Medical Malpractice Insurance for orthopaedic surgeons

Chronic Unreduced Anterior Shoulder Dislocations

– Discussion:     – chronic unreduced dislocations of greater than 6 months duration may involve significant destruction of the humeral head from large Hill Sachs              lesions or reverse Hill Sachs defects; – Treatment:     – these usually require arthroplasty;     – w/ TSR humeral component is placed in 60 – 75 … Read more

Circumferential Growth

– Discussion:     – to understand functions of & reasons for haversian systems, one must consider manner in which diaphysis grows circumferentially;     – since bone is hard substance, it can grow only by adding new material to its surface;     – at birth, diaphyseal portion of human femur is tube about 6 mm … Read more

Cimetidine/Tagamet

– for PUD, prophylaxis in trauma, burns, surgery;  – Adult: active PUD: 300 mg PO/IV tid-qid, or 400 mg PO bid;  – over 90% of ulcers should heal after 12 wks of therapy – Hosp Prac. 1979  – ulcers which have not healed after 12 wks, probably will not heal w/ H2 Blockers;  – for … Read more

Chronic Slip

– Discussion:     – most common presentation is chronic slip (60 % of cases);     – may cause pain refered to hip, distal medial thigh, or knee;     – on exam, look for loss internal rotation, which may be manifested by observing the extended hip move into external rotation as hip is … Read more

Chronic Sclerosing Osteomyelitis

– Discussion:     – chronic sclerosing osteomyelitis (of Garre) has dense sclerotic appearance and often no associated lucency on radiographs;     – lesion usually involves the entire circumference of the bone and is much more widespread than a stress fracture;     – thinner linear sclerotic appearance of a stress fracture should be … Read more

Chronic Heel Pain

– Diff Dx:  – stress fractures (identified on 45 deg medial oblique view)   – inflammatory arthritides (RA or Reiter’s Syndrome)  – plantar fasciitis  – distal tibial tarsal syndrome   – heel pad atrophy;  – after the age of 40, the adipose tissue begins to atrophy, w/ resulting loss of absorbency

Chronic Capitolunate Instability

– Discussion: (see: dynamic instability);     – capitolunate joint has high potential for instability, since it is mainly stabilized only by the radiocapitate ligament (and captiotriquetral ligament, to a lesser degree); (see wrist ligaments);     – may result from malreduced radial styloid frx, or any condition which shortens or reduces tension in the … Read more