Fiachra Power @FPower123

Orthopaedic Surgery Fellow specialising in Upper Limb & Paediatric Orthopaedics. Hurler on sabbatical. Husband. Father of 3. Tá gaeilge agam. All views my own. Joined December 2013

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Fiachra Power @FPower123

2 years ago

@SiobhanOConnor3 @clgNaFianna Why would you torture the poor child by making him go to his first day wearing that top 😂

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Fiachra Power @FPower123

2 years ago

@deln_ioann I’d start with XR’s out of cast but if in doubt get a CT and if no convincing signs of union I would put a 4mm cannulated screw (with a washer) through that Thurstan-Holland fragment.

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Fiachra Power @FPower123

2 years ago

@DrGrantHogue @Davembmd Bloccs worked very well from recent experience with my son. You do need to make sure about the size selected, etc so not idiot proof unfortunately.

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Fiachra Power @FPower123

3 years ago

@Peds_Ortho Anecdotal but sure sees like it here in Melbourne Australia as well of late. Some nasty GAS infections needing multiple washouts to get on top of.

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Fiachra Power @FPower123

3 years ago

@eflow_freeflow hi, your website seems to be down. Can’t access it from PC or phone.

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Fiachra Power @FPower123

3 years ago

@Sade52109597 @northwoods1980 Or could just window the cast over the coin and remove it rather than redo the full cast.

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Fiachra Power @FPower123

3 years ago

@cihalpin Snap

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Fiachra Power @FPower123

3 years ago

@Pranai_B @Davembmd The centre I trained in use arthrex pec button instead of tightrope for this. Length not an issue. arthrex.com/shoulder/pec-b…

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@Davembmd @Peds_Ortho @CPOrthopedics Basic science to show it doesn’t induce growth disturbance (in porcine model) was published in JPO in 2008 out of the unit I’m currently training in. Variation on the technique still in use in select cases. pubmed.ncbi.nlm.nih.gov/18157044/

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Fiachra Power @FPower123

4 years ago

@childortho Wouldn’t call myself an expert but I suspect that what you are seeing is artefact from the overlying edge of the POP. No evidence of a lesion on pre-backslab XR. When you convert the backslab to a molded full cast with straight ulnar border you can re-XR and show that it is gone

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Fiachra Power @FPower123

4 years ago

@orthobullets @Pedsorthobklyn @BrianScannellMD @traumaticum @Pranai_B @GiblyMd @DrMaraK @natashaomalley @glitter_doctor @RugbyMD Of note though the study specifically excluded open distal ulnar fractures. pubmed.ncbi.nlm.nih.gov/23287758/

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Fiachra Power @FPower123

4 years ago

@orthobullets @Pedsorthobklyn @BrianScannellMD @traumaticum @Pranai_B @GiblyMd @DrMaraK @natashaomalley @glitter_doctor @RugbyMD I think most would agree with antibiotics, tetanus cover, debridement of open fracture site and stabilisation. Pinning the distal ulnar physis makes me irrationally nervous despite evidence that it doesn’t induce growth arrest so maybe pin radius only or add ante TENS ulna

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Fiachra Power @FPower123

4 years ago

@orthobullets @MJSteffesMD @FollowMercy @GiblyMd @glitter_doctor @sportsdoc2016 @Talal_1010T @bonesurgeon98 @Pranai_B @natashaomalley @DrMaraK @JenniferJBeckMD @jbhungry Skeletally mature so for me that’s ORIF both bones and mobilise. Having said that he’s young so you could get lucky and he could bone up in a cast or with TENS but prefer not to depend on luck.

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Fiachra Power @FPower123

4 years ago

@orthobullets @MJSteffesMD @FollowMercy @GiblyMd @glitter_doctor @sportsdoc2016 @Talal_1010T @bonesurgeon98 @Pranai_B @natashaomalley @DrMaraK @JenniferJBeckMD @jbhungry Wide ulnar fracture gap on AP (?soft tissue interposition) and still has 50% translation with a small diameter TENS that just about crosses the fracture site so not stable enough for me to mobilise so will be in a cast anyway and may have delayed union so not sure TENS adds much.

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Fiachra Power @FPower123

4 years ago

@Pranai_B @orthobullets @MJSteffesMD @FollowMercy @GiblyMd @glitter_doctor @sportsdoc2016 @Talal_1010T @bonesurgeon98 @natashaomalley @DrMaraK @JenniferJBeckMD @jbhungry @Pranai_B I think they are using adult instead of #paedsortho shorthand for this one and 15M = 15 year old male rather than 15 months. I like the idea of the retrograde ulnar TENS, will have to give it a try.

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Fiachra Power @FPower123

4 years ago

@Gnomelover1970 Given medial bruising and evidence of medial callus you would have to suspect ulnohumeral instability as well.

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Fiachra Power @FPower123

4 years ago

@Gnomelover1970 Radial head dislocation with plastic deformity of ulna (PUDA way off) presuming no actual ulnar fracture that’s not included in that view.

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Kate Sheridan @SherKatie

4 years ago

Are you living with chronic pain in Ireland? Please help us to learn from your experiences so that we can explore Irish Pain Services. Click the link to start: bit.ly/3bjV08k #painresearch #Irishhealthservice #chronicpain

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Fiachra Power @FPower123

4 years ago

@Davembmd Great result 👌

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Irish Orthopaedic Trainees Association @IrishTrainees

4 years ago

Congratulations to Prof May Cleary on receiving the Silver Scalpel award for training excellence. Exemplary trainer in every way. @UHW_Waterford @RCSI_Irl @UCC #ortho