Medical Malpractice Insurance for orthopaedic surgeons

Peroneal Artery

– Discussion:     – largest branch of the posterior tibial artery  is peroneal artery arising high in leg and coursing downward in posterior compartment lateral             to and deeper than the posterior tibial artery;            – lies in the deep posterior compartment, just medial to fibula, just posterior to tibialis posterior, and just anterior … Read more

Peroneal Nerve

– See: – Innerv. Musc. Lower Limb – Innervation of the Leg and Foot: – Anatomy: – common peroneal nerve is derived from (L4, L5, S1, S2) as a part of the sciatic nerve; – posterior component, supplies short head of biceps femoris in thigh, crosses posterior to lateral head of gastrocnemius, and becomes subQ behind … Read more

Peroneal Nerve Palsy in TKR

– See:  TKR Menu:                  – Peroneal Nerve and Peroneal Nerve Palsy                – Nerve Injury from THR  – Discussion:     – peroneal nerve palsy following TKR usually presents acutely but in some cases there will be a delayed presentation;     – risk factors:          – use of epidural anesthesia;         … Read more

Peroneal Tendon Dislocation

– See: Peroneus Longus / Peroneus Brevis: – Discussion: – acute dislocation occurs by sudden forced dorsiflexion w/ concomitant eccentric contraction of the peroneal muscles; – classic teaching that the tendon dislocation occurs from a combination of dorsiflexion and eversion (like skiing), where as other authors feel that the injury occurs from dorsiflexion and inversion … Read more

Periosteal Chondroma: (Juxta Cortical Chondroma)

– Discussion:     – cartilaginous tumor that arises from surface of cortex deep to the periosteum producing broad based cartilaginous mass that may extend into soft tissues;     – often develops after adolescence (in contrast to osteochondroma)     – persists as mass of mature cartilage w/o calcification or ossification (in contrast to chondrosarcoma); … Read more

Periosteal Resurfacing of Knee Chondral Injuries and Arthritis

– see: autologous hamstring resurfacing arthroplasty – References:       – Technical considerations in periosteal grafting for osteochondral injuries.       – [Combination of microfracture and periosteal transplantation techniques for the treatment of full-thickness cartilage defects]       – Fresh bone marrow and periosteum transplantation for cartilage defects of the knee.       – A retrospective analysis of two independent prospective cartilage repair … Read more

Periosteal Osteosarcoma

 – See: Classic osteosarcoma – Discussion:     – uncommon variant of classic osteosarcoma;     – primarily affects young adults;     – presents as an enlarging, painless mass growing on surface of the bone;     – most frequently seen in anterior proximal tibia & the posterior surface of the distal femur; – … Read more

Peri-Operative Dosing (for patient on Steroids)

  – pts who have had adrenalectomy, adrenal insufficiency, pituitary surgery, renal cell ca, or seminoma therapy should be given supplemental steroids;  – previously, it has been recommended that patients who are on steroids or who have taken steroids in the past year be provided with supplemental IV steroids inorder to prevent an adrenal crisis;  … Read more

PERICARDITIS

– diffuse ST elevation concave upward and/or diffuse PR depression and/or diffuse T wave inversion;  – clinical correlations:  – idiopathic, viral Infections, other Infectionsincluding bacterial, fungal and TB,  – acute MI, collagen vascular dz, uremia, cancer, Dressler’s syndrome, and Postpericardiotomy syndrome