Ok ortho folks, I'm looking to hear some OR tricks/tips. Impetus for this was a recent soul sucking case where the screw driver broke off in the head of a peripheral glenoid screw on an infected revision shoulder(I'm looking at you, Arthrex....). Baseplate was rock solid and wouldn't move despite the infection. Tried the dermabond trick to no avail. Screw removal set was pointless. Midas Rex didn't help and the baseplate was still locked in place. Eventually, I was able to just muscle the whole baseplate out of the vault with some bone loss. Tears were shed and select words said.

So, let's hear some tricks. From positioning to managing intra op disasters.

Intern here. Constantly dealing with the fear of being fired. Does anyone else constantly worry about being fired from orthopedic surgery residency? I feel like I’m always walking on eggshells, constantly being criticized by attendings and coresidents, and second guessing every decision I make. I understand that orthopedics is a demanding specialty and that criticism is part of becoming a better surgeon, but it’s exhausting feeling like every mistake or moment of uncertainty could jeopardize my future. Even when I try to learn from feedback and improve, it sometimes feels like nothing I do is good enough. The hardest part is not knowing whether this is just the normal culture of surgical training, whether I’m genuinely underperforming, or whether I’m letting the constant criticism get into my head. For those who have been through orthopedic surgery residency, how common is this fear, and how do you cope with it without letting it consume you?

I'm a recently passed resident from my university. Having seen and assisted a plethora of orthopaedic surgeries, I find being the chief surgeon as the most difficult post.

To be able to perform surgeries is so difficult. There are so many ways a simple procedure can go haywire. You have to be so careful and cautious in each and every step of surgery, from incision to closure, that I am finding it very stressful and overly difficult way of moving ahead.

I love orthopedics but i also want a chill and relaxed life. I want a 9-5 OPD kind of life, where I can sit and see patients, maybe give them a slab or cast, do basic dressing and suturing, do X-rays and prescribe medicines.

I don't want the headache and stress of performing operations.

Can I survive a life as an Orthopedician like this ?

Anyone have any suggestions for the best way to optimize use of resources? I've mainly been using Orthobullets. My program gets PGY1s into the OR early and often, so to prepare for cases I've mainly been using youtube/Vumedi/AO for anatomy and approach review. Other resources my seniors have suggested (Rockwoods, Wiesel's, AAOS, etc) are made available to use through my program, however I don't know the best way to include those into my studying.

I'm sure there's an element of "finding what works for me" as residency goes on, but any guidance on what resources to use/how to best use them would be appreciated! Thanks!

I like the surgeries in pretty much every subspecialty.

Was originally interested in joints but im concerned about the medicare cuts that surgeons keep having to face.

I’m now heavily considering Hand, Shoulder/Elbow, or Spine.

Plan is to go into private practice in a big metro area.

We created an orthopedic specific study web application aimed to maximize the learning and retainment of orthopedic knowledge for medical students, residents, and attendings. Currently free access, no credit card or subscription required. We are still engineering features to optimize learning with the goal of providing maximal coverage of orthopedic topics in a time efficient manner. Have an OITE rapid review section for total topic coverage with high yield summaries. Always looking for feedback for further improvements.

Current MS4 in a research year. Home state is NY and looking to maximize chances at matching in NY. Besides doing a subI at my home program (which is not in NY), is it a bad idea to do all my subIs in NY? Do you think programs (mainly outside of NY) see this as a red flag when it comes to interview offers and making match lists?

I have the OITE in less than a month. Schedule is busy without a lot of time to be reading/studying. I just got access to AAOS res study and have done about 40 questions out of 3,000+. Each Q takes me at least 10 minutes because I dont know shit. Was wondering if anyone had any high yield study resources / cheat sheets / videos that would be helpful. TIA

I’m a little confused with which one is my EPL tendon because photos on google point to this tendon as EPB

"I will be doing a 6-week AO Visiting Fellowship and I want to improve my skills in pelvic trauma. Do you think it would be more beneficial to go to the R. Adams Cowley Shock Trauma Center in Baltimore, or would Memorial Hermann in Houston be a better choice? Any advice is appreciated!"

Edit: Thanks to everyone who replied! After considering your advice, I've chosen Houston. Let me know if you are around there, it would be great to connect and meet up!

Is it very difficult for 1st gen doctor in surgical branches?

I am thinking to take ortho at 10.3k rank

But i asked one orthopedic surgeon famous in my city told not to take surgical branches as a firsst gen doc bcz of long learning curve and no family hospital backup,

.

What should i do?

I’m trying to better understand orthopedic surgery in ambulatory surgery centers (ASCs) and would love to hear from surgeons working in these settings.

A few things I’m curious about:

What procedures make up most of your ASC cases (hips, knees, shoulders, sports medicine, etc.)?
Roughly what percentage is each?

What are the biggest challenges or frustrations in your surgical workflow?

Do you currently use robotics or surgical navigation? If so, what do you like or dislike about it? If not, why?

How much does OR time matter? Would saving 5–15 minutes per case make a meaningful difference?

If you could improve one thing about your current surgical workflow, what would it be?

I’m involved in early-stage surgical technology development and doing some exploratory customer research. Not promoting a product—just trying to understand the real problems surgeons face.

Would appreciate any insights, even if you only answer one question. Thanks!

Same as above

Does anybody know of a conference/meeting/course in March at a western us/canada ski resort? Preferably an ikon resort. Foot/ankle, sports,general and trauma are cool. I have some education money to spend! I’ve seen the Rocky Mountain shoulder and elbow at vail but looking for other choices.

Fellow Ortho colleages, EM here

I'm confused by the management of dislocated elbows. Ortho bros at my shop recently scolded me for not reducing an elbow with an radial head fracture under full sedation as the stability of the joint would have been easier to assess with sedation

I read the AO guidelines which tell us to refrain from certain tests since ligamentary instability is to be assumed anyways... but it's clearly not my field of expertise

is there a consensus here what tests are to be performed in such a case? Do These tests change if there is s a fracture of any kind?

Do you need or at least profit from full sedation to perform these tests?

any insights appreciated (including video links...). Next time I reduce an elbow I'd like to be able to assess stability post reduction...

The more I learn about this company, the more concerned I get. Over the years I have peripherally seen patients that were involved in some form of care from Lantern - typically dealing with complications they have had with their surgeries. Most of the time my first reaction was "why did you even have surgery in the first place"? Tons of joint replacements in people with little to no arthritis, shoulder scopes on relatively normal shoulders etc.

I have never seen a single patient that had surgery with them that has said that conservative management was ever offered to them. It was always straight to surgery.

I thought they just had terrible surgeons in network that are pushing people into surgery that don't need it. But as I learn more, it seems like it is Lantern themselves pushing people into the surgeries. They have non-surgeon practitioners making the decision for surgery and then sending the patient straight to their in network surgeons for immediate surgery - typically without further evaluation.

That didn't make sense to me because I thought they were an insurance company. I didn't understand why they would want to waste so much money on unnecessary surgery.

Then I learned that they are actually a brokerage. Apparently they get a percentage of every surgery performed - so they are extremely incentivized to push as many surgeries as possible. They compare their costs with a competitor to tell their customers "we saved you millions vs the competitor". But the truth seems to be that they are instead overcharging by millions by pushing surgeries that aren't needed.

My understanding is they also get a cut of travel costs also so they also push people to travel as far as possible for their surgeries with no regard to quality of care and follow up.

Does this sound right to anyone else? The whole system seems crazy to me and doesn't make sense.

https://www.jbjs.org/reader.php?rsuite_id=0c2567e3-4743-4f73-b407-ab0222801559&source=JBJS_Case_Connector/16/3/e26.00038&topics=ta+hp#figures

Hey all, just submitted my ortho application last week and have gotten extremely mixed reviews on my chances of matching so I thought I'd try my luck here.

M4 at a mid-tier MD school

Step 1: Pass on first attempt

Step 2: 264

Preclinical Years: No red flags, all pass

Clinical Years: Honored every clerkship except 1 and my MSPE comments I would like to think are actually fantastic

Extracurriculars: Ex-D1 athlete, have really good and broad extracurriculars mainly focused on healthcare access, also in a dual degree and supplemental degree program

Awards: AOA & GHHS

Random: Woman, URiM

Aways: 3 aways and a home rotation, got good feedback on aways and already interviewed at a couple of them

Research: This is where the issue is... I have like 7 research experiences but not a lot of output. I have 5 presentations with 3 abstracts and 3 manuscripts in submission. Multiple other research projects that I'm working on. One project was a pretty big deal and several years long but I have like no output from it yet, though I could talk about it forever.

Letters: 3 good ones i think, no idea lol

I've just heard really mixed reviews on my app, including some pretty upsetting advice I got on what I should do with my application season a few days ago. Just wanted to get some more advice, thank you!

I didn't make this, but no one is using this year's sheet yet so I figured I'd drop a link for my fellow applicants

Stay strong on the sub-i trail everybody, splints ain't gonna roll themselves

Lets hear it. Are we closing? are we standing in a corner scrubbed for 7 hours without touching the patient? Are we using the saws?

am I even allowed to discuss this? lmk. Seems like theres a lot of variability.

Placed in Mexico approximately 5+ years ago.

Pts surgeon said everything was "fine".