Operational Orthopedics

Orthopedics for the General Medical Officer
Main Topics for Discussion

My Experience

I served as a Diving Medical Officer for 2 years
Dive site injuries at waterfront versus remote sites
Useful tools to have at your disposal
- Digital Camera, Jump Drive, Internet access
- Casting/splinting materials
- Local anesthetics (without epinephrine)
- A comprehensive phone list

Resources

Orthopedics, Naval Medical Center San Diego

The castroom number is (619)532-5342 or 532-8439

Multiple Subspecialists available

Your closest Navy orthopedics department

Make contact with your go-to orthopods early and establish a good working relationship

Wheeless’s Ortho Textbook Online

Know exactly what you want and make that clear

Physical/Occupational Therapy

These departments can be a huge help
OT works with the UE from the elbow down. They make custom splints, provide therapy protocols, utilize modalities
PT works with the shoulder, back, and lower extremities. Consider them for back school, ankle proprioception, post-injury pre-op rehab, etc.
If you do not have these on your ship or nearby, protocols are often available on-line, in texts, or from a civilian provider in town.

The Role of the Operational Navy Corpsman

The operational corpsman is a very active and hands-on part of the healthcare team.
They often know more than you do about common problems.
Make sure you get them OJT in nearby castrooms, pt depts, etc.
Ingrown toenail removal, blister care, splinting, crutch sizing - these are just a few of the things they can help you with.
If you have the good fortune to have an experienced IDC, you’re living the good life

Orthopedic Emergencies

Aka "Fire up the helicopters…"

Cauda Equina Syndrome

Bilateral buttock/le pain
Urinary retention
Bowel incontinence
Saddle anesthesia
Decrease in LE strength/sensation
This can be rapidly progressive. Loss of bowel, bladder, or erectile function may be irreversible!