Another theatre memory

In my job I was often called to theatre to provide real time fluoroscopic imaging during orthopaedic surgery. The work varied a little but mainly it was elderly patients for DHS (Dynamic Hip Screws) following a fracture of the neck of femur or young males for a tibial nail ( following a mid shaft fracture of the tibia a long metal rod was placed down the shaft of the bone to hold the two halves together during the healing process). Both of these procedures saw me sitting a mobile C-arm between a patient’s legs and aiming at the fracture site whilst providing flash images of the site or real time scanning while screws were put in or holes were drilled. Mostly these procedures are done under GA, or general anaesthetic. Sometimes though you would get a very frail older person who desperately needed the hip screw but couldn’t be put under GA due to other health issues so they would have a spinal injection and the procedure would be done whilst the patient was awake.

Now I had attended other less gruelling procedures where younger patients were not under anaesthesia, for example k-wiring of a broken wrist which was easily done with a nerve block or ligature and would be over and done with in five minutes. Anyway, I was called up to do a theatre list which included a little old lady having a DHS under nerve block. I thought nothing of it and moved my machine in and glanced around to see the patient had a green drape covering them from the chest up akin to the drapes used during a c-section birthing. The surgeon made his incision and had me flash the hip to show the fracture in two planes, once from the front and once from the inside leg, the latter position I was to stay in for the rest of the procedure as normal. The normal chatter of the theatre was a little subdued to normal and I could hear the anaesthetist chatting away to the patient. Didn’t phase me, it was just a variation on a theme for me. Then the big guns came out, namely an air-driven drill, an air-powered screwdriver and a hammer along with the metalwork that was to be placed inside the patient’s femur. As the surgeon drilled and screwed I overheard the patient complaining to the anaesthetist that they shouldn’t allow builders to make so much noise around theatres when they are filled with patients. I wasn’t the only one to hear it, I glanced at the surgeon who had stopped drilling to listen and saw his eyes crease at the edge of his facemask indicating he was smiling to himself. He indicated to the anaesthetist to let it go and not unduly worry the patient about the ‘building work’ noises coming from her groin.

X-ray image of my own hip, with orthopedic implant on femur (Photo credit: Wikipedia)

That had me smiling but when the surgeon was cauterising some muscle and blood vessels to attach the screw plate to the femural shaft the lady then commented to say she did not realise theatre was so close to the canteen. The surgeon had to put down his tools at that point and walk away briefly as he was creased up with laughter. The scent of cauterised human flesh is akin to roasting pork or frying bacon.

NB: the image is not MY hip but is taken under GNU free license from Wikipedia