Medical Malpractice Insurance for orthopaedic surgeons

Vercuronium

– Discussion:  – nondepolarizing neuromuscular blocking agent similar to pancuronium. – has advantages over other nondepolarizing muscle relaxants by producing less hemodynamic changes, a shorter duration of action;  – dose reductions are not required in renal failure, but may be indicated in hepatic disease.  – Dose:  – usual intraoperative doses are 0.08 to 0.1 mg/kg … Read more

Verapamil/Calan

– See:  – Class IV Agents  – Discussion:  – Ca channel blocker, prolongs AV conduction, slows sinus rate, & exerts Negative Inotropic effect;  – Useful for converting narrow complex SVT to sinus rhythm in stable patients if carotid sinus massage unsuccesful;  – Useful for Unstable Angina, HTN, A.fib & A. Flutter (except when A.fib/flutter is … Read more

Venous Repair

– Venous Anastomosis: – Discussion:   – thickest layer in the vein is the adventitia and cannot be stripped away from vessel as it can in the artery & therefore need to use gentle          technique in teasing away the excess adventia and trimming it with scissors;   – vessel walls are not as self supporting … Read more

Venous Malformations

– See: AV malformations – Discussion:     – venous malformations, although present at birth, often are not noticed until 1 year of age. They engorge when dependent, decompress when elevated, and enlarge with trauma, puberty, pregnancy, or use of oral contraceptives;     – frequently confused with hemangiomas     – present at birth     – … Read more

Local Anesthesia following TKR

– intraoperative injection:              – 300 mg ropivacaine (0.2%) (150 mL) + 30 mg ketorolac (1 mL) + 500 µg of epinephrine (1:1000) (0.5 mL) (prepared on the sterile field)              – 18 gauge needle is used to inject in 3 equal 50 mL doses into each of 3 locations:                     (a) posterior capsule                     (b) medial, lateral … Read more

Vastus Medialis

    – See quadriceps muscle; Origin: Lower 1/2 of the intertrochanteric lines, medial lip of linea aspera, upper part of medial supracondylar line, medial intermuscular septum          tendons of adductor magnus and adductor longus; Insertion: Medial border of the patella by the ligamentum patella into the tibia tuberosity; Action: Extends the leg at the knee … Read more

Vastus Lateralis

– See Quads Origin: upper part of intertrochanteric line, anterior and lower borders of greater trochanter, lateral lip of gluteal tuberosity, upper         half of linea aspera, lateral intermuscular septum, and tendon of the gluteus maximus; Insertion: lateral border of the patella by the ligamentum patella into tibia tubercle; Action: extends the … Read more

Vastus Intermedius

– See Quads Origin: Proximal 2/3 of the anterolateral surface of the femur, lower 1/2 of the linea aspera, upper part of the lateral supracondylar line;          Lateral intermuscular septum; Insertion: By tendons of the rectus and vastus muscles into the superior border of the patella and by the ligamentum patella into the       … Read more

Vascularity of the Lunate

– See:        – Blood Supply to the Wrist        – Kienbock’s Disease – Discussion:     – majority of lunates have both dorsal & palmar vessels & are thus as well vascularized as the other carpal bones;            – neither single intraosseous nor extraosseous disruption alone will cause avascular necrosis … Read more