Simini Boards Cast

In this BoardsCast episode, we continue Tobias Chapter 44 — Bandaging, External Coaptation, and External Devices for Companion Animals with a simple but important reframing: “Put a brace on it” is not a treatment plan.   An orthosis only works when its stiffness, hinge location, permitted motion, fit, and skin tolerance are matched to the actual mechanical problem. The core rule is: An orthosis is...

In this BoardsCast episode, we finish Tobias Chapter 44 — Bandaging, External Coaptation, and External Devices for Companion Animals with the concept that determines whether even the most advanced prosthetic device succeeds or fails: The interface determines whether the prosthesis works.   A prosthesis is not just a replacement for missing limb length. It is a load-transfer system . Force has to m...

In this BoardsCast episode, we begin Tobias Chapter 44 — Bandaging, External Coaptation, and External Devices for Companion Animals with a challenge to one of the most common orthopedic reflexes: “Should we splint it too, just for protection?” The problem is that immobilization is not a harmless extra layer of security. Every time you restrict a limb, you are making a biological and mechanical tra...

In this BoardsCast episode, we continue Tobias Chapter 44 — Bandaging, External Coaptation, and External Devices for Companion Animals with one of the most important practical reframes in day-to-day orthopedics: The bandage is a pressure system.   A bandage can look perfect on the outside and still be creating focal compression, friction, ischemia, and tissue injury underneath. The goal is not sim...

In this BoardsCast episode, we continue Tobias Chapter 44 — Bandaging, External Coaptation, and External Devices for Companion Animals with a simple mechanical rule: “Immobilize the limb” is not a plan.   Different injuries fail in different directions. Flexion. Extension. Abduction. Rotation. Weight bearing. If you do not define the dangerous motion first, you cannot choose the right external dev...

In this BoardsCast episode, we continue Tobias Chapter 43 — Overview of Minimally Invasive Osteosynthesis Principles with the mechanical rule that sits underneath every bridging construct: The implant bridges. Biology fills the gap.   In a highly comminuted fracture treated with MIO, the cortical column is not reconstructed. That preserves the fracture hematoma, periosteum, and blood supply—but me...

In this BoardsCast episode, we finish Tobias Chapter 43 — Overview of Minimally Invasive Osteosynthesis Principles with the complication lesson that matters most: Preserving biology only helps if the alignment and fixation are actually correct.   MIO lowers the biological cost of fracture repair by preserving the hematoma, periosteum, and soft-tissue envelope. But that biological advantage comes w...

In this BoardsCast episode, we begin Tobias Chapter 43 — Overview of Minimally Invasive Osteosynthesis Principles with a surgical principle that completely changes how you look at a comminuted fracture: Preserve the biology. Stop chasing every fragment.   A shattered bone is not just a pile of calcium waiting to be reconstructed. It is a living biologic system made up of fracture hematoma, periost...

In this BoardsCast episode, we continue Tobias Chapter 43 — Overview of Minimally Invasive Osteosynthesis Principles with the planning rule that makes MIO possible: If you can’t see the fracture, you have to plan it.   Minimally invasive osteosynthesis preserves fracture biology by giving up direct visualization. You leave the hematoma, periosteum, and soft-tissue envelope alone—but in exchange, y...

In this BoardsCast episode, we continue Tobias Chapter 43 — Overview of Minimally Invasive Osteosynthesis Principles with the reduction principle that separates biological fixation from traditional fragment-by-fragment reconstruction: Reduce the limb, not every fragment.   For most diaphyseal fractures, a successful reduction does not require every intermediate piece of bone to be put back exactly...

In this BoardsCast episode, we begin Tobias Chapter 42 — External Skeletal Fixation with the philosophy that makes ESF fundamentally different from internal fixation: The frame lives outside. The biology stays inside.   External skeletal fixation stabilizes the major bone segments using transosseous pins or wires connected to a rigid frame outside the skin. That lets the surgeon create mechanical...

In this BoardsCast episode, we continue Tobias Chapter 42 — External Skeletal Fixation by focusing on the part of the construct most likely to determine whether the frame survives: The frame can be perfect and still fail if the anchor fails.   The pin-bone interface is the strength-limiting interface of linear external fixation. That means success depends not just on the frame—it depends on how th...

In this BoardsCast episode, we continue Tobias Chapter 42 — External Skeletal Fixation with a mechanical principle that changes how you think about ESF construction: Frame stiffness is a geometry problem, not an inventory problem.   You can use the exact same pins, clamps, and connecting bars—and build two completely different mechanical systems depending on where those components sit in space. Th...

In this BoardsCast episode, we continue Tobias Chapter 42 — External Skeletal Fixation with a completely different way to think about fixation: The wire provides fixation. The ring turns fixation into a machine.   A fine wire by itself looks weak. But pass it through bone, anchor it to a rigid ring, tension it, add another wire from a different direction, and suddenly you have a three-dimensional...

In this BoardsCast episode, we continue Tobias Chapter 42 — External Skeletal Fixation with the idea that an external fixator should not be treated as a static construct: The right frame today may be the wrong frame later.   Early in healing, the fracture needs protection. The callus is immature, the biology is fragile, and the frame has to carry most of the load. But as healing progresses, the bo...

In this BoardsCast episode, we begin Tobias Chapter 41 — Internal Fracture Fixation with the decision that should come before implant selection: Strategy first. Hardware second.   Before choosing a plate, nail, or screws, the surgeon has to decide whether the fracture should be anatomically reconstructed or biologically bridged . That starts with separating two concepts: Alignment = restoring leng...

In this BoardsCast episode, we continue Tobias Chapter 41 — Internal Fracture Fixation with one core rule: The implant isn’t good or bad. The implant is matched or mismatched.   Every implant has a mechanical job it does best. The mistake is asking one implant to resist a force it was never designed to control. We break down four major forces acting on a fracture: Tension Axial compression Bending...

In this BoardsCast episode, we continue Tobias Chapter 41 — Internal Fracture Fixation with the mechanical upgrade that turns a simple IM pin into a true fracture-control system: A regular IM pin controls bending. Lock the nail to bone, and now you control bending, rotation, and axial load.   The key is the lock. A smooth intramedullary pin sits inside the canal and resists bending well, but the b...

In this BoardsCast episode, we continue Tobias Chapter 41 — Internal Fracture Fixation with a simple mechanical reframe: A screw is a force converter.   The exact same screw can either simply hold two fragments in position or actively compress them together. The difference is not the label on the package. It is how the screw is applied . That gives us the central rule: Lag is an effect created by...

In this BoardsCast episode, we continue Tobias Chapter 41 — Internal Fracture Fixation with a major mechanical reframe: The plate does not decide the job. The construct does.   A plate is not just a strip of metal screwed to bone. It is part of a larger system made up of the plate, screws, bone, fracture configuration, and load path. The first question is simple: Who is carrying the load — the bon...

In this BoardsCast episode, we begin Tobias Chapter 40 — Open Fractures with a critical reframe: An open fracture is a whole-patient, whole-limb injury — not just a broken bone.   The exposed fracture may be the most dramatic thing in the room, but it is not automatically the first priority. High-energy trauma can also produce systemic injury, hemorrhage, neurovascular compromise, soft-tissue dest...

In this BoardsCast episode, we continue Tobias Chapter 40 — Open Fractures with a critical reframe: Don’t grade the hole. Grade the injury.   The size of the skin wound does not tell you how severe an open fracture really is. What matters is what happened to the biology underneath it: the muscle, periosteum, blood supply, bone coverage, and contamination burden. We break down the Gustilo-Anderson...

In this BoardsCast episode, we continue Tobias Chapter 40 — Open Fractures by challenging one of the oldest rules in open-fracture management: Biology doesn’t own a stopwatch. The historical “six-hour rule” is not a biologic cliff. Infection control is a race against bacterial proliferation, contamination, and tissue necrosis —and winning that race requires three things working together: Antibioti...

In this BoardsCast episode, we continue Tobias Chapter 40 — Open Fractures with a simple but essential principle: Coverage is not cosmetic. Coverage is biology.   You can perfectly stabilize an open fracture and still fail if the bone remains exposed inside a hostile wound. The surrounding soft tissue envelope is a living support system that protects bone, tendons, ligaments, nerves, and vessels w...

In this BoardsCast episode, we continue Tobias Chapter 40 — Open Fractures with a principle that changes how fixation should be chosen: The strongest construct is not automatically the best construct.   In an open fracture, fixation has to do more than hold the bone. It must also preserve the remaining soft tissue biology and allow repeated access to the wound. That gives us three jobs for the con...