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Good morning. This week's article was a fun one to write. A dive into all the inner workings of how orthopedic surgeons actually fix bones so they heal right. Plus, I haven't drawn you pictures in a while. That changed this week...in a big way.
Also, you guys seemed to like the newsletter service as much as I do. It's cool, right? In case you missed it, find something new to learn here.
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☝️ First Hand
Have you ever seen an x-ray of someone's broken leg fixed with plates and screws? Or ever wondered how an orthopedic surgeon fixes fractures?
Complete with x-rays of real cases and drawings to help them make sense, this week's article is a peek behind the sterile curtain of the Operating Room to learn just how Humpty Dumpty is put back together again.
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👀 X-ray of the Week 👀
You may recall the above x-ray from a few weeks ago. A fracture-dislocation of a finger joint...that rarely goes well.
Permanent stiffness is the expected outcome of this injury.
Fortunately, just the right combination of patient motivation and bone healing (and yes, I'll take a little credit for the work) has led to a stunning outcome.
Above is a video of the patient's finger motion at just 7 weeks after the injury. The bone isn't even completely healed yet!
Needless to say, we were both absolutely thrilled.
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Rules of Thumb Q&A
**Reminder. This is not medical advice. No patient-doctor relationship is formed. This content is for educational purposes only**
Reader Question:
"I have 'Mommy wrist.' Do I need to stop breastfeeding?"
Evidence:
- De Quervain's tenosynovitis (sometimes called Mommy wrist) affects new parents, gamers, texters, and teachers alike.
- That's because it's an overuse of the wrist tendons at the base of the thumb. Tendons that are subject to increased stress any time the wrist is in flexion and/or ulnar deviation with repetitive tasks.
- Things like lifting a baby out of the crib, holding their head for nursing, repetitive scissor use, holding a video game controller, holding your phone to text...
What would I do?
- For my typical patient who comes in with this question, I typically recommend that there's definitely no need to stop nursing.
- That being said, the position of wrist flexion and ulnar deviation (think of how you cradle a baby's head) is a setup for this nasty tendinitis. It's definitely worth your time to explore other ways (or products) to support your child's head.
- And invest in a good wrist brace that supports the thumb (called a thumb spica brace). There are no amazing braces out there, but they'll do the trick if they're good enough. This will be difficult with a child, but try to get one month of 24/7 bracing under your belt (you may have to remove for diaper changes/baths, but do your best).
- If that doesn't work, consider seeing a hand surgeon for a steroid injection for fast relief.
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🩸 Finger on the Pulse 🩸
**Unlike your favorite cryptocurrency, health and science news doesn't produce blockbuster headlines every day. To keep this section more valuable (aka, actually good content), I'm going to trim it down to my favorite single link of the week. I'll bring you only the best stuff.**
🇺🇸 Ozempictown USA: The weight-loss drug hype continues to sweep the nation. Meet this small town in Kentucky where nearly 4% of the population is on the prescription med...
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Just forward this email to a friend or send them to rulesofthumb.nickgolinvauxmd.com/join.
The more this grows, the more I can invest in it!
-Dr. G
PS. Rules of Thumb is a completely free resource to all those who want to learn more about the human body. Support Rules of Thumb here 🙏.
**Please do not use this email to try to obtain medical advice. I cannot legally or ethically provide that. If you are having a medical emergency, please call 911 and do not attempt to contact me through email.**
Rules of Thumb Archive • www.nickgolinvauxmd.com
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Disclaimer (because, you know, lawyer stuff)
If you are having a medical emergency, call 911. Do not attempt to contact or obtain medical services through this site. This content is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this site or materials linked from this site is at the user's own risk. The content of this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. The content is my own and does not necessarily reflect the views of OCC.
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