Rotation - Adult Orthopaedic Surgery
Become proficient in the Orthopaedic examination of the adult with chronic joint
pain, including variations gait. Learn to differentiate the forms of arthritis
from neuromuscular disease both chronic and acute. Learn surgical techniques of
the adult reconstructive surgery. Learn the principles of pre-and post-operative
care. Pre-op skills will include templating for THR and TKR. Post-op management
skills will include pain control and DVT prevention. You will learn, recognize,
and treat complications. Become familiar with the adult reconstructive Orthopaedic
literature.
References: Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related
Research, Journal of Arthroplasty and OKU: Hip and Knee Recon 1&2.
Rotation - Fracture/Trauma
Become proficient in the acute care and management of extremity trauma, including
application of splints and casts. Understand the fundamental of closed treatment of
fractures, including traction, and apply that knowledge to patient care. Understand
the theory of operative treatment of fractures and apply that knowledge to patient
care. Utilize instrumentation systems for fixation of fractures. Learn and use the
open fracture classification. Become familiar with common fracture classification
and their implications for treatment. Understand complications of fractures and
extremity trauma, including compartment syndrome and infection. Understand the
Worker's Compensation and No-Fault insurance systems. Work with the General
Surgery Trauma team as well as other consulting services to provide coordinated
care to the patient with multi-systems injuries.
References: Rockwood and Green's Fractures in Adults and Children, Broner et al
Skeletal Trauma, Manual of Internal Fixation, Letrournel's Pelvic and Ace Tabular
Injury and Fractures, Journal of Trauma, and the Journal of Orthopaedic Trauma.
Rotation - Pediatric
Orthopaedics and Pediatric Spine Surgery
Become proficient in the Orthopaedic examination of the child, including the upper
extremity, the spine, the lower extremity, the infant hip, the evaluation of gait,
and evaluation of the multiply injured child. Learn how to evaluate the spine for
scoliosis and understand the nonoperative and operative treatment of this condition.
Appreciate the complexities of juvenile athletic injuries and the arthritic conditions
of childhood. Learn the developmental milestones of infancy, childhood, and adolescence.
Learn to evaluate and differentiate the common Orthopaedic syndromes of children. Be
familiar with the hallmarks of child abuse and the multi-disciplinary care of this
problem. Understand the indications and principles of nonoperative and operative
care for each. Learn how to utilize various imaging techniques in the pre- and
postoperative care of children. Know how to interact effectively with the pediatric
team, which includes the parents, the pediatrician, the nurses, the therapists, and
the social workers.
References: Tachdjian's Pediatric Orthopaedics, Lovell and Winter's Pediatric Orthopaedics,
the Pediatric volumes of Skeletal Trauma and Rockwood and Green, the Journal of Pediatric
Orthopaedics, and the Pediatric OKU.
Rotation - Hand and Elbow Surgery
Learn the anatomy of the elbow, forearm, wrist, and hand. Become familiar with the common
clinical problems of this anatomic area that present to the practicing Orthopaedist. Learn
the appropriate techniques for evaluating these patients both pre-and postoperatively. Apply
these skills in both the outpatient and inpatient settings. Participate in surgeries in the
hospital as well as in the ambulatory surgery center. Learn all aspects of a comprehensive
hand, wrist, and elbow examination. Appreciate the application of the skills of a trained
hand therapist in the treatment of hand and elbow problems. Understand the findings and
techniques of advanced imaging studies as they apply to hand/wrist/elbow pathology and
trauma. Learn how to diagnose hand, wrist, and elbow problems and effectively treat them
surgically. Diagnose and treat complications. Be introduced to the use of magnification
in surgery. Use surgical loops and the operative microscope.
References: Green et al Operative Hand Surgery, Peimer's Surgery of the Hand and Upper
Extremity, Blair's Techniques in Hand Surgery, Gelberman's The Wrist: Master Techniques
in Orthopaedic Surgery, Trumble's Hand Surgery OKU-Hand, and Morrey's The Elbow and Its Disorders.
Rotation - Sports Medicine
The resident will become familiar with the common sports injuries, both acute and chronic.
Learn the diagnosis and management of these injuries with emphasis on the use of arthroscopy.
An appreciation of conditioning as a means for preventing injury will be studied along with
an understanding of the physical demands of sports and the implication of these demands on
injury patterns. The special problem of the upper extremity in overhead sports will be addressed.
Intense rehabilitation that is needed to return an athlete to competitive sport will be studied.
The reaction between the patient, the coach, and the patient's family will be observed during
on-field evaluations at high school and/or college games.
References: Delee and Drez's Orthopaedic Sports Medicine, OKU: Sports Medicine, Fu's Knee
Surgery, Insall's Knee, Rockwod's The Shoulder, McGinty's Arthroscopy.
Rotation - Spine
Understanding the physical diagnosis of the nervous system as it applies to Orthopaedics
and spine surgery. Apply this knowledge to the outpatient, inpatient, and emergent patient
with spinal problems. Study the acute care of the patient with spinal cord injury. Learn
the chronic problems encountered by the patient with spinal cord injury. Study the
rehabilitation of this complex group of injuries. Learn the management of injury and
surgical complications in the spine patient. Review operative and nonoperative alternatives
of care, including spinal bracing. Understand the Worker's Compensation system involvement
with this group of patients. Study the imaging tools needed for their evaluation.
References: Bridwell and DeWald's Spine, Rothman and Simeone's The Spine, and OKU: Spine.
Rotation - Orthopaedic Oncology
Exposure to all aspects of the initial evaluation, workup, treatment, and follow-up care of
primary and metastatic bone tumors as well as soft tissue sarcomas. Learn to understand
cancer and how it affects patients with musculoskeletal cancer.
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