Medical Malpractice Insurance for orthopaedic surgeons

Sequelae of MI

* Arrhythmia: * Consider Sinus Tach due to CHF/Pain/Anxiety * Rx of Cardiogenic Shock * Syncope * Stroke * Rx CHF / SOB  – may develop in > 50% of pts, many will resolve within 48 hrs;  – this is an acute process, normal heart size, little retention of NaCl/H2O;  – CHF is due to … Read more

Treatment of Septic Joint Based on Location

     – open joint injuries – septic knee – septic hip: – pediatric septic hip – adult hip: – references: – Sepsis of the hip in paraplegic patients. – Hematogenous septic arthritis of the adult hip. – Ruptured aneurysm of the common iliac artery as a cause of unilateral hip pain – SI Joint: – … Read more

Septic Arthritis in the Adult

– Pts w/ RA:     – may be prone to bacterial infections because of inherent phagocytic defect or because of long-term oral or intraarticular administration of corticosteroid or other immunosuppressive agents;     – staph. aureus is recovered from 80 % infected rheumatoid joints; Nongonococcal Bacterial Arthritis in Adults Treated at Boston U.Med Center; … Read more

Treatment of Septic Joint Based on Age

  – Treatment Based on Age:     – less than 3 months – up to 60-100% of neonates w/ septic arthritis have adjacent osteomyelitis. – septic arthritis is both more common and more often associated w/ metaphyseal osteomyelitis in neonates than in older children; – may occur from transphyseal blood vessels (see epiphyseal vessels), which … Read more

Septic Arthritis: General Orders and Treatment

Diff Dx » Evaluation (before antibiotics are infused) synovial fluid analysis culture & gram’s stain; leukocyte count glucose and viscosity (both decreased w/ infection); blood culture, CBC, CRP, & sed rate radiographs (and possibly ultrasound): need to rule out concomitant metaphyseal osteomyelitis; misc: bone scans Treatment based on antimicrobial suseptabilities as well as patient age: … Read more

Sepsis

– the effects of endotoxins have been blamed for all the effects of Gm neg septicemia;    – hyperpyrexia, vasoconstriction followed by vasodilation, …    – the initial clinical symptom of bacilemia is usually a shaking chill;    – it is not unusual for the patient to initially have an elevated BP followed by a marked fall … Read more

Sensory Conduction Changes

– See: Motor Conduction Latency: – Sensory Amplitude:     – among the earliest changes in a nerve compression sydrome is changes in distal sensory amplitude, followed by an increase in distal            sensory latency; – Sensory Conduction Latency:     – more sensitive than is motor conduction velocity;     – amplitude of action … Read more