Week 2

This week was a little different because I had visitors from Ithaca! Marjolein came down for several meetings and presentations, and Natalie came with to do uCT scans of the vertebrae and humeri from our previous loading experiment. I spent Wednesday afternoon, Thursday, and Friday learning how to use the uCT, and scanning all of the bones.

On Tuesday, when we went up to Helen Hayes I was able to see a greater variety of patients. Dr. Bostrom examined several patients with shoulder injuries, where I learned how to tell if a patient has a substantial rotator cuff tear from the x-ray based on the distance between the humeral head and the rest of the joint, and a few with traumatic brain injuries. I thought it was fascinating how intracranial pressure is dealt with in TBI patients. Part of the skull is removed and implanted between the fatty tissue and muscles in the patient’s upper abdomen. Once the patient has recovered enough the piece of skull is replaced. It seems crazy to me that these patients essentially have part of their brain only protected by skin.

I was also able to see engineering principles in action in the OR. One of the patients undergoing a total hip replacement was rather large, and there were some difficulties when it came to reaming the femur. The x-rays showed that his medullary space was extremely narrow and his cortex was very thick, which was why a lot more force was required to push the reamer down the femur. These variations can be explained by Wolff’s Law: bones adapt to the loads they experience. This man’s bones were under fairly high loads on a regular basis, so they remodeled to better bear those loads. It was nice to see that things we learned in undergrad really do have real life applications.