Brett Moreira

Orthopaedic Surgeon

  brettcmor@gmail.com

  0402 344 463

About me

Upper Limb Surgeon, Trauma

Within the realm of medicine, where science and wonder intertwine, strides forth a figure of mystique. Dr. Brett Moreira, a luminary in upper limb surgery, wields a touch akin to magic, knitting bones and rekindling hope with an artistry that echoes the wizarding world. As daylight fades and shadows dance, he transforms into a spellcaster of healing, conjuring remedies that bewitch the weary back to strength. Amid this tapestry of science and enchantment, Dr. Moreira stands as a healer not only of limbs but also of spirits, his skills echoing like the hushed incantations of a spell.

Roster

  • Week 2
    • Operating – Monday Williamstown – Elective – All Day
    • Operating – Wednesday Footscray – Trauma – PM – II
    • Outpatients – Friday AM
  • Week 3
    • Operating – Tuesday Williamstown – Elective – All Day – II AM
  • Week 4
    • Outpatients – Friday AM
    • Operating -Friday Williamstown – Elective – PM – II

Surgical Preferences

Common surgery performed and preferences:

Total Shoulder Replacements (Anatomic or Reverse)

Position: Beach chair with T-max table & spider arm required.

Shoulder block: Happy with blocks

Equipment:

Anatomic:

Tornier- Simpliciti/Perform- aim for stemless

Mathys- anatomic stemless

 

Reverse: TBC depending on diagnosis – ie: cuff arthropathy, OA, fracture

1) Exactech Equinox – rep Andrew Stubbs or Mark Jones. Only pre-op CT required as per Exactech protocol. The Surgical Liaison nurses usually organise this.

2) DJO- Activate- rep Chris Meyers. Only pre-op CT required as per DJO protocol. The Surgical Liaison nurses usually organise this.

3) Tornier- for fracture- must have NICE loops

 

Arthroscopic rotator cuff repairs

Position: Beach chair with T-max table and Spider arm

Shoulder block: Up to the Anaesthetist

Equipment: Werewolf S&N

 

Stryker – rep Olivia Russo

  • aim double row, knotted medially, lateral knotless

S&N- Bec

  • aim double row, knotted medially, lateral knotless

Arthrex- rep Nic Weir

  • aim double row, knotted medially, lateral knotless= Speedbridge

 

 

Arthroscopic shoulder stabilisation – Bankart repairs +/- Remplissage

Position: Beach chair with T-max table and Spider arm

Shoulder block: Up to the Anaesthetist

Equipment: Arthrex- rep Nic Weir

  • usually Fibretak/Suturetak configuration
  • Threaded large Cannulars
  • Percutaneous Remplissage kit
Arthroscopic capsular release for adhesive capsulitis

Position: Beach chair with T-max table and Spider arm

Shoulder block: Up to the Anaesthetist

Equipment:

Werewolf S&N

Arthroscopic subacromial decompression

Position: Beach chair with T-max table and Spider arm

Shoulder block: Up to the Anaesthetist

Equipment: Werewolf S&N and an arthroscopic burr and shaver

Laterjet shoulder stabilisation

Position: Beach chair with T-max table and Spider arm. Done all open, not arthroscopic

Shoulder block: Up to the Anaesthetist

Equipment: Arthrex Laterjet kit with coracoid plate. Rep is Nic Weir (Mob: 0427955201. E: Nic.Weir@arthrex.com.au). 90 degree angled saw blade from stryker and curved sharp osteotomes.

Arthroscopic SLAP repairs

Position: Beach chair with T-max table and Spider arm.

Shoulder block: Up to the Anaesthetist

Equipment: Arthrex knotless suturetak anchors. Rep is Nic Weir (Mob: 0427955201. E: Nic.Weir@arthrex.com.au).

 

Trauma workload and preferences

Mainly does oncall at Sunshine. Will occasionally do oncall at Footscray once in a blue moon.

Clavicle fractures

Styker clavicle locking plates

For acute AC joint injuries – Stryker or Synthes clavicle hook plate

For chronic AC joint injuries – Pureplay CC ligament reconstruction- rep Chris Meyers

Proximal humeral fractures

If internal fixation required – S &N Evos proximal humerus plate- rep Fin Bruckner (must have 4.7 locking cancellous osteopenia screws)

If Reverse Total Shoulder Replacement for fracture – Tornier Reverse + NICE loops x 6

Humeral shaft fractures

Proximal shaft – S&N EVOS – rep Fin Bruckner

Mid shaft – Synthes large fragment locking plate (posterior approach)

If # pattern suitable- MIPO S&N plating ANTERIOR

Distal shaft – Synthes 3.5mm extra articular distal humeral locking plate

Humeral nail – proximal and shaft #- Synthes Multiloc- rep Jose

Elbow fractures

Distal humeral supracondylar/interconylar fractures: If internal fixation required – Stryker distal humeral periarticular locking plates with 4mm ASNIS screws

If total elbow replacement required – Tornier/Wright medical Latitude total elbow replacement

Radial head fractures: Internal fixation – LMT-  headless compression screws

Radial head fractures: Replacement – pyrocarbon radial head replacement (Tornier/Wright or LMT)

Olecranon fractures: Aim for Arthrex Fibretape x 2 2mm (see paper by Adam Watts)- all suture TBW

If comminuted then olecranon plate fixation – Medartis/Synthes/Stryker

Distal radius fractures

Synthes DR VA locking plate

If # dictates fragment specific fixation- LMT/Trimed

Scaphoid fractures

Medartis scaphoid specific locking plate. See paper by Talia and Thai et al and Muirhead and Thai et al.

Speed tip screws for waist # -Medartis

Ankle fractures

Stryker small fragment set – 1/3 tubular plate for most Weber B fractures.

Stryker Variax + Synchfix for diastases/syndesmotic injuries

Paragon – locking fibular plates

Fractured neck of femur

Nail, Nail and nail- rare indications for DHS- if DHS for sub capital, will use FNS Synthes.

Displaced subcapital fractures >75 or poor mobility can get a unipolar hemiarthroplasty- Exeter Unitrax.

<75 or good pre-morbid mobility = THR Exeter/Trident

Talus, Lisfranc, Calcaneal, metatarsal fractures

Paragon or Arthrex depending indication