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
Comment on “Tf???”
TranscendentalEmpire@lemmy.today 2 weeks agoProbably 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.
Murse@slrpnk.net 2 weeks ago
TranscendentalEmpire@lemmy.today 2 weeks ago
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.
Murse@slrpnk.net 2 weeks ago
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?
No explanation stands out as especially obvious under normal circumstances (although I’ll reiterate that ortho isn’t my specialty, so my understanding of normal here is as broken as that leg).
What do you suspect?
TranscendentalEmpire@lemmy.today 2 weeks ago
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.
Zagorath@quokk.au 2 weeks ago
Fucken scabs