Instructional course lectures
-
Pediatric musculoskeletal infections can cause devastating complications (including death) in this era of methicillin-resistant Staphylococcus aureus and other virulent bacterial strains. The complexity and severity of these infections require timely diagnosis and treatment. A thorough emergency department evaluation, diagnostic workup, and early surgical intervention can influence outcomes. ⋯ Because of genetic changes and inducible resistance, methicillin-resistant Staphylococcus aureus causes more complex infections than in the past. Deep, soft-tissue abscesses; pyomyositis; osteomyelitis; and septic arthritis often occur concurrently, causing destruction of musculoskeletal tissue. Severe and life-threatening complications, such as septic emboli, deep venous thrombosis, and multiorgan system failure may result from these infections.
-
Being served with a medical negligence lawsuit usually is a traumatic event for an orthopaedic surgeon. The course of litigation is long and tedious, and the defendant physician must be well prepared for the experience. It is imperative that the physician contact his or her insurance carrier immediately after being served with the complaint because many legal actions are time dependent. ⋯ Because the testimony of expert witnesses often decides the outcome of the case, it is important for the physician to help the attorney identify the best potential witnesses. A thorough knowledge of the tactics that the plaintiff's attorney may use during cross-examination can help ensure that the truth is clearly portrayed. The American Academy of Orthopaedic Surgeons Professional Compliance Program is designed to ensure that all testimony in medical liability cases is fair and factual.
-
The metaphyseal deformity, in even a mild slipped capital femoral epiphysis (SCFE), results in acetabular labral and cartilage injury. SCFE is the most extreme form of femoroacetabular impingement, and the mechanism of cartilage and labral injuries is similar. ⋯ In situ pinning is the most effective treatment to halt short-term slip progression; outcomes are favorable in many hips. In medical centers with substantial experience with hip preservation techniques, open or arthroscopic osteochondroplasty can be used to treat mild SCFE, and a modified Dunn epiphyseal reorientation can be used for more severe deformities to decrease the potential for secondary osteoarthritis.