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One time I was in the ER, and a doctor noted that my heart beat has a rather pronounced split s2 rythm which is something that doctors need to learn to discern when listening to a heartbeat, so for the next hour as I was waiting around, I had several other younger physicians stop by and say “hey I was told to come listen to your heartbeat.”
Made me feel a little special in a very peculiar way I haven’t known since.
Couldn’t they just, you know, simulate it on a computer? Or listen to a recording? I guess it’s possible you’re very old.
Not a doctor, but am in various situations where I have to pick sounds out. There’s something very valuable about having a natural example, especially if the person listening has to find that example all on their own.
They were told they should listen to the heartbeat. Also I’ve worked at several colleges, I’ve seen what they train with - it’s very impressive. They can definitely simulate it today
Notice how you used the word simulate?
Until you use the world “replicate” I’m going to go ahead and say that real world experience is still better. Maybe not much better… but when it comes to doctors, I’ll take “just better” 7 days a week.
A girlfriend’s father had a condition where his organs were mirrored to the opposite side of the body and his circulatory system ran backwards (https://en.wikipedia.org/wiki/Situs_inversus)
Him and his family doctor loved bringing new coworkers in to do a “liver check” or something like that, and watch the person probe around with their hand and slowly get confused, then kind of freak out, when they couldn’t find organs in the body.
They did it for many years and both thought it was hilarious.
I’m left-handed and always secretly wished I had this and a right-handed twin so we could literally be mirror copies of each other.
Well, could be genetic. You figure out when the main bone cracks.
It’s always a great feeling when a doctor looks at something from you and then calls their colleagues to look as well…
Is it better when it’s a bunch of young doctors?
A little better, at least then it’s something the doctor likely understands, but thinks it is at least a bit of a teachable situation.
If they call in a peer or superior, then it means something was over their depth and then you really worry.
I’d say yes. If it’s regular rare it’s interesting for the younglings, if its extra rare it’s interesting even for the experienced.
The students just want to see freaky stuff. E. g. my appendix ruptured when I was 15 and it took my mother a few days to realize I’m not faking. So I have a bunch of scars, some parts are missing and other’s just look a bit off. Nothing I don’t know or can’t live with.
But when they call their fully grown colleagues to look at THAT. That’s creepy. That’s not good.
“Good news, you’re about to have a disease named after you!”
My eye doctor did that on one of my recent visits. Apparently my astigmatism is exceptional…
Back in school went to the school clinic for strep throat, and upon listening to my heart, he said “just a moment”, then pulled in the med student and quizzed them on what they were hearing and how it was abnormal.
Which led to a follow up echocardiogram where the technician was explaining everything we were looking at and what it was, until a very specific view then she shut up, tapped a bunch of things on the device, printed out something, then moved to another view and resumed describing everything except what she just saw.
How… reassuring… did she ever tell you what that was about?
Oh the tech wasn’t allowed to discuss medically relevant stuff.
The doctor followed up and I have an essentially benign heart anomaly. Growing up first doctors didn’t think it was worth exploring, then doctors said it went away, that was my first visit to a doctor after moving to a bigger city and those doctors were shocked a doctor would say it went away and not even bother to image it before dismissing it.
I have the same nail in my tibia. I Also fractured my fibula and they said that they don’t normally do much for a fibula break.
All that hardware tells us otherwise.
Could be doctors trolling the staff.
When you put something back together and end up with spare parts.
I have a screw box.
That’s a strange thing to call your partner.
I call my box Glory.
I don’t care obviously, but my friend wants to know if there’s a story behind this.
And even weirder, someone put all these titanium pins in my tibia!
Titanium? In this economy?
Learning the hard way that the titanium nail gun is not a toy
Most likely actual source: fibular free flap reconstruction.
https://myoms.org/what-we-do/oral-head-and-neck-pathology/fibula-free-flap-reconstruction/
Tl;Dr the fibula doesn’t hold weight, it’s just there to provide a connection point for tissue and ligaments, so when you need a long, straight length of bone that isn’t doing anything important they just cut out a section of fibula. Plus if you get really really lucky (or are a child) it might even grow back.
Um… so looking at the tibia, that is 100% an intramedullary tibial nail:
…which means their tibia was broken as fuck, and there’s a pretty hefty chance the fibula was also broken as fuck in that same injury.
