Medical Malpractice Insurance for orthopaedic surgeons

Sucralfate/Carafate

 – Discussion:  – for short term treatment of duodenal ulcers, gastric ulcers,  – provides local acid resistant barrier, inhibits pepsin;  – constipation may be a frequent side effect;  – may be of benefit in intubated patients  – does not increase gastric pH  – because of risk of aluminum toxicity, (released when compound ionizes), sucralfate is … Read more

Succinylcholine

– Precautions:  – because succinylcholine causes an increase in intra gastric pressure that may lead to gastric aspiration, crycothyroid pressure should be applied; – also causes increase in intraocular pressure and in relatively contra- indicated with injuries in an open globe;  – increases intracranial pressure;  – Precautions w/ Spinal Cord Injury:  – w/ possible cervical … Read more

Subtrochanteric Frx: Anatomy and Factors in Bone Healing

Anatomy axis of femoral neck forms angle of approx 135 deg w/ femoral shaft, and is anteverted from the frontal plane by variable amount (- 4 to 36 deg, average 10 to 20 deg in Caucasians); distinct cortex surrounds the cancellous bone of the neck, the center of which becomes progressively empty with age (Ward’s triangle); center of … Read more

Subtrochanteric Fractures

  – See:  proximal femoral shaft fractures / – Discussion: – definition: – between lesser trochanter and 5 cm distal, even as far as center of isthmus of the femoral shaft; – technically starts below the lesser tuberosity; – medial and posteromedial cortex is a site of high compressive forces, while lateral cortex experiences high tensile stresses (forces … Read more

Subtrochanteric Fracture Stability

– Discussion:     – classifaction and fracture stability     – frx stability is based on presence or absence of posteromedial butress;     – farther down shaft of femur primary frx is located, greater incidence of delayed union and implant failure;     – forces acting on hip joint           … Read more

Subtalar Fusion for Treatment of Calcaneal Fracture

– See: subtalar arthrodesis – Primary Fusion: – indicated for fractures w/ more than 3 parts; – restores length of gastrocnemius-soleus complex – corrects flat foot – relieves the narrow peroneal space; – in the presentation by Infante AF, et al (15th Annual Meeting of the Orthopaedic Trauma Association 1999), the authors advocate immediate subtalar … Read more

Subsynovial Intra Articular Ring

– Discussion:     – arises from ascending cervical arteries     – epiphyseal arterial branches form at subsynovial intra articular ring, and go on to enter the head of the femur;     – disruption of this arterial ring occurs from high femoral neck frx;             – these pts … Read more

Subscapular Nerve

– See: brachial plexus – Discussion:     – subscapular and thoracodorsal nerves arise from posterior cord of brachial plexus            while this is on costal surface of subscapularis;     – both subscapular nerves usually receive fibers from C5 and C6;     – upper subscapular nerve passes directly into … Read more