Medical Malpractice Insurance for orthopaedic surgeons

Hypervascular or Hypertrophic: (horse hoof)

–  Discussion:     – hypertrophic non unions are rich in callus and have a rich blood supply in the ends of the fragments;     – they result from insecure fixation (inadequate stability) or premature wt bearing in a reduced fracture whose fragments are viable;      – fracture is capable of mounting a healing response … Read more

HyperMagnesemia: 1.6-2.6 mg/dL

Increased: Renal Failure: Hypothyroidism Mg containing Antacids Addison’s dz Diabetic coma Severe Dehydration Lithium intoxication Signs and Symptoms:  – Generalized Neuromuscular Depression  – Decreased Deep Tendon Reflexes (Early) > 7.0  – Weakness  – PR lengthening if > 8.0  – Flaccid quadriplegia (w/ severe HyperMg)  – Hypotension  – MS Changes & Coma

Hyperosmalar Non Ketotic Coma

– Treatment of Hyperosmolar Non Ketotic Coma:  – Infusion of Normal Saline to restore volume  – Reg Insulin 10-25 units IV  – Insulin drip 5-10 units/hr until Serum Glucose < 500 mg/dl;  – Insulin given IV has plasma t 1/2 of 5 min and a biologic effect for about 20 min;  – thus, even brief … Read more

Hyperparathyroidism

(see also: Renal Osteodystrophy; Remodeling of Bone) Discussion caused by excessive production of parathyroid hormone which leads to hypercalcemia, recurrent nephrolithiasis, pancreatitis, peptic ulcers, and mental changes; incidence of approx 5 /10,000 pts per year; usually affects adults over 50 yrs & occurs more commonly in females; causes: in most cases is due to single … Read more

HyperPhosphatemia

– Diff Dx:     – Renal Failure     – Secondary Hyperparathyroidism     – Hypoparathyroidism (surgical, psuedo)     – Immobilization     – Addison’s dz     – Bone dz (Healing frx)     – Factitious increase (hemolysis of specimen)     – Vit D toxicity     – Tumoral Calcinosis – … Read more

Hyperpronation of Rheumatoid Foot

– Discussion:     – hyperpronation, by virtue of its mechanics, inevitably results in hallux being forced into valgus even in absence of RA dz in first           metatarsal joint;     – in this situation fusion of first MP joint is preferred option;          – this does not apply when there is severe forefoot … Read more

Hyperpronation of the Foot

– Discussion:     – hyperpronation refers to the inward rotation of the foot during gait;     – the term is vague and probably should be replaced by precise descriptions of the relative positions of the hindfoot and forefoot during gait;     – w/ hyper-pronation, there is an inability of the foot to supination … Read more

Hypertension

– See: antihypertensive agents – Outside Links:    Flight Surgeon Manual    GMO Manual    Hospital Corpsman 1&C    Sickcall Screener’s  Handbook    Sickcall Screener’s  Handbook LTG    Iowa Family Practice Handbook – Hypertension    Iowa Family Practice Handbook – Hypertensive Crisis    Merck Manual – Young Hypertensive Patient:     – consider ACE, combined … Read more

Hyperflexion Injuries

– See:       – Anterior Subluxation & Wedge Fracture       – Bilateral InterFacet Dislocation       – Spinous Process Fracture (avulsion frx – “Clay Shoveler’s Frx)       – Flexion Tear Drop Fracture – Discussion:     – anterior subluxation is characteristic that more commonly results from a hyperflexion … Read more