My guess is the missing segment was fragmented to the point of not being saveable, and removed during the same operation the IM nail was placed.
That doesn’t necessarily mean the OP is bullshit - maybe they had some new resident docs, or nurses, or techs or w/e who hadn’t seen that before and it was a genuine wtf moment for them. I love it when new staff get that look!
Hmm that must be the same medullary as medullary rays in wood!
Is it not a problem to have part of your fibula missing? Can you operate without it?
You’re fine until the Bluetooth disconnects.
The comments on this thread are gold 😂💜
Muscle contractions and spasms will be indistinguishable between pain or pleasure. Just kidding, it will hellish if you get dehydrated and get muscle spasms. You don’t need it. Source, got a rod myself.
I don’t think we’d have lasted long as a species without a little bit of “redundancy”.
I don’t know horses get pretty screwed when they break a leg even with the best medical technology at the owners disposal.
Fair.
Is that like non-functional doomed, or like we can’t use them for sport any more so we opt to kill them doomed? I’ve heard the spiel about horses breaking a leg before, but I’m not actually sure what it’s supposed to imply.
It’s doomed as in they’ll die with most bad leg injuries. Horses cant support themselves on 3 legs. They’re just too big. There was a foal with 3 legs that lived for a couple years and made its round on social media, but it was eventually put down because it just grew too large. Poor thing should have been put down immediately because the life it lived was of terrible quality despite getting specialized care.
I’ve seen a few horses get put down for a bad leg injury. Almost had to put down my childhood mare after she fucked up her leg in a fence. She made a full recovery, but it took almost a year for it to heal. Her leg got caught in the wire fence and it got shredded to the bone. It was awful, but she was able to stand on it enough to keep herself upright and all that, so we decided to try to get it healed and were miraculously successful
That’s actually weirdly comforting. I always thought it was a comment on how quick humans are to just dispose of our companions once they start needing care.
And on that note, excellent work for NOT doing that and taking care of your hooved friend! ^_^
I mean there are pretty ruthless horse people, but not many are like that. Everyone I know goes above and beyond for their horses. My mare was considered a lost cause by many when I met her two years ago. I spent those two years rehabbing her and becoming her bestie and now she’s in incredible shape physically and mentally. 10/10 worth the effort. I’ll probably only get a couple more years with her because she’s very old, but she living an exceptionally wonderful life now and that’s all that matters to me. I want her to have the best old age she can. She’s had a hard life and deserves to live out the rest of her days in comfort and happiness
To be fair to horses, their legs are fingers, which doesn’t help the problem.
I’m imagining sports would be a lot more brutal if once a player got injured, they send out “the vet” onto the field to destroy them if they got any broken fingers or toes.
I’m fine with that
On the internet, nobody knows you are a horse
To be clear, othopedics is not my area of expertise, so grain of salt, but to my understanding, it’s basically the radius bone, but of the leg. Aim your toes forward in the normal anatomical position; now rotate your entire foot to the left or right. That’s your fibula working. Without it, very limited rotation; but otherwise you can still walk and function mostly normally, just a bit impaired.
I have no idea how ‘chunk missing in the middle’ plays into that. Guessing you’d still have some rotation, but without a secure anchor point, it wouldn’t be great.
Aim your toes forward in the normal anatomical position; now rotate your entire foot to the left or right. That’s your fibula working. Without it, very limited rotation; but otherwise you can still walk and function mostly normally, just a bit impaired
Eh… I do specialize in orthopedics and rehabilitation. You can still do all these things without a fully functional fibula, just to a reduced degree. The fibula only contributes to a few degrees of range of motion in the lower limb, we are talking about millimeters. It can be noticeable given enough time or a high enough level of vigorous activity. Most people would live a fairly active lifestyle without noticing this kind of damage to the fibula.
we are talking about millimeters
No shit? I would have guessed at least like 15 degrees of rotation. I think I took the radius comparison a bit too literal.
The radius moves a lot more than the fibula, which makes sense considering the need for moderate rigidity for weight bearing. The fibula only moves around a degree in internal and external rotation and less than a degree in the sagital tilting.
If you think about the rom in the ankle compared to the wrist it makes a bit more sense.
Yeah I wasn’t thinking ankle at all. And even here and now, I’m trying to rotate my own leg while keeping the ankle rigid, and… yea it doesn’t go very far. Never really appreciated just how large a role the ankle plays there.
