When Science Saves the Day: A Bullet Wound, A Shattered Bone, and the Beautiful Art of Orthopaedics

Hello everyone! Trust you're having a good day already

The more you see the application of Science in our day to day activities, the more you truly get to appreciate how wonderful, beautiful and powerful it can be.

I am currently rotating my surgery units and I'm in Orthopaedics unit like I said yesterday in the post I made about us having hope on the 20% blood supply spared for the leg to see if it would be enough to keep us from amputating that leg here

In that post, I also mentioned about the second victim who was still on admission.

Here Comes The Beauty Of Science And The Art Of Orthopaedics

The second victim is a 34-year-old man who was shot in the hand, specifically the arm. This broke his humerus (a comminuted fracture type) and eventually led to the damage of his radial nerve but luckily , his arterial supplies were intact without any damage.. it was still something very surprising because for that level of injury, we were thinking the whole neurovascular components might be compromised.

I will walk you down to clarity to what we've done and the progress we've made so far with him using x-ray pictures of him..

This was the initial X-ray he took when he was brought to the hospital.
You can see clearly the discontinuity of the bone of the arm, that is the humerus, shattered by the bullet's high velocity.

We initially commenced daily wound dressing with povidone-iodine and normal saline while we prepared for definitive surgery by getting all the necessary investigations done before operating him.

In the meantime, just for temporary support, we immobilised the hand with a Plaster of Paris Bandage Backslab to limit the movement and also to reduce his pain significantly.

This is the picture when he was on Backslab intervention

Finally, we were ready for surgery and our main aim of the surgery was to;

• Attain a step forward in the damaged bony structure healing

• To remove all the loose bone pieces that were scattered across the soft tissues because of the high velocity of the bullet

This was the surgery day and we achieved all our aim of the surgery...

• To significantly debride the muscles which were already necrotic because they are nidus or proper spots for infections to grow and multiply.

Then, instead of going back to POP Backslab, we used linear rail system which is the "iron thing" you are seeing sticking out from his skin into his bone.
Scary? Maybe😂. But very effective! It's all for good.

Functions of The Linear Rail System

• It helps to keep the bones stable enough more than Backslab plaster of Paris Bandage

• It allows gradual bone lengthening in a unidirectional bone like the humerus as the callus is forming

• It helps in realignment of the bone

• It also helps us to easily access the soft tissue damages and wound care too.

Six days later, we went to the radiology room to realign the bones under x-ray guidance

As you can see, this is what it looks like now

We still have a long way to go with the lengthening and eventual nerve repair, but, compared to where we were coming from, you will agree with me that, Science Is Beautiful and Orthopaedics? Absolutely stunning and pretty 😍

Sorry it was much more science inclined and you might find it difficult understanding most of the write-up if it's not your field... I just wanted to put it out there that orthopedic is pretty 😂

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Thanks for reading and have a nice day ahead 👍

ALL IMAGES ARE MINE

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