Orthopaedics Progress Review

---
name: orthopaedics-progress-review
description: |
  Review progress for patients with bone, joint and muscle injuries or conditions against their plan and adjust it with evidence.
  TRIGGERS - Use when a orthopaedic surgeon needs a progress review & adjustment for patients with bone, joint and muscle injuries or conditions in an orthopaedic theatre and fracture clinic.
category: Orthopaedics
license: MIT
version: 1.0
---
# Progress Review & Adjustment — Orthopaedics

Review progress for patients with bone, joint and muscle injuries or conditions against their plan and adjust it with evidence. The deliverable is a progress review summary with decisions and an updated plan.
This skill is written for a orthopaedic surgeon working with patients with bone, joint and muscle injuries or conditions in an orthopaedic theatre and fracture clinic.

## When to use
- You are a orthopaedic surgeon preparing, delivering or reviewing this part of your work in an orthopaedic theatre and fracture clinic.
- You need a defensible, repeatable approach that produces a progress review summary with decisions and an updated plan.
- A colleague, auditor or client asks how this was done and what evidence supports it.

## Key Concepts
| Term | Meaning |
|------|---------|
| Fracture | a break in a bone |
| Arthroplasty | surgical replacement of a joint |
| Compartment syndrome | dangerous pressure build-up within a muscle compartment |

## Workflow
1. **Step 1** - Pull together operation notes and the latest results for surgical site infection rate since the last review
2. **Step 2** - Compare actual progress with the plan's goals and timelines; identify what moved, what stalled and why
3. **Step 3** - Discuss the evidence with patients with bone, joint and muscle injuries or conditions honestly, including where the original plan no longer fits
4. **Step 4** - Agree adjustments: continue, intensify, change approach or close — and record the reasoning
5. **Step 5** - Update the plan and review date, and communicate changes to everyone involved in an orthopaedic theatre and fracture clinic

## Profession-Specific Components
| Component | Details for Orthopaedics |
|-----------|-------------------------------|
| Core documentation | operation notes; fracture assessments; implant records; physiotherapy referrals |
| Core tools & equipment | operating microscopes and drills; C-arm fluoroscopy; splints and casts; traction equipment |
| People involved | patients with bone, joint and muscle injuries or conditions; the orthopaedic surgeon; colleagues and other services in an orthopaedic theatre and fracture clinic |
| Primary record | operation notes — keep it current, dated and attributable |

## Output Format
**Context:** [Situation in an orthopaedic theatre and fracture clinic] | **Objective:** [What this must achieve] | **Audience:** [patients with bone, joint and muscle injuries or conditions and other stakeholders]

The finished output is a progress review summary with decisions and an updated plan, structured as:
1. Summary of position and evidence
2. Detail, following the workflow above
3. Decisions, actions, owners and dates
4. Review point and escalation route

### Action Plan
1. **Immediate:** Confirm scope, consent and the evidence available in operation notes.
2. **Short-term:** Complete the workflow steps and record outcomes against surgical site infection rate.
3. **Medium-term:** Review results, close actions, and update local procedures in an orthopaedic theatre and fracture clinic.

## Success Metrics
| Metric | Target | Method |
|--------|--------|--------|
| surgical site infection rate | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |
| fracture clinic waiting time | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |
| implant revision rate | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |
| mobility recovery scores | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |

## Guardrails & Quality Checks
- Never let this happen: wrong-site surgery.
- Never let this happen: compartment syndrome missed.
- Never let this happen: post-operative infection.
- Work only within the competence and authority of a orthopaedic surgeon; escalate or refer anything beyond it.
- Record facts and observations, not speculation, and keep records confidential to an orthopaedic theatre and fracture clinic's rules.
- Verify names, dates, figures and measurements twice before anything is issued or signed off.
- Use only real, verified information from the case in hand — never invent results, credentials or evidence.

## Example (illustrative)
A orthopaedic surgeon in an orthopaedic theatre and fracture clinic applies this workflow for patients with bone, joint and muscle injuries or conditions: they open
operation notes, work through the five steps using operating microscopes and drills, and close by recording
the outcome against surgical site infection rate and agreeing the next review date. (Illustrative example only —
replace with the real details of the case in hand.)