The American journal of orthopedics
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Obesity, one of the most common health problems in the United States, is becoming more prevalent. At the same time, because of technological advances, the rate of spine surgeries is on the rise. Given these trends in obesity and spine surgeries, it can be inferred that the number of obese patients who undergo spine surgeries will increase as well. ⋯ Nevertheless, appropriate clinical outcomes can be achieved in obese patients who undergo spine surgery. Obesity is not a contraindication for spine surgery. Patient selection is key in achieving favorable clinical outcomes.
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Open reduction and internal fixation constitute the standard of care for management of displaced distal femoral condylar fractures. The techniques most commonly used include conventional and locked plating with the primary goal of articular surface congruency. However, a specific implant for the isolated medial femoral condyle fracture is lacking. We report the use of a calcaneal plate as a novel technique for managing medial and lateral femoral condylar fractures.
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Defensive medicine is defined as medical practices that may exonerate physicians from liability without significant benefit to patients. No study has evaluated the United States national incidence of defensive medicine in the field of orthopedic surgery. In the study reported here, we investigated the practice of defensive medicine and the resultant financial implications of such behavior by orthopedic surgeons in the US. ⋯ With there being 20,400 practicing orthopedic surgeons in the US, we estimated that the national cost of defensive medicine for the specialty of orthopedic surgery is $2 billion annually. Orthopedic surgeons' defensive medicine is a significant factor in health care costs and is of marginal benefit to patients. Policies aimed at managing liability risk may be useful in containing such practices.
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We present the case of an 18-year-old woman who was healthy other than a history of multiple arthroscopic right knee surgeries culminating in subtotal lateral meniscectomy in a valgus knee. The patient was referred to our office for evaluation for realignment osteotomy and meniscal transplantation. Her diagnosed case of neuroma of the infrapatellar branch of the saphenous nerve was managed with neurectomy, which produced prompt and complete resolution of pain.