Yeah, it’s the only weight bearing compound triplanar joint in the body. So it’s a lot more complex than something like the ball and socket joint of your hip. That’s why ankle and foot surgeries face a lot more complications and need for revisions compared to most other orthopedic operations.
It can be noticeable given enough time or a high enough level of vigorous activity.
So are we talking this would impact you if you’re an elite athlete, but not an advanced amateur? Or is it more that it’ll impact sports where changing direction quickly matters (like any football or court sport) but not more steady ones (like cycling or running)?
You’d probably notice it more if you were doing sports with a lot of lateral movements, pivoting, and changing direction. Not so much with something like cycling. You might notice over time it if you were doing something like marathons as it does help absorb some ground force reaction on heel strike.
So you wouldn’t notice it unless you’re a ballerina or something like that?
It’s not an issue, and pretty easily as it’s not a major weight bearing structure. It mostly functions as an attachment point for various muscles and as A part of the articulation of the ankle joint. Part of it is commonly harvested for use as a bone graft.
The most commonly harvested area starts right at the top of where the missing section begins, so I suspect this post may be bullshit.
It basically depends why it’s missing. In general it is not a problem if it is removed after an injury but it can lead to knee problems. However if you have a trauma that warrants a removal you will have very likely knee problems anyway.
If you are missing part of it from birth it is a big problem, because it is usually a sign of Fibular hemimelia and then you will most likely get an amputation
Probably just an atrophic nonunion fracture. If it was that damaged and you were already doing a tibial nail, there wouldn’t really be a reason not to do a fibular nail at the same time.
The fibula has fairly poor blood flow compared to the tibia, it’s not really that rare for the fracture to never callus and bridge back together. If that happens a lot of the times the bone will be subject to resorption.
If it was that damaged and you were already doing a tibial nail, there wouldn’t really be a reason not to do a fibular nail at the same time.
Yeah… supply issue maybe? Or patient opted out due to cost?
/shrug
Supply issues aren’t really an issue, orthopedic operations like this aren’t exactly emergent care. If you have time to procure a tibial nail there isn’t a reason you wouldn’t be able to get a fibular nail at the same time.
As far as cost, the same logic applies. When an orthopedist is coming up with a treatment plan you submit the treatment plan that would best lead to the overall best outcome for the patient, you don’t really formulate based on the most economic outcome.
The insurance company isn’t going to deny a fibular nail, but approve a tibial one. If they are going to go out of pocket, the cost of the fibular nail would be negligible when compared to the overall cost of the operation. The most expensive aspect of an orthopedic moderation is the operating room and the anesthesia, not the additional hardware or operating time.
Just spitballing. Consent issue maybe? Like it only covered tibia, and the staff didn’t notice until the patient was under / couldn’t get a hold of family to have it added?
How quickly can it absorb?
That’s not really how consent works, at least not in the US. You typically give consent for the operation, not for every individual procedure that’s done in the operation. A lot of the times you don’t really know what’s going to be needed to be done until you have the patient opened up, so the provider has a lot of leeway to operate as they see fit.
How quickly can it absorb?
Depends on the individual and what bone we are talking about. Though that’s quite a lot of bone to dissipate, so my guess would be that it’s a fairly old injury.
Are you sure it was there before? I think you where born without it.
They should lay off the bone hurting juice
Looks like major leg construction, someone removed it and forgot to put it back in
“… limb lengthening surgery side effect may include missing bones , desire to reverse the surgery,… death… and ither things. Results may vary. No batteries included . No refunds guaranteed. Ask your doctor today.”
🌟🌟 Happy Go Lucky music plays im the baxkground 👯💃
Didn’t think of limb lengthening
That’s not what this is. That hardware is to set a bone, and those bone lengthy rigs are more complex.
Most likely scenario is either the bone was shattered enough that repair wasn’t possible, or it was used for a bone graft. The fibula is a common bone that’s used because it’s not very load bearing.
Someone yoinked it while you were under for surgery or something??? Lmao
I saw a guy selling fibulas on the black market and I thought it was humerous. He had that too but it cost an arm and a leg.
“Do you want the good news or the bad news first?”
“The good news”
“We’re going to name the disease after you”
“Well, then what’s the bad news?”
“We’re going to name the disease after you”
dog chewed on it
