Week 8: Twin Cities Orthopedics

July 20th, 2013

Laura Ettlin ’14 Mansfield Foundation Fellow in Physical Therapy

With only a few more weeks at Twin Cities Orthopedics I am finishing up my experiences and opportunities. This week I was able to view some x-rays of ankle replacement, ankle fusion as well as a tibia plateau fracture stabilization. A few of the physical therapists explained how the surgeons stabilize the injured areas and how the implanted hardware can limit motion. In an ankle fusion, for example, a metal plate is placed anteriorly and screws are used to attach the tibia and talus to the plate. A second example of x-rays images I viewed was of an ankle replacement which is similar to a knee replacement. The distal end of the tibia and the proximal end of the talus is smoothed out and replaced with a metal piece that mimics the ankle joint. Again screws are put in place to keep the parts stable. The x-ray images provide an insight look to the anatomical features of the patients surgical site. This may also explain certain range of motion restrictions for a patient.

This week I also sat in on several evaluations for new patients. When a new patient comes in to receive physical therapy they first go through an evaluation with a PT. Paperwork from doctors (who likely referred the patient to PT) is reviewed and the patient explains their injury and symptoms. By the end of the session the PT prescribes a home exercise program for the patient and the patient sets up more sessions for the future. After the evaluation the physical therapist must fill out paperwork which is all done behind the scenes. There is an online program which is connected to all doctors and surgeons that work at Twin Cities Orthopedics. There is a lot of information that is filled out regarding the patient’s injury and symptoms as well as the physical therapists plan for their rehab. The evaluation includes goals, both short term and long term. For patients with routine surgeries such as knee or hip replacements the evaluations are relatively standard and may include specific goals such as “patient wishes to return to ice skating in the winter”. Even tough the paperwork is not the most enjoyable part of the job it is certainly important. The paperwork is reviewed by insurance companies to grant the patient more PT sessions or to charge medicare for the services the patient receives.

This week I was able to see the big picture of what happens behind the scenes, including the paperwork submitted by the physical therapists. I have seen almost every aspect of what a career in physical therapy entails. Only a short time left at TCO, and I look forward to absorbing as much knowledge as possible and wrap up my observations of patient’s progress with knee replacements.

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