Medical Malpractice Insurance for orthopaedic surgeons

Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome

– Definition:        – “RSD” is an imprecisely used term; has been used to describe changes in soft tissue and bone;        – RSD may not involve the sympathetic nervous system and may not be the consequence of a reflex;        – 1995: IASP Consensus Conference: “Complex regional pain … Read more

References for Osteoporosis

Appendicular bone density and age predict hip fracture in women. The Study of Osteoporotic Fractures Research Group Intermittent cyclical etidronate treatment of postmenopausal osteoporosis A prospective study to evaluate the dose of vitamin D required to correct low 25-hydroxyvitamin D levels, calcium, and alkaline phosphatase in patients at risk of developing antiepileptic drug-induced osteomalacia. Hypothalamic … Read more

References for Myocardial Infarction

Serum CK-MB is useful in diagnosis of acute myocardial infarction after total hip arthroplasty.  Surveillance for postoperative MI after noncardiac operations.   Effect of early intravenous heparin on coronary patency, infarct size, and bleeding complications after alteplase thrombolysis: results of a randomised double blind European Cooperative Study Group trial.  Effects of prophylactic antiarrhythmic drug therapy in … Read more

Raynaud’s Phenomenon and Disease

– See: vascular malformations of the upper extremity – Discussion:     – first described by Maurice Raynaud in 1862;     – involves vasoconstriction of the cutaneous arteriovenous shunts, digital arteries, and precapillary arterioles;     – pallor of the digits with or w/o cyanosis on exposure to cold;     – Raynaud’s disease … Read more

RA: Medical Management

– See:        – Anti-inflammatory agents        – Corticosteroids        – Cyclosporin A        – Sulfasalazine (anti folate activity) – Remittive Agents:     – salicylates     – gold             – gold salts (inhibit monocyte function)             – side effects … Read more

Prostacyclin

– Action:     – powerful vasodilator and inhibits platelet aggregation thru activation of adenylate cyclase, which leads to an increase in intracellular cyclic adenosine monophosphate;     – prostacyclin and thromboxane A(sub 2) are formed from arachidonic acid, w/ endoperoxides & prostaglandins G2 and H2 as           intermediates;     – variety of drugs with diverse mechanisms … Read more

Promethazine/Phenergan

– for N/V/motion sickness, potentiates narcotics; – adult: 12.5-25mg PO,PR,IM,IV bid/qid; (reduce dose w/ IV and slowly) – drowsiness common; compatable with morphine and meperidine; – motion sickness: 0.5 mg/kg/dose q12hr PO prn; – N/V: 0.25-0.5 mg/kg/dose q4-6hr IM or PR prn; – is a phenothiazine derivative that possesses antihistaminic, sedative, anti-motion sickness, antiemetic and anticholinergic … Read more