Medical Malpractice Insurance for orthopaedic surgeons

Alkaline Phosphatase

– Normal Values: Adult: 45-125 U/L, Child 20-150 U/L; – Increased: – increased calcium deposition in bone – hyperparathryroidism – pagets disease – osteomalacia / rickets: in both cases there is failure of mineralization; – caffey’s syndrome (infantile cortical hyperostosis) – osteoblastic bone tumors (metastatic or osteogenic sarcoma) – alk phos level is high in … Read more

Akin Procedure

– See: Hallux Valgus Menu: – Discussion: – indicated for hallux valgus interphalangeus – when deformity is located at IP joint; – some authors feel that this procedure is better suited as a salvage procedure; – procedure consists of a closing lateral wedge osteotomy of proximal phalanx combined w/ excision of medial eminence; – may … Read more

Albrights Syndrome

Discussion consists of polyostotic fibrous dysplasia, cafe’-au-lait spots of “coast of Maine” variety, and premature menses; it is more common in girls than boys and accompanies approx 1 in 30 cases of polyostotic fibrous dysplasia; there is appreciable coincidence of other endocrinologic dz including hyperthyroidism & Cushing’s dz as well as hyperparathyroidism and hypophosphatemic rickets; in polyostotic cases of … Read more

Alcohol Withdrawl

  – Discussion: –  onset- usually a few hours to 10 days after last drink (Usually 6-48 hr); – early symptoms: tend to be mild; – nausea, vomiting, anorexia, insomnia, diaphoresis, agitation, tachycardia, HTN, if seizures occur, – common abstinence syndrome, occurring at 6-8 hr, is the earliest withdrawl syndrome and is often present when the … Read more

Alcohols

– See: Skin Prep; – alcohols are most effective on clean skin; – the most effective alcohol concentration is between 70 and 90% – alcohols may not kill all spores; – as a drawback it has a skin dessicating effect    

Adult Radial Neck Fractures

– See: Pediatric Radial Neck Frx – ORIF of radial neck frx in adults: – similar principles as radial head frx – see: posterolateral approach: – consider the new precontoured radial head locking plates; – careful not to injure posterior interosseous nerve – safe zone:                  – radial head is covered by cartilage on 360 degrees of … Read more

Adult Scoliosis

Discussion cardiopulmonary problems (thoracic curves > 60-65 deg alter PFT’s; curves > 90 deg may cause myelopathy & may affect mortality; progression is unlikely in curves < 30 deg single major thoracic curves > 60-80 deg are likely to increase in size even after growth was complete; rate of progression is about one degree per … Read more

Advanced Cardiac Life Support

     V. Fib and Pulseless VT      V. Tach      PSVT      A. Fib      A. Flutter      PAT      Bradycardia      ventricular ectopy      Asystole      Angina / MI – Misc:     – IJ Central Line Insertion;     – CPR     … Read more