Medical Malpractice Insurance for orthopaedic surgeons

Heterotopic Ossification

– See: Ossification of Soft Tissues: and Myositis Ossificans – Discussion:     – occurence and formation of mature bone in non-osseous tissue;      – may present w/ signs of localized inflammation or pain, elevated skin temp, ect.     – tends to occur after thr, spinal injury, head injury (11%), burns, bruises, elbow trauma, total hip replacement;     … Read more

Hemophilic Arthropathy: Extraarticular Lesions

– Discussion: – extraarticular bleeding may involve muscles, nerves, blood vessels, and even bones; – slowly expanding hematoma will interfere w/ function & perfusion of surrounding tissues; – intramuscular hematomas that fail to resorb quickly lead to fibrosis, contracture, cyst formation, or myositis ossificans; – bleeding into the calf muscles may cause a severe equinus … Read more

Hemophilic Arthropathy: Pathologic Changes

(see also: coag pathway) Discussion disease is most crippling when repeated bleeding into joint produces arthritis; left untreated most severe hemophiliacs will suffer crippling arthritis in one or more joints by early adolescence; after joint bleed, or hemarthrosis, synovium must absorb degradation products of the blood; repeated hemarthroses will cause synovial hypertrophy and inflammation; some hemophiliacs develop … Read more

HEMOPHILUS B Conjugate Vaccine (ProHIBiT)

– For routine immunization of children 18 mo  – 5 yrs of age against diseases caused by Haemophilus influenza type B;  – Actions: Hemophilus B conjugate w/ Diptheria toxin; active immunization;  – Dosage: 0.5 ml (25ug) IM in Deltoid or Vastus Lateralis;  – Supplied: Injection 0.25 ug/0.5ml;  – Booster not required;  – Not protective at … Read more

Henoch Schonlein Purpura

– Discussion:     – a vasculitis of unknown etilogy;     – mean age of onset is 6 years;     – small vessel vasculitis involving:     – skin:          – rash is typically from the waist down;          – rash begins w/ urticaria but quickly turns … Read more

Hematology / Bleeding in CRF

– See: Uremic Bleeding – Discussion:     – w/ bleeding consider need for DDAVP, additional transfusions (which may decr bleeding in RF), and aggressive dialysis;     – intravenous administration of erythropoietin in doses ranging from 25 to 500 U /kg of body wt 3 times a week causes a dose-dependent rise in the hematocrit and eliminates … Read more

Hematuria: Diff Dx

  – False Pos:  – Anticoagulation  – Myoglobinuria  – Bleeding diathesis  – Hemoglobinuria  – Entero-vesical fistula  – Porphyria  – HbS  – GU neoplasm  – Vigorous Exercise  – Polycystic kidney  – Renal Infarction  – Trauma  – Renal Vein Thrombosis  – Infection  – Transfusion RXN  – Stones  – Burns;  – Prostatic hypertophy  – Intersitial Nephritis  – Glomerulonephritis  … Read more

Hemi-resection Arthroplasty of R-U Joint

    – See:   – Bower’s Procedure – Discussion:     – invovles resection of ulnar articular head, leaving shaft and styloid relationship intact;     – interpositional anchovy of tendon is placed in cavity to limit contact of radial & ulnar shafts which may migrate to each other after this procedure;     … Read more

Hemi-vertebrae & Segmented Vertebrae

– Discussion:      – open disk usually has an active growth plate;      – double hemivertebrae:            – those that are ipsilateral and adjacent to one another are more likely toproduce a progressive scoliosis and require                    arthrodesis;            – two or more hemivertebrae on the … Read more