Medical Malpractice Insurance for orthopaedic surgeons

Warfarin (Coumadin)

Action inhibits Vit K dependent production of clotting factors  mainly inhibits prothrombin (II) and VII but also IX and X  VII (t/2=4-6hrs), IX (t/2=18-24hrs), X (t/2=18-24hrs), II (t/2=18-24)  proteins C (t/2=6 hrs) and S (early);  hence PT increases in 48 hrs 2nd to decr of VII but many days of therapy needed for therapuetic levels … Read more

Volar Finger Tip Infections / Felon

– See: Infections of the Hand – Discussion:     – if infection extends thru dermis, the pad of digit becomes involved;     – usually cause by staph aureus;     – barriers to proximal migration of infection:           – anatomic arrangement of fibrous septum;           … Read more

Volar PIP Dislocation

      – Discussion:     – rare injury caused by compression and rotation with PIP joint flexion;     – may occur as simple dislocations or fracture dislocations;     – it is often unstable and irreducible;     – volar dislocation involves disruption of central slip, along w/ collateral ligaments and palmar … Read more

Waddel Criteria

– Discussion:     – Waddel determined 5 findings on PE which correlated w/ non organic LBP known as the 5 Waddell criteria;     – he noted that most patients w/ documented organic LBP had one or none of Waddell criteria, and that patients who had 3/5 Waddell           criteria were much more likely have non organic LBP; … Read more

Vitamin A

– Discussion:  – it is also required in appropriate amounts for membrane stability;  – excess or defeciency may lead to rupture of lysosomal membranes;  – Vit A participates in the biology of epithelium, and in excess it causes proliferation of basal cells and hyperkeratinization;  – Toxicity:  – causes increased intracranial pressure, vomiting, and lethargy Effect … Read more

Vitamin-D Deficient Rickets

– See: Rickets: – Discussion:     – this is the classic form of the disease;     – it usually results from a deficiency in dietary intake of vitamin D, often coupled with inadequate exposure to sunlight;     – reduced vitamin-D intake causes a diminution in the absorption of calcium from the GI … Read more