Friday, July 23, 2010

Nice Experience

Last week was so wonderful.Alhamdulillah...Allah gives me chance to operate plating of femur for my first experience under senior guidance, Dr Anuar Ramadhan.Learning process needs hard work, patience and motivation.Belief to yourself, be confident insyaAllah He will lead you throughout the way.

To plate a femur, for a thin young man, usually not so difficult.We may begin with place our patient in lateral position, putting the fractured limb at the uppermost on the operation table.Locate his greater trochanter, and move superiorly to find tip of it.Then incise the skin in line with that mark, only do at the area that need to be exposed.The first that you will see after subcutaneous tissue is tensor facsia lata.Do another incision to this fascia until you find vastus lateralis muscle lying beneath.Split this musle by blunt incision until reach the bone.Once femur identified, use retractors to lift up the bone.Then you may now begin plating !

Sounds easy, but be careful with perforater vessels around.Ligate or coagulate them to control bleeding.Like what Dr Anuar told me, to do open reduction is the most difficult part in this operation.Imagine the fractured site as a jingsaw puzzle, then try to fix the bone as complete as possible to replace it back to the normal alignment.Once able to reduce, maintain with bone holder.Select your plate size and start making holes for the screws.Before closing, make sure tighten all the screws first to reduce risk of implant failure.

Lots of energy needed, indeed.So prepare yourself fisrt before entering operation theathre ! All the best.

# Thanks a lot to Dr Anuar Ramadhan for your kindness and supports.May Allah bless you all the while and helps you to become a good excellent orthopaedic consultant one day, insyaAllah.

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Friday, July 16, 2010

Appreciate your limbs !

It is hard to meet a day without MVA ( motor vehicle accident ).So it is almost impossible for me now to do oncalls without case.Sometimes the numbers reached up to total 25 cases only in one day !

But, Alhamdulillah Allah gives me strength.I like orthopaedics.I like dealing with bones, muscles, fresh blood, and even maggots in diabetic foot !
Really, Allah is merciful.I learn many things in this posting.How I'm feel very lucky to have complete four limbs while certain other people have to sacrifice their leg.Human only appreciate things when that things lost...na'uzubillah.

Be careful my brothers and sisters.Drive safely.I've already seen many cases here, don't follow them.Please pray before you drive, and keep zikrullah while you're driving.When your limbs get fractured, then it will create problems.Think about people around you, your mum, father who realy concern and care about you.Don't burden their life because once you fractured, you need somebody to help you moving and that's the time they have to sacrifice themselves for you.At least...

Last week, a man around 60 years of age, underwent above knee amputation.Pity on him, he actually still in denial state.He could not accept that he will lost his limb untill his son managed to counsell him.When I was in the operation theatre room, Dr Zubir's initial plan was just wound debridement even in the consent written KIV AKA.At last we found that the infection was very bad and spreaded up to above knee then AKA was proceed.We did in spinal anaesthesia, so the man actually knew that we were operating him in the OT during that time.He kept asking for cold drinks even before we put him on the table and continue mumbling until the time we cut his left limb into two.Alhamdulillah...the operation was successful.

Knowledge is wonderful.It is.

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