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Useful information about working in Orthopaedics

Who to call

Orthopaedic on-call Registrar

For medical referrals, see below.

At any time the department is covered by a House Officer, Registrar, Senior Registrar and Consultant. House Officers wanting assistance should first contact the Registrar who in turn contacts the Senior Registrar who contacts the Consultant as required.

Medical referrals on orthopaedic patients

  • >65 years old between 0800-1600h - call on-call OPH Registrar

  • >65 years old between 1600-0800h - call on-call Medical Specialties Registrar

  • <65 years old between 0800-2200h - call on-call Medical Registrar

  • <65 years old between 2200-0800h - call on-call Medical Specialties Registrar

Clinical Pathway

Clinical pathways exist for:

  • Patients with Neck of Femur fractures

  • Patients undergoing total hip and knee replacement surgery

Copies of these pathways will be given to each house officer at the orientation meeting for the run

Elective orthopaedic surgical patients

Pre-operative work-up of patients for joint replacement and other major orthopaedic surgery will include:

  • Baseline blood tests including coagulation profile

  • Group and hold

  • Chest x-ray

  • ECG

  • Mid-stream urine examination

Routine post-op antibiotic prophylaxis

  • Routine post-operative antibiotic prophylaxis is usually cefazolin 1 g IV q8h for 3 doses. Postoperative antibiotics are only required if implants/metal-ware have been placed, otherwise a single dose at the time of anaesthetic induction is enough.

  • For patients with antibiotic allergy or colonisation with resistant organisms, see the full guideline on HIPPO.

  • If there has been a compound wound or deep infection the recommendation for duration and type of antibiotic should be in the written or dictated op note.

Routine post-op weight-bearing status

  • Elective THJR and TKJR will be mobilised full weight-bearing after surgery.

  • Routine NOF fracture fixation will be weight-bearing as tolerated (WBAT) unless otherwise specified in the operation note.

  • Routine fracture fixation patients should have weight-bearing status identified in the hand written and dictated operation note. If this is unclear please check with your team Registrar.