The Surgeon Skips Town

The other day, I learned that my orthopedic surgeon, the guy who was gracious enough to reconstruct my ankle, is leaving town. Though his departure is shrouded in mystery (the letter I received referred to "unforeseen circumstances"), he apparently found a better gig downstate. Which meant I needed to gather and transfer my records to another "ankle man."

Fortunately, my daughter already goes to a podiatrist that we like (and who's willing to take me on as a patient). Most notably, the change allowed me to page through my records -- a small sheaf of documents -- and review my case. A walk down memory (or is that "surgery"?) lane. Here are some highlights:

12/29/08: This pleasant gentleman presents for evaluation of his right ankle. He twisted his ankle and fell on the ice several days ago.

Physical examination: Demonstrates tenderness both medially and laterally.

Radiographic findings: Radiographs demonstrate a displaced fracture of the right ankle. This includes a displaced fibular fracture and disruption of the ankle mortis.

Impression: Severe displaced fracture of the right ankle.

Plan: The patient will be scheduled for an ORIF of the right ankle. We discussed all possible complications and the patient wishes to proceed with surgery. The surgery will be performed on 12/31/08.

12/31/08: Open reduction and internal fixation of the right ankle.

Operative findings: The patient had a displaced fracture of the right ankle that involved the medial and lateral malleolus as well as complete disruption of the syndesmosis requiring the placement of syndesmotic screws.

Procedure: The patient was brought to the operating room and placed supine on the operating table. Once under anesthesia, the patient was prepped and draped in the usual sterile fashion about the right ankle and the right lower extremity. A tourniquet was inflated. A lateral incision was made. Dissection was carried down to the fibula...

1/30/09: Mr. Brien returns for evaluation of his right ankle ORIF. The staples were removed and the cast was removed. The incisions look great.

2/2/09: I had a long talk with the patient about the fact that we will need to remove those syndesmotic screws at some point. For now, I would like to keep him on nonweightbearing and simply work on range of motion.

2/27/09: [Mr. Brien] is doing well considering the severity of his injury.

Radiograph shows excellent position of the ankle internal fixation. Exam shows intact neurovascular status of the right ankle and foot.

The patient is going to begin 50% weightbearing on the right ankle. He is aware of the possibility of posttraumatic arthritis.

4/20/09: Mr. Brien returns for evaluation of his right ankle. I took the staples out of the right ankle at the site where we removed the syndesmotic screws two weeks ago. The patient is going to increase his ambulation with full weightbearing and physical therapy...

5/18/09: Mr. Brien returns for evaluation of his severe right ankle fracture. He is making steady progress.

Physical examination: Demonstrates good range of motion. There is only slight swelling of the ankle.

Plan: The patient will increase his ambulation...

8/10/09: Mr. Brien returns for follow-up of his severe right ankle fracture. Examination shows excellent range of motion of the ankle.

10/12/09: Mr. Brien returns for evaluation of his right ankle fracture. Examination shows mild swelling of the ankle.

Impression: Doing well following ORIF of a severe right ankle fracture.

Plan: Mr. Brien will return to see me in six months.