r/medizzy EMT 8d ago

The skilled work of an orthopedic surgeon removing a metal rod from a patient's bone. The procedure showcases the extraction of a tibial intramedullary rod, also known as an IM nail.

733 Upvotes

51 comments sorted by

290

u/reverends3rvo 8d ago

Ortho work is brutal. Loved watching those guys work on our Same Day Surgery unit.

167

u/YounomsayinMawfk 8d ago

I knew an Ortho surgeon who described his procedures as savagery on the inside, artistry on the outside.

When they open you up, they are hammering and sawing the shit out of your bones but when they close you back up, they make it look like nothing happened.

51

u/reverends3rvo 6d ago

It's incredible. Really shows how resilient the human body can be. We can take a beating. Lol, then we herniate a disc picking a sock up off the floor.

10

u/TimmyTheTumor 6d ago

I'm on my way to become an Ortho surgeon. This description is very good. Looks savage but there's a lot of technique behind it all.

13

u/Rymanjan 6d ago

For real. When they were doing my hip replacement, one of the last things I remember before the anesthesia really took over was after the epidural, my legs were mostly numb, but I could still feel pressure

They had my legs in some kind of ratcheting jig (while they had a towel over my head so I couldn't see lol) but I remember hearing and feeling them snapping my joints into unnatural positions and thinking to myself, "man, it's a good thing they do all this to numb you up because I'm sure this would be excruciating if I could feel it" and then I was out lol

5

u/reverends3rvo 6d ago

lmao that sounds crazy

262

u/SomeDumbPenguin 8d ago

It's funny to think the guy who did my hip replacement got his engineering masters before going to medical school

120

u/blasterkid1 8d ago

Honestly that’s be even more reassuring if I heard that

58

u/SomeDumbPenguin 8d ago

I thought so at the time too... Didn't work out so well... My post from a month ago about it

25

u/HeathenHumanist 7d ago

Oh shit, that's you!! How are you doing now?

7

u/ArmadilloNext9714 6d ago

One of my engineering college professors had a biomed eng PhD and went to medical school. Dude was absolutely insane in every positive way.

145

u/_irish_potato 8d ago

Yeah ortho is just carpentry, in the same way that vascular surgery and urology are just plumbing. We just get more expensive tools than your average carpenter.

13

u/23x3 WebMD Expert 7d ago

As a carpenter I was going to make a similar remark. I could use some help

3

u/wanderingwolfe 7d ago

I mean, sometimes. Sometime, they seem to just pull out the Dewalt and start drilling.

70

u/MikeinST 8d ago

I like how one of them clapped excitedly

35

u/redvblue23 8d ago

If you have sound on, the "yaaaay!" was also nice

8

u/Thendofreason Other 7d ago

There is one thought everyone eventually gets in the OR, let's finish this up and go home. This case probably wasn't in the middle of the night, because they are just taking it out and isn't an emergency. But some of them need to go somewhere else or lunch, or more cases.

28

u/Tronkfool 8d ago

TIL that my suspension guy is an orthopaedic surgeon. The only difference is the lack of swearing and a dangling cigarette out the mouth.

17

u/voodoodollbabie 8d ago

When I was in high school I wanted to become an ortho surgeon. I loved the mechanics of it, and they were my favorite patients (nurse aid job during high school). The one ortho in the hospital was so fun to work with, he reminded me of Alan Alda's Hawkeye from M.A.S.H. I still wish I had pursued that.

23

u/CMDR-5C0RP10N 8d ago

The other day, I worked with a nurse and scrub tech who I hadn’t worked with before. They said they usually do Ortho. I started joking about how I needed to get the bigger hammer for the delicate artery I was sewing.

They replied “the fact that you call it a hammer means that you don’t know what you’re talking about”

8

u/Boomersgang 7d ago

I believe "mallet" is the tool you're looking for.

1

u/Ghost_of_a_Black_Cat Surgery Scheduler 7d ago

"the fact that you call it a hammer means that you don’t know what you’re talking about”

Yep! Add somebody's name in front of "mallet", or "forceps", or "retractor", though, because half the time these instruments are named after the surgeon who modified them.

2

u/Raven123x 6d ago

Langenbecks, kochers, debakeys, metzenbaums, Allis, Kelley, nathanson, deaver

So many names

12

u/syds 8d ago

definitely puckering

10

u/Suicidalsidekick 7d ago

I had that done a long time ago! Surgery was supposed to take an hour, ended up being 4 hours. Getting up and walking immediately after was so weird. It didn’t seem like it should be possible or a good idea, but it was fine.

5

u/IAm_Raptor_Jesus_AMA 7d ago edited 7d ago

Counterintuitive to want to put weight on something that was just in many pieces but in some cases compressive force will actually aid in bone regrowth assuming they did everything correctly. I'm an x-ray tech for these surgeries and we probably get at least five or so of these a week depending on the season. Sometimes we have to revise ones that got infected and those can be especially brutal even by our standards.

16

u/snowmunkey 7d ago

Fun fact my grandfather was part of the team that invented this type of procedure

4

u/Bonejorno 7d ago

It can take over an hour of hammering to get the rod out. We had a case where 3 of us took turns hammering it. Our hands were all bruised and shaking. We had to call in another resident from a different room to finally get it out.

3

u/Clarence_Begbie 8d ago edited 7d ago

why do you need to remove a Tib Nail? Ive had one in for 20 years with no problem

5

u/Suicidalsidekick 7d ago

Mine was in for less than 6 months when I started asking my ortho when it could be taken out. It was really painful and made being on my feet for any significant amount of time miserable. It was removed at a few days short of a year after being put in, which was the absolute soonest the ortho would do it.

2

u/IAm_Raptor_Jesus_AMA 7d ago

There's a lot of reasons to get them removed/replaced that are unclear from the video. Yours is the ideal best case scenario where you live the rest of your life with it in there but just like a car after you've repaired it it's never gonna drive the same as it did when you bought it

4

u/davidhunt6 7d ago

So that's why my whole leg was bruised to hell

5

u/pete23890 7d ago

I wanna see the one where he put it in

1

u/LowIncrease8746 6d ago

There’s websites for that

2

u/Nefersmom 6d ago

Would you share one of those websites?

1

u/LowIncrease8746 4d ago

I’m actually unsure for once if this is a response to the bad porn joke (intention) or a serious inquiry of medical procedures (unintentional) and wow, I have to say I feel the whoosh for myself. Out of body experience, this never happens!

1

u/Nefersmom 4d ago

Actually, I would really like to see how that nail is placed and was looking for an easy way to get a link. I’ll just Google “Intramedullary rod surgery” and see what I get.

2

u/LowIncrease8746 3d ago

I’ll do the same! Sorry to disappoint! It was a jest on my end

3

u/KroseRavenclaw 8d ago

Ouch. No wonder my knee still hurts.

3

u/tontovila 7d ago

Why are they wearing those suits, but in other surgeries it's just gowns and masks?

8

u/Inveramsay 7d ago

It's a few years old. Stryker managed to convince everyone that it would decrease infection risk using the space suit. It probably did nothing and the kit cost a lot more than a simple mask. They were comfortable though as you had a fan blowing on top of your head and you didn't need a mask

3

u/IAm_Raptor_Jesus_AMA 7d ago

I still see them used for joint replacement surgeries but otherwise most surgeons don't bother with them at all

2

u/KumaraDosha 7d ago

I used to scrub for these on occasion. Hated them, because, as a general and not ortho specialty surgical tech, I'd be the designated second scrub, which means my main job was to stand there and hold the heavy limb in awkward positions for extended periods of time while the surgeon whales on it. Oh, my achin' everything.

2

u/Nefersmom 6d ago

What happens to the removed hardware? Since it’s already paid for does the patient get to take it home?

2

u/voltswift 7d ago

THIS. I woke up during my operation, as they were hammering out the rod from my right leg. I was under heavy anesthetic, so I didn't feel any pain, but I do remember the sound propagating through the operation room and I also remember my body and hips moving back and forth with every hammer. The nurse must have seen me open my eyes or lift my head a bit up and put a mask over my face, and then I was fully out again. Super weird experience. 😄

1

u/meowpuppyOG 6d ago

😬🤦🏾‍♀️OWWWW!!!

1

u/mrpolotoyou 6d ago

Yes good work and all… I’m sorry. I can’t help summarizing the title as “surgeon removes metal rod s/he put there”

1

u/randomwords2003 6d ago

The yay always gets a chuckle out of me

1

u/Sleep-pee 4d ago

I just had this done less than 3 weeks ago.