The Weight I Carried

A femur, a fracture I caused, and a patient who wasn't worried at all.

Last hip of the day. A femoral neck fracture.

A young gentleman, late fifties. Big bone guy. His femur needed one of the largest stems that we make. Tight going in. I got the broach and the trial seated where I wanted them. Leg length matched. Everything looked great.

Then I went to implant the final stem and it felt way easier than the trial.

That's not a good sign.

The X-ray looked reasonable at a glance. Look closer and I saw it. A crack running down the calcar, past the lesser trochanter.

Took the stem out. Extended the incision. Cabled above and below the lesser. Put the stem back in. It fit well. He had a longer curved incision now, and because of the cables, I held him to toe-touch weight bearing.

I went to see him after. He was resting in bed. I told him what happened.

The good news is we fixed your fracture. Unfortunately, when we were putting in your stem, I broke your femur further down than it already was.

Oh, was that there from the original break? he asked.

No. That was one I caused during surgery when I was putting in your hip replacement. But I fixed it. Everything came out well. But now you have a much longer incision.

Hey doc that doesn't matter, he said. I don't care about that.

Then he patted me on the arm. Thanks doc.

I was carrying the weight of that one a lot more than he was.

I thought about that fracture every day. Right up until his first post-op visit.

I was in the middle of clinic when he came strolling in. And I mean strolling. He had a cane. Not a walker. And he was carrying it, not using it.

Hey doc. How you doing? I feel great.

My heart dropped. Where's your walker?

Oh, I don't need that anymore.

Quick. Get him an X-ray. I feared the worst.

I shouldn't have. He was walking.

The film looked great. I told him to take it easy and kept him going.

After that two-week visit, I never saw him again.

I wondered how he was doing. I rationalized that if I wasn't hearing from him, he was doing okay.

Who knows where he is to this day.

Mistakes happen. Complications happen. Operate long enough, live long enough, and you'll cause some.

Well the good thing is, the mistake you catch and fix is rarely worth the worry you give it. But that worry means you care. Use it. Let it make you better at the next one instead of carrying it for nothing.

Good Thing Monday goes out every Monday. One story, one good thing.

Tell me your good thing this week. I read every one.