From what I've seen in the US, it varies a lot from one facility to another. For surgery, most of what I've seen the consents address the expected operation "and all other indicated procedures" that give the surgeon the discretion to add something on intraoperatively if it's justified. That said, the facility I'm at now decidedly does NOT do that. They can add an operation on if it's an emergency, but something like a fibular nail would require specific consent. ...which they should have ahead of time, cuz imaging would make the need for one pretty obvious, but dumb shit happens and things get missed... So fast forward to the operation, patient is under, skin is cut, and circulator points out "uh, hey we only have consent for tibia..." If they have a family member available who can make decisions on the patient's behalf, that person could give consent, but if not they'd probably just skip it and schedule it as a later surgery.

...shit can get goofy.

Not a doctor, but am in various situations where I have to pick sounds out. There’s something very valuable about having a natural example, especially if the person listening has to find that example all on their own.

They were told they should listen to the heartbeat. Also I've worked at several colleges, I've seen what they train with - it's very impressive. They can definitely simulate it today

Dont even get me started on the Bone Apple Tea. Not in this economy.

Back in school went to the school clinic for strep throat, and upon listening to my heart, he said "just a moment", then pulled in the med student and quizzed them on what they were hearing and how it was abnormal.

Which led to a follow up echocardiogram where the technician was explaining everything we were looking at and what it was, until a very specific view then she shut up, tapped a bunch of things on the device, printed out something, then moved to another view and resumed describing everything except what she just saw.

A little better, at least then it's something the doctor likely understands, but thinks it is at least a bit of a teachable situation.

If they call in a peer or superior, then it means something was over their depth and then you really worry.

Hmm that must be the same medullary as medullary rays in wood!

How.. reassuring.. did she ever tell you what that was about?

I'm left-handed and always secretly wished I had this and a right-handed twin so we could literally be mirror copies of each other.

Well, could be genetic. You figure out when the main bone cracks.

I got into a car crash and went to the ER to get an X-ray done to make sure nothing was off, not this was a week after the crash. Anyways hurt like a bitch and after awhile of waiting the X-ray gets done and the tech just kinda looks at it for a minute, turns to me and says "Two bits of good news, your knee is just inflamed and swollen no breaks, also Ive been doing this for awhile and your bone density is absurd" which is how I found out that I'm a freak of nature who has borderline unbreakable bones. Explains why I struggle to swim in fresh water so much.

Oh the tech wasn't allowed to discuss medically relevant stuff.

The doctor followed up and I have an essentially benign heart anomaly. Growing up first doctors didn't think it was worth exploring, then doctors said it went away, that was my first visit to a doctor after moving to a bigger city and those doctors were shocked a doctor would say it went away and not even bother to image it before dismissing it.

Do you have claws?

Sadly no. But I am five foot five, can go berserk, and like retro motorcycles. Though I think Wolverine is more of a Harley guy rather than a Honda and Enfield guy.

All that hardware tells us otherwise.

Huh. I've only ever seen that word in the context of anatomy, but I guess it also belongs to the cores of trees. TIL.

I don't care obviously, but my friend wants to know if there's a story behind this.

"Well, then what's the bad news?"

"We're going to name the disease after you"

I have this exact same anomaly, I learned about it from a dexa scan.

Could be doctors trolling the staff.

That's not what this is. That hardware is to set a bone, and those bone lengthy rigs are more complex.

Most likely scenario is either the bone was shattered enough that repair wasn't possible, or it was used for a bone graft. The fibula is a common bone that's used because it's not very load bearing.

Yeah it's not too uncommon as I understand just not the norm. Though with me being so short it does give me the joke that evolution is trying to reinvent Neanderthals and I'm it's Alpha version.

Basically they told me that I was in the top 1% of their data collection efforts And I want to say he said something about it being two standard deviations off normal.

Makes sense, thanks

Fair enough, like I said me finding out was just an X-ray tech pointing it out and saying it was kinda cool. So I have no clue where I fall within actual standards.

Notice how you used the word simulate?

Until you use the world "replicate" I'm going to go ahead and say that real world experience is still better. Maybe not much better.. but when it comes to doctors, I'll take "just better" 7 days a week.

It can be noticeable given enough time or a high enough level of vigorous activity.

So are we talking this would impact you if you're an elite athlete, but not an advanced amateur? Or is it more that it'll impact sports where changing direction quickly matters (like any football or court sport) but not more steady ones (like cycling or running)?

an atrophic nonunion fracture

Fucken scabs

You'd probably notice it more if you were doing sports with a lot of lateral movements, pivoting, and changing direction. Not so much with something like cycling. You might notice over time it if you were doing something like marathons as it does help absorb some ground force reaction on heel strike.

Fascinating. Thanks for sharing!