Medical Malpractice Insurance for orthopaedic surgeons

IV. Extremity Fractures in an Austere Environment

CPT Jessica D. Cross CPT Daniel R. Possley     A. Describe the initial non-surgical and surgical management of extremity fractures   I. Introduction             A. Majority of wounds sustained by soldiers in combat zone are to the extremities, largely due to the nature of modern body armor1             B. Similarly, high energy extremity injuries are … Read more

Isolated Talocalcaneal Interposition Fusion: A Prospective Follow-up Study

Foot Ankle Int. 1997 Oct;18(10):616-621   Fellmann J, Zollinger H   ABSTRACT   BACKGROUND: This is a prospective clinical and radiological study of the treatment of talocalcaneal deformity or degeneration by a modified technique of isolated talocalcaneal fusion.   METHODS: Thirty-six patients were evaluated with clinical examination, plain dorsoplantar and oblique radiographs, and computed tomography … Read more

Inlet and Outlet Views

– Inlet View of the Pelvis: (cauded projection)          – caudad projection, also called inlet view, best demonstrates ring configuration of pelvis, & narrowing or widening of diameter of ring is immediately apparent.       – evaluates for posterior displacement of pelvic ring or opening of pubic symphysis;       – technique:            – … Read more

Wound Closure Initial Wound Care of Tibial Fractures

– Technical Considerations:          – consider debriding the wound with a separate set of surgical instruments / drapes          – exposure: extend the traumatic incision longitudinally in order to fully expose zone of injury;          – pressure irrigation         – debridement of open tibia fractures         – Arguments for Leaving Wound Open w/ Delayed Closure:           … Read more

Inhibition of Tumor Necrosis Factor

– Discussion:     – these agents bind TNF and block inflammation by inhibiting the subsequent effects of this cytokine;     – infliximab:           – a chimeric monoclonal antibody against TNF-(alpha)           – variable region of a murine antibody grafted to the constant region of a … Read more

Ingrown Toe Nail

– Discussion:     – occurs from inappropriate and excessive soft tissue inflammation to irritation of lateral nail fold;     – inciting causes include tight fitting shoes, or a sharp spike of nail against lateral nail fold;     – w/ an excessive inflammatory response, granulation tissue will grow up and over the nail; … Read more

Inflammatory Bowel Disease

– See: Spondyloarthropathies – Discussion:     – associated with a peripheral arthritis, which reflects activity of bowel disease;     – frequently associated with erythema nodosum;     – large joint oligoarthritis occurs in 10 to 20 % of pts, usually during flares of the bowel disease;     – fevers, synovitis, & vesiculopustular … Read more