Medical Malpractice Insurance for orthopaedic surgeons

Clarithromycin / Biaxin

– Discussion:     – lincosamides/macrolides type antibiotic;     – used to treat bronchitis, Helicobacter pylori, otitis media, sinusitis, pharyngitis, and pneumonia;     – dose: 250 mg to 500 mg PO every 8-12 hours;     – this medication should never be used if there is a question pregnancy;     – may … Read more

Class I Agents

A :  PROCAINAMIDE  DISOPYRAMIDE QUINIDINE  B:  LIDOCAINE  TOCAINIDE PHENYTOIN  MEXILITINE C:  FLECAINIDE ENCAINIDE  LORCAINIDE    

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 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

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

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

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

Chondrosarcoma

– See: Bone Tumor Menu – Discussion:     – malignant cartilaginous tumor of bone (3rd most common malignant bone tumor / comprises 20% of malignant bone lesions);     – it is less common and less aggressive than osteosarcoma;     – staging:             – histologic grading is best predictor of stage;             – most often presents as … Read more

Chopart Amputation

– See:       – Syme’s Amputation       – Transmetatarsal Amputation – Discussion:     – Francis Chopart first described disarticulation thru midtarsal joint;     – Chopart amputation removes the forefoot and midfoot, saving talus and calcaneus;     – Chopart amptutations should not performed for ischemia;     – this … Read more