Medical Malpractice Insurance for orthopaedic surgeons

Acetaminophren/Tylenol

for mild pain, HA, F, Nonnarcotic analgesic, Antipyretic, Adult: 350-650-1000mg PO q4-6hr; Max: 3.2 gm per 24hr; OD may cause hepatoxicity (often delayed), antidote is N-acetylcystiene; No antiplatlet activity; No antiinflamitory property Caution with patients with Glucose 6 Phos defficiency; Contraindications: Acetominophren hypersensitivity; overdosage presents early as Nausea, Vomiting, and malaise, and presents late as clinical and … Read more

Acetabular Protrusio

(see also: Bone Grafting for Acetabular Defects) Discussion it is probably the result of remodeling of weak, medial acetabular bone after multiple, recurring stress fractures. intrapelvic protrussion of the acetabulum may be primary or secondary; protrusio acetabuli is not found only in inflammatory arthritides; most cases are in patients with osteoarthritis. primary protrusio: Otto Pelvis … Read more

Acetabular Exposure and Preparation for Reaming

(see also: acetabular component) Discussion it is essential to have optimal acetabular exposure; once acetabular exposure is achieved, then note native acetabular anteversion; Exposure for hips w/ severe osteoarthritis (or w/ heavily scarred hips) it may be necessary to fully release the quadratus femoris, and a portion of the gluteal sling; because the majority of … Read more

Acetabular Component Revision: Pelvic Discontinuity

THR menu acetabular component posterior column fracture Discussion (see also: classfication and bone graft options) condition in which superior aspect of pelvis is separated from inferior aspect because of bone loss or a fracture through acetabulum; most discontinuities represent unhealed transverse acetabular fractures which occurr through areas of pelvic bone loss; in the study by … Read more

Acetabular Component Loosening

(see also: acetabular component Loosening of Press Fit Acetabular Components (press fit acetabular components) normal bone ingrowth generally for bone ingrowth to occur, the component must lie with 50 micrometers of the acetabulum, inorder for host bone ingrowth to occur; as noted by Bloebaum RD, et al (1997), bone ingrowth into component averages only 12%, … Read more

AC Joint Arthrosis / Open Distal Clavicle Excision

Discussion general discussion: clinical and radiographic findings Surgical Technique Subacromial Decrompression Arthroscopic Distal Clavicle Excision: Open Clavicle Excision: Surgical Technique: Modified Weaver Dunn Procedure: Complications lateral elevation of the clavicle: lateral elevation is often associated w/ pain; ref: Sequential Resection of the Distal Clavicle and Its Effects on Horizontal Acromioclavicular Joint Translation references: Complications after … Read more

Absent Thumb

Discussion total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation; absent thumb may be inherited as autosomal dominant or may be sporadic; absent thumb is frequently observed in Holt-Oram syndrome, Fanconi’s anemia, and ring D chromosome abnormalities; absent radius is almost always associated with … Read more

Diff DX: Gout

(see also: Hyperuricemia) Differential Rheumatoid Arthritis: Infection: w/ rapid destruction of gouty joint (by intraarticular infection), crystalline deposits may be released into synovial fluid, leading to confusion; note that indomethacin can quell the clinical symptoms of early septic arthritis (just as it will w/ gout), and therefore, NSAIDs should not be used to differentiate between … Read more

Pathophysiology of Gout

Discussion: humans lack the enzyme uricase which is involved in elimination of excess nucleic acid purines & nitrogenous waste products through production and excretion of allantoic acid; hence in humans, uric acid is end product of purines degradation; gouty arthritis begins w/ deposition of MSU crystals in synovial & periarticular tissue; factors related to microtophus … Read more

Gout

(see also: Therapeutic Principles & Anti-Gout Meds Discussion gout refers to articular dz of MSU deposits (tophi) in soft tissues. it is caused by deposition of monosodium urate crystals in poorly perfused tissues, as well as bursae, ligaments, articular cartilage, and synovial membranes; on average, a family history of gout can be obtained in less … Read more