Medical Malpractice Insurance for orthopaedic surgeons

ORIF of Hand Frx w/ K Wires

– Discussion:     – K wires should never cross at the fracture site, since this will cause rigid distraction;     – K wires should cross either proximal or distal to the fracture and gain firm anchorage in the proximal and distal metaphysis; – Holding Power of the Wires:     – increased penetrating ability and … Read more

ORIF of Hand Frx w/ Screws

– Indications:     – displaced long oblique fractures, spiral frxs, or articlar fractures (> 25%) of metacarpals or phalanges;     – screw fixation used w/o a plate, requires that the frx length will be at least twice diameter of the metacarpal; (lag screw theory)     – a minimum of 2 screws are … Read more

Orthofix

    – Metacarpal Pin Insertion:        – 2.7 mm drill is used for both cortices for 3.3 mm thread and 4 mm shank are used for most applications;        – tapered screws should not be backed out, since they will loosen;        – cortical screw: either: 4.5/3.5 thread diameter and … Read more

ORIF of Calcaneal Frx Using Lateral Approach

– Preoperative Planning:                   – Surgical Stratedgy:      – pt in true lateral position      – J or L approach w/ subperiosteal dissection off lateral wall, including calcaneo-fibular ligament (sural nerve in flap);      – extension from tuberosity to calcaneo-cuboid (watch peroneals)      – … Read more

ORIF of Distal Radius Fractures

– Discussion: (distal radius fracture menu and colles fracture) – volar surface of distal part of radius is slightly flattened, except for its distal margin, which slopes volarly to form a prominent ridge from which volar radiocarpal ligaments originate. – short radiolunate ligament originates off of volar margin of lunate facet and attaches to volar surface of lunate and helps maintaining stability … Read more

Opponens Pollicis

  – Origin:     flexor retinaculum and tubercle of trapezium bone; – Insertion:  radial side of entire length of first metacarpal bone; – Action:     flexes & abducts first metacarpal w/ medial rotation at hand; – Synergists: abductor pollicis,  adductor pollicis; – Nerve:        Median, C8 > T1; – Discussion:   … Read more

Anterior Plating Technique for Distal Radius Frxs

– see distal radius fracture menu (volar Barton’s frx)               – orif of distal radius fractures – Surgical Approach:      – standard volar approach:           – most indicated for simple extra articular fractures and when there is absence of ulnar comminution / displacement:           – incision starts at thenar crease of palm, curves toward middle of forearm, w/ … Read more

Opponens Digiti Minimi

  this is a test .  the word finger should   origin: hamulus of the hamate bone and flexor retinaculum; insertion: entire length of ulnar border of 5th metacarpal; action: flexes and slightly rotates the 5th metacarpal; helps to cup the palm of the hand; synergists:   flexor digiti minimi brevis, abductor digiti minimi; nerve … Read more