Medical Malpractice Insurance for orthopaedic surgeons

Physeal Bone-Bridge

– Discussion:     – bone bridge obliterates growth-plate cartilage & prevents growth;     – peripheral bone bridges predispose patient to angular deformities;     – most common sites of growth arrest include the distal tibia, distal femoral and distal ulnar physis;     – much less common sites include distal radius and proximal humerus;   – Radiology: … Read more

Phenobarbital

– for seizure disorders, insomnia, anxiety; – Adult: sedative- hypnotic: 30-120mg PO or IM qd prn; – Anticonvulsant:loading dose:10-12 mg/kg in 3 divided doses, then 1-3 mg/kg/24 hr; – Note tolerance will develop to sedation; – paradoxical hyperactivity seen in pediatric patients; long half life allows single daily dose; therapeutic dose: 15-40; >45=toxic; Contraindications: Respiratory disease … Read more

PHENTOLAMINE

– See: HTN  – Discussion: – given IV for marked elevation of BP;  – causes decrease in peripheral resistance & increase in venous capacity, due to direct action on vascular smooth muscle;  – this may be accomanied by Tachycardia;  – in emergencies: 2.5-5mg may be given IV;  – 5-10 mcg/kg/min by continuous IV

Phalangeal Frx Intraosseous Wires

– See: Phalangeal Frx – Indications:     – open transverse phalangeal fractures, replantation;     – certain transverse phalangeal fractures, avulsion & intra-articular fractures; – Advantages:     – allows fixation of small intra-articular frx fragments;     – there is no transfixation of soft tissues, which is seen w/ multiple K wire fixation; … Read more

Phalangeal Injury

   – Amputation of the Finger and Hand    – Arthrodesis of the MP joint and Finger Joints    – Boutonnere Injuries    – Characteristics of Phalangeal and Metacarpal Fractures    – Compression Screws    – Condylar Frx    – Crossed Finger Flap    – Dislocations of PIP    – Digit Reimplantation    – Dislocations:         … Read more

Phalen’s Test for Lumbar Stenosis

  – this test attempts to reproduce symptoms of leg pain, weakness, or numbness by causing neural ischemia;   – w/ patient upright, bend the patient into extension for a full minute;   – this should accentuate the Spinal Stenosis;   – positive test will produce a crescendo of leg symptoms followed by rapid relief of these … Read more

Phenazopyridine/Pyridium

– Symptomatic relief of urinary tract irritation from surgery, endoscop, infection; Local anesthetic on urinary tract mucosa; – Dose:  200 mg PO tid after meals x 1-2 days; – GI disturbances, red orange urine color; Not for chronic use; Encourage high fluid intake

Phenelzine/Nardil

Phenelzine is a MAOI; DOSING INFORMATION:  Recommended oral adult doses of phenelzine are 45 to 75 mg/day; alternatively, – Onset of activity is noted within 2 weeks, however, maximal effects are not seen until up to 6 weeks of therapy.     – Phenelzine is well absorbed following oral administration and is excreted primarily as metabolites … Read more

Pes Planus / Flat Foot

– Discussion: – loss of normal medial longitudinal arch leads to pes planus, which can be flexible or rigid; – may arise as a consequence of hyper-pronation or from increased eversion of the subtalar joint; – hence, the calcaneus lies in valgus and external rotation relative to the talus; – associated midfoot sag may be … Read more