Anonymous:
ASSESSMENT
The subluxation is probably secondary to the sbsence of methyl methacrylate cement in the original fixation. Loose component, total joint replacement, right carpal-metacarpal joint.

PLAN
Obtain orthopedic consultation for removal of loose component and insertion of cemented trapezium component, abductor tendon transfer.
I have a problem with your use of "probably secondary."
Is it your assessment that the dislocation was caused by the lack of methyl methacrylate cement?
If yes, just say so.

ASSESSMENT:
Subluxation probably secondary to the absence of methyl methacrylate cement in the original fixation. Loose component, total replacement, right carpal-metacarpal joint.
PLAN:
Obtain orthopedic consultation for removal of loose component and insertion of cemented trapezium component. Abductor tendon transfer.
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