Even though my seniors have been relieved 3 months before their exams, they still have to come to the OT due to lack of hands.
I was involved in two cases today, one was a Bilateral AVN case. AVN (Avascular Necrosis of the femoral head) is lack of blood supply to the femoral head. it occurs due to various resasons, in our case it was due to chronic intake of steroids for his asthma. Anyways he had it in both his hips, left being worse than right. We first wanted to tackle the better hip so that the disease process can be arrested earlier and we can give him a biologic hip. We did an indigineous procedure known as Bakshi s procedure developed by an indian surgeon in the 1980s. It involves making a small trough in the femoral neck followed by placing a muscle pedicle graft and holding it in place with a screw. the procedure went on quite well without any complications. This was the first time i was assisting this kind of a procedure, so it was fun.
The second case was a an old elbow case ( distal humerus fracture) operated about a year back and the patient had now come back with implant failure. We faced some difficulty in the procedure though, due to severe fibrosis because of the previous operation. elbow is one region where there is a high chance of fibrosis post op. it takes quite an effort from the patient to get his elbow back to its original shape. anyways coming back to the case. it took quite a bit of time to isolate the ulnar nerve which is an essential step before proceeding to fix the fracture. There was a lot of fibrosis surrounding the nerve and because of the distorted anatomy it became even more difficult to identify it. But my prof did identify it and fixed the fracture with what is known as an reconstruction plate and screws. Eventually my junior and I closed up the case and had to rush for a seminar on " open fractures management" immediately. It was quite informative actually.
Quite an eventful day actually. learnt quite a bit today. and i hope to find some followers though and also i hope to put up posts on a more regular basis.:)
