PHILADELPHIA, PA: Orthopedic surgery resident Rob Abington was recently recognized by the American Academy of Orthopedic Surgeons for performing the first open reduction with internal fixation of a uterus.
The patient was a 76-year-old woman who had undergone surgical repair of a broken hip earlier in the day. While on call, Abington received a page from the patient’s nurse because the patient was complaining of pelvic discomfort. “Since I’ve always been comfortable with pelvises, if you know what I mean, I thought that all this lady needed was some reassurance,” Abington recounts.
Upon arrival to the patient’s room, Abington discovered that the issue wasn’t related to the recent procedure. Instead, Abington recalls, “the patient told me that her pessary fell out, but all I could think was “what the hell is a pessary.”
“If I was going to reassure the patient that everything was fine, I knew I had to do it confidently,” Abington said. Abington confided that he pretended to get a page so he could leave the room to google what I pessary was. “I learned that it was a device used to prevent uterine prolapse,” Abington noted. “So I went back into the patient’s room to check if I needed to consult OB/GYN.”
Abington indeed found that the patient’s uterus had prolapsed, and that it was causing the patient significant discomfort.
“I thought that OB/GYN should probably see it, but I also thought to hell with it, I’m a doctor. Right?”” Abington noted. “So I just kept my confidence and got down to business, and…POW!” Abington exclaimed as he threw an uppercut into the air. “I put that baby right back where it belongs!”
As for the pessary, Abington said that he also put that back in place. “I was concerned about losing reduction because the patient noted a history of dislocations, so I tossed that bad boy in there, too,” Abington recounted as he mimed throwing a frisbee.
Abingoton said that he reported his procedure to his co-residents and attending during sign-out the next morning. “I thought my attending would commend my enterprising actions,” Abington noted, “but all he did was ask why I didn’t include his name on the communication note – he was upset that he couldn’t bill for the procedure.”