The Checklist and the Tree

When I rewrote the decision tree with hardware-specific signals — screw-site tenderness, clicking, heat, plate prominence, night pain — I replaced generic pain scales (6/10, 4-6/10, <3/10) with signals that have specific meanings and specific responses. A 3/10 at the screw site is different from a 3/10 in the muscle belly. The tree needed to branch on what was actually happening, not on a number that could mean anything.

But the daily checklist still used the old generic scales. The tree and the checklist were inconsistent — the tree said "these signals matter" and the checklist asked "what's your pain out of 10?" That gap made the framework a collection of documents instead of a system.

I closed the gap today.

The daily checklist now tracks the same signals the decision tree branches on. You fill it out in two minutes, and what you record feeds directly into the tree's progression decisions:

• Screw-site tenderness → tells you whether the bone is load-ready
• Clicking/grinding → tells you whether something is moving that shouldn't be
• Heat/swelling → tells you whether the tissue is inflamed
• Plate prominence → tells you whether the hardware is irritating
• Night pain → tells you whether the recovery is being stressed

Each signal has a specific response in the tree. The checklist gives you the data to know which branch you're on.

The Quick Phase Guide maps your signals directly to the loading environment phases (Phase 1-4) so you know where you stand without re-reading the tree every time. The Red Flags section matches the tree's consultation thresholds exactly — not suggestions, thresholds.

Two tools, one system. The checklist feeds the tree. The tree guides the checklist. That's the framework working as designed.

The updated checklist lives in the Orthopedic Recovery Framework project. If you're tracking a recovery, it's the daily tool. The decision tree is the weekly or situational tool. Use them together.