Likes 7 Dislikes 0

Yup please.

9 years ago | Likes 1 Dislikes 0

As a PT student, yes please.

9 years ago | Likes 1 Dislikes 0

Love my PT folks, lord's work!

9 years ago | Likes 1 Dislikes 0

And we love MD's that know the value of what we do :D

9 years ago | Likes 1 Dislikes 0

PT/OT cheerleader all day ;)

9 years ago | Likes 1 Dislikes 0

Ok so dumb question, how do you stich that up when there doesn't look to be enough skin? Or does it strech and make it fit?

9 years ago | Likes 1 Dislikes 0

I generally start by lining up an obvious landmark and move from there. A bit of undermining can free up more tissue.

9 years ago | Likes 1 Dislikes 0

And not dumb, the patient didn't think I could do it either;)

9 years ago | Likes 2 Dislikes 0

I generally start by lining up an obvious landmark and move from there. A bit of undermining can free up more tissue.

9 years ago | Likes 4 Dislikes 0

That's awesome, thank you for sharing

9 years ago | Likes 1 Dislikes 0

I'm currently in surgical tech school and ortho has always interested me, also worked at an ortho clinic. Always love hearing these stories!

9 years ago | Likes 1 Dislikes 0

I came up as a surg tech in the Air Force

9 years ago | Likes 1 Dislikes 0

Awesome! How long were you a ST for??

9 years ago | Likes 1 Dislikes 0

5 or so years, but did a bunch of other stuff in the AF

9 years ago | Likes 1 Dislikes 0

I did work at Barksdale AFB as an ortho tech, but it was a contract job that they called me last minute for the last month. I couldn't 1/?

9 years ago | Likes 1 Dislikes 0

Stand the lack of patients. Seeing only 10-15 pt's a day was a drag. I was use to seeing 70-100 pt's a day.

9 years ago | Likes 1 Dislikes 0

5 or so years, but did a bunch of other stuff in the AF

9 years ago | Likes 1 Dislikes 0

All you've gotta remember: position of use and anticipation is key;)

9 years ago | Likes 2 Dislikes 0

Awesome! Thanks for the tips!

9 years ago | Likes 1 Dislikes 0