Medical Malpractice Insurance for orthopaedic surgeons

Management of Coagulopathy / Bleeding

 – Anticoagulant Induced Bleeding:  – Coags  – Coag Pathway  – Platlet abnormalities:  – Transfusion Rx   – Dilution Coagulopathy:        – may result from massive transfusions;       – rarely occurs w/ < 12 units of transfused pRBC, but occurs in nearly all pts that have received > 20 units of pRBC;        – note: coagulopathy associated with … Read more

Management of Fibula in HTO

– Discussion:     – proximal tibiofibular joint will prevent valgus correction unless fibula is shortened or tibiofibular ligaments are removed;     – transection if tibiofibular ligamets: (preferred technique)            – performed thru same incision as for osteotomy;            – proximal tibiofibular joint capsule is disrupted … Read more

Malignant Melanoma

– See: Tumors of Soft Tissue – Prognosis:     – prognosis of malignant melanoma worsens w/ increasing tumor thickness and also appears to be related to tumor site, age, and sex;     – lesions on the scalp, hands, and feet, particularly in older pts and males, all have a poorer prognosis;     … Read more

Malleolar Screws

– Discussion:     – malleolar screws with cortex thread, shaft & trocar tip have limited use in the metaphyseal area, distal humerus, trochanteric area, &          sometimes in the ankle, where the bone is rather dense;     – malleolar scew has a smooth shaft and is partially threaded;     – … Read more

Mallet Deformity: (Baseball finger)

– See: – Phalangeal Injury – Pediatric Mallet Finger – Mallet Frx – Anatomy: – extensor mechanism of digits; – terminal extensor tendon is comprised of the convergence of lateral bands, and more proximally by terminal fibers of the oblique retinacular ligament; – Acute Injury: – from forcible flexion of the extended DIP joint: – … Read more

Mallet Fracture of Thumb

– Non Operative Treatment:  – indicated for small (< 30-40%) fragment or displacement < 2 mm;  – use mallet finger splint; – Indications Operative Treatment:  – fragments > 30% of joint surface or displacement > 3 mm may require ORIF;  – volar subluxation from mallet fracture:      – needs to be re-evaluated after application … Read more

Mallet Fractures

– See:       Distal Phalangeal Frx       Mallet Finger – Discussion:     – may result from forceful hyper-extension;     – displaced frx fragment moves volarly with the distal phalanx w/ DIP flexion     – diff dx: dorsal DIP dislocation;     – indications for treatment:     – … Read more

Mallet Toe

– Discussion:  – refers to flexion posture of DIP;  – may occur as isolated disorder or along w/ hammer toe deformity;  – this deformity occurs most often in 2nd toe, which is frequently the longest & which is impinged in a tight fitting shoe, causing DIP flexion;  – mallet toe is common in diabetics with … Read more

Malignant Fibrous Histiocytoma

– See: Bone Tumor Menu: – Osseous Sarcoma:     – occur less often in bone than in soft tissue;     – occurs in older patient population & may arise out of Pagets Dz or from a bone infarct (such as sickle cell);     – it usually presents as an aggressive stage IIb … Read more