Medical Malpractice Insurance for orthopaedic surgeons

Piriformis

– Anatomy:     – origin: anterior surface of sacrum between and lateral to anterior sacral foramen, capsule of sacroiliac articulation, margin of the greater sciatic foramen,           and sacrotuberous ligament;     – insertion: superior border of greater trochanter of femur;     – action: external rotation of hip & … Read more

Piperacillin / Pipracil

– See:        – Penicillin Family        – AntiPseudomonal Agents – Discussion:     – piperazine penicillin derivative with increased activity against many gm negative bacteria – P.aeruginosa, Enterobacteriacae – S.faecalis; Anaerobes (B.fragilis);     – for serious infect.: 200-300 mg/kg/24hr IV in 4-6 divided doses;     – for complicated … Read more

PIP Joint in Duputren’s

– Discussion:     – flexion contractures of PIP joint are more difficult to correct;     – flexion deformities of PIP joint may be caused by contracture of a diseased central cord (which is an extension of palmar pre-tendinous cord);     – PIP join contracture may be presaged by development of firm, fixed … Read more

Pindolol /Visken

– See: Class II Agents – Discussion:     – non selective B1 and B2 blocker;     – used to treate HTN

SCFE: Screw Placement

– Discussion:     – incorrect placement of pins is a common error;     – superior quadrant of femoral head should be avoided:          – this is where retinacular vessels enter, and pin penetration into this area may cause AVN;          – pins should not be placed superiorly … Read more

Pilon Frx Wound Closure

– Discussion:     – if the tourniquet is used, then it should be left elevated until wound closure is complete (expect wound swelling as soon as the tourniquet is released);     – if swelling prevents tension free wound closure, anterior wound may be left open for DPC in 3-5 days when swelling subsides; … Read more

Pilon Frx: ORIF of the Fibula

– Discussion: (see pilon frx discussion)     – fibula is usually fractured above the joint line;     – some authors will avoid ORIF of the fibula in these injuries if there is excessive fibular comminution (ie poor chance of good fixation) and               if there is excessive varus of the articular surface (ORIF would accentuate the varus); … Read more

Pillar View

– Discussion:     – demonstrates lateral masses (pillars)     – pillar frx is usually visible in inferior articulating facet of involved mass;     – pillar frx is usually visible in the appropriate oblique projection;          – however, it may not be apparent in oblique projection if fragments are neither … Read more