Day 4 – Huff Ortho

Today was slightly different from the previous three days of the week. Since Dr. Huff does not go to the office or have any surgeries on Fridays, I did not go to the hospital today. Instead, I researched a number of cases that I had seen in the previous week from home. In my research, I looked into cases that I was curious about. Two of these cases were Osteochondritis dissecans and Stener Lesions.

Stener lesions, also known as “gamekeepers thumb”, originated from Scottish hunters who had developed thumb problems. Due to humanely dispatching their harvest, they would put pressure on their MCP joint. This would then cause stress to the ligament within that joint causing a tear. As a result, the ligament would then lay on top of the thumb bone and not within the joint. With the ligament attached to the bone further behind than needed, the thumb then would develop a sway away from the other fingers instead of remaining parallel with them. This sway is one of the biggest indicators of a Stener lesion for a doctor. In regards to treatment, there is virtually no way to fix a Stener lesion without surgery. During the surgery, the doctor would break the ligament away from the place at which it rested during the lesion. Then, the doctor would attach the ligament on the MCP joint where it would be anatomically correct.

Another case that I found particularly interesting this week was Osteochondritis Dissicans (OD). This case appears when there has been a trauma lesion to the knee joint. When the lesion forms, a portion of the bone within the knee socket, whether it be the tibia or femur, breaks loose due to pressure. This broken part of the bone then rests inside of the joint until surgery. As a result, the patient is then under a tremendous amount of pain since there is loose bone inside of their knee joint, and there is also an area of exposed bone without cartilage around it. Osteochondritis Dissicans is actually fairly rare, and it mainly affects adolescents because they are more prone to having growing pains rather than adults. In regards to treatment, surgery is the main option. During the week, I had the opportunity to witness a surgery in order to fix the OD. The main goal of the surgery was to locate the missing piece of bone tissue and then place it back onto the lesion using darts. These darts were made of plastic and had barbs on them so that they would stay in place after the surgery during the healing process. However, the surgery is much more difficult than it sounds. With a great deal of perseverance, Dr. Huff located the piece of bone and took it out of the knee through a small incision. To compensate for the missing piece of bone, he then drilled holes into the lesion. These holes went all the way to the bone marrow. The result of the bone marrow cells entering the lesion is that new bone would then form around the lesion to recreate the bone.

Overall, I had a great week with Dr. Huff, and I can’t wait for next week!

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