Medical Malpractice Insurance for orthopaedic surgeons

Planning for THR: Considerations for Specific Diseases

– Surgical Considerations:     – preoperative anticoagulants:            – consider use of cell saver;            – if patients have a medical condition that requires preoperative anticoagulants, then consider using press fit femoral and acetabular components;                   – a prerequisite for cementing femoral stems, is the ability to … Read more

Physical Therapy after TKR

– See: Function and Activity after TKR  – Post Operative ROM:     – most important factor predicting ultimate ROM is range of motion before surgery;             – ref: Range of Motion Correlates with Patient Perception of TKA Outcome.     – patients with significant stiffness before surgery will have the most difficulty gaining range of motion; … Read more

Phytonadione/Vit K

– Discussion:      – for correction of PT from: warfarin & hyperalimentation;      – w/ parental treatment, prothrombin deficiency is controled in 4-8hr, normalized in 24 hrs;      – watch for IV anaphyllaxis, give slowly;      – patients who require brief reversal of anticoagulation from warfarin therapy are more easily treated … Read more

Pelvic Fractures Menu

  – See: Acetabular Frx Radiographs Work Up for Pelvic Fracture – Anterior Posterior Compression Injuries – Arterial Anatomy of Lower Limbs – Classification – Crescent Fracture – DVT – External Fixation – Iliac Wing Fractures – Ilioinguinal Approach – Lateral Compression Injuries – Malgaigne Fracture – Neurologic Injury – Pediatric Pelvic Fractures – Posterior Pelvic … Read more

Ossification of Soft Tissue and Periosteum

– See:   – Diff Dx: Hypercalcemia   – Diff Dx: HyperPhosphatemia   – Approaches To Differential Diagnosis In Musculoskeletal Imaging: Soft Tissue Calcifications – Discussion:     – calcium hydroxyapatite can be deposited in periarticular soft tissues or within joints;     – in either event the disease may be monoarticular or polyarticular;   … Read more

Nerve Injuries in THR

– See: Total Hip Replacement Menu:             – arterial injuries: in THR              – nerve injury              – nerve palsy from TKR – Discussion:     – incidence of sciatic (tibial and/or peroneal) &/or femoral palsies after THR ranges from 1-3%;     – incidence of nerve palsy is 1-2% of primary … Read more

Management of Vascular Injuries in Knee Dislocation

– See:         – Arteriography         – Arterial Trauma         – Compartment Syndrome         – Knee Dislocation         – Popliteal Artery         – Reperfusion Injury – Discussion:      – note that the worst error to make is to underestimate the need to … Read more

Management of Pulmonary Embolism

– See: – deep venous thrombosis / respiratory failure – Discussion:     – time range of diagnosis of PE following discharge:  14-68 days (JR Lieberman et al);           – ref: Early pulmonary embolism after injury: A different clinical entity?     – in the report by Lawton RL and Morrey BF (1999), the authors advise that patients … Read more