Medical Malpractice Insurance for orthopaedic surgeons

Tumors and Lesions of the Spine and Sacrum

– Primary Spinal Tumors:     – primary spinal cord neoplasia     – primary tumors of vertebral body:            – 75% percent of vertebral body tumors are malignant;            – multiple myeloma (most common primary tumor of spine)            – chordoma   … Read more

Tubulation

– Discussion:     –  type of bone remodeling in which there is widening of marrow cavity as the cortical diameter increases with growth;     – tubulation occurs from osteoclastic activity on endosteal surface of diaphysis

Tumors of Foot and Ankle

– Bone Lesions:     – enchondroma: (relatively common)     – osteoid osteoma:  (talus, navicular, or calcaneus)     – fibrous dysplasia     – adamantinoma (foot)     – metastatic lung cancer (? GI or GU)     – osteochondroma            – subungual exostosis, may develop on a distal … Read more

Tumors of Soft Tissue

       – Bone Tumors      – Biopsy      – European Cancer Institute – Soft Tissue Sarcomas      – Metastatic Tumors      – MRI      – Stage Classification Tissue type: – Osseous      – Myositis ossificans      – Extraosseous osteosarcoma – Carilaginous:      – Chondroma      – Extraosseous chondrosarcoma      – Synovial Chondromatosis – Fibrous:      – Fibroma      – Fibrosarcoma      – Desmoplastic Fibroma      – … Read more

Tumoral Calcinosis

– See: Ossification of Soft Tissue and Periosteum: – Discussion:     – heritable dz characterized by periarticular metastatic calcification;     – typically the shoulders and hips are affected most often;     – vascular and visceral calcification does not occur;     – hyperphosphatemia may play a role in this disorder; – Clincal … Read more

Troglitazone / Rezulin

– Discussion:     – has been taken of of the maket due to liver toxicity;     – a type of PPAR gamma activator which blocks insulin resistance, and allows lower dosages of            insulin without loss of efficacy;            – may also be given with … Read more

Trochanteric Osteotomy Technique

– Discussion:  – indicated for increased exposure requirements or unacceptable laxity of the abductors; – Technique:  – release the origin of the vastus lateralis from vastus tubercle;  – osteotomy is performed 1 cm below vastus tubercle  

Tuberous Sclerosis

– Discussion:     – is classically characterized by a clinical triad of epileptic seizures, mental retardation and skin lesions which have been considered          hamartomas of the skin and brain;     – adenoma sebaceum is the most familiar cutaneous stigma;     – high percentage of pts (66%) have radiographic findings … Read more

Tuberculosis

Discussion although the disease is generally more likely to be chronic, acute mycobacterial arthritis has been reported; periarticular bone lesions may accompany the synovial involvement; pulmonary tuberculosis is evident in only half the patients with skeletal involvement; pulmonary TB signs vary with stage of dz, few early on; later high fever, wt loss, prolonged, productive … Read more

Total Shoulder Replacement

– Discussion:     – see shoulder replacement discussion (total shoulder vs hemiarthroplasty vs reverse arthroplasty)     – the indications for total shoulder arthroplasty (versus hemiarthroplasty) are controversial;            – there is some controversy regarding pain relief and component survivorship;            – Gartsman GM, et al (2000), the authors compared hemiarthroplasty (24 … Read more