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Report: AO course in Sydney 2011

  1. What did I learn?
    1. How to respect soft tissue. A better outcome of any surgery depends very much on the delicate handling and respect for soft tissue. The use of instruments cannot be emphasized. On top of that, the importance to delay surgery to ensure that the soft tissue has settled is important.
    2. Preoperative planning. This is important as it ensure one to think about the difficulty and what particular approach to use, the instruments one will use etc. Also it makes one to meditate and start thinking about all the fine details of any procedure.
    3. Absolute and relative fixation. The morphology and difficulty of any fracture determines this. Also the anatomic location of the fracture. If possible, we must ensure an absolute reduction in the forearm at all cost. Of course, fragmented fracture of the long bones can be dealt with by relative stability. Also the type of construct use is also highlighted.
    4. In the practical sessions, the important points of ORIF are highlighted. An important one is to avoid over stripping of the periosteum. Also, how to use the important instruments on how to do an IMNail (femur and tibia), external fixation etc.
    5. Group discussions. During the group discussions we contribute various ideas on how to approach a particular problem. I learnt the importance of communicating with your colleagues and other very important senior surgeons. Listening and accepting and trying to comprehend each other's point of view are of greatest importance.
    6. A fracture of children and adult. The management of a fracture of a child and adult is very different. An adult is not an expanded version of a child. It is different because a child is growing and because of the growth plates.
  2. What will I change in my daily work?
    1. CMEs. In order to stay focus and be like my other colleagues I need to continue to read resources, presentations and research. We have now ventured on a 3 times a week CME and continue teaching ward rounds.
    2. Preoperative conference. Unlike any time since I joined the team, we now have regular preoperative conference. We look at each case for operation the next day, we look at the patients overall status, review the X-rays, discuss the difficulty of the injury, what approach to use, the intended hardware to use and the post operative expectations and what to do. This is very important and I can tell the benefit of it.
    3. Research. I need to start looking at problem areas and try to make some sort of study.
    4. Take a more proactive role in the running of the clinical services.
    5. Communication with local and overseas colleague on problem cases. Join the iPath.
    6. To start some major operations e.g. IMN, PMR etc.
  3. What do I want to learn next?
    1. Hand surgery - For some reason I am very interested and have done some hand cases.
    2. Do the advanced AOTrauma
    3. Look forward to Swiss attachment. I am not so sure if we are allowed to assist in cases.
    4. The ATLS. Need to do one.
    5. Arthroscopy-techniques
    6. To do hip and knee replacements.

© May 2011, Dr George Kabwere

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