Abstract:
:The risk of litigation in the emergency room is not directly proportional to the severity of injury. In fact, the risk of initiation of legal action is greater in cases of relatively modest permanent and partial disability. In these cases, failure to obtain and document informed consent, failure to effectively communicate with the patient and family, and failure to assure followup and prompt assessment of complications are the factors that have most frequently led to litigation. Orthopaedic surgery ranks fifth among medical specialties in the total number of claims filed and also fifth in the cumulative amount of financial payments. Approximately 30% of filed cases ultimately result in some form of financial payment. The driving force behind litigation is financial gain for plaintiff's attorneys and compensation for plaintiffs. The motive is not the improvement of medical delivery systems or individual behavior. Access to useful data of a legal nature is extremely difficult. Only a small number of cases go on to a jury-based decision of public record. It is difficult to get accurate and complete information on the total number of cases filed, cases withdrawn, terms of settlements, and arbitrations because of the confidential nature of the settlement process.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Gould MT,Langworthy MJ,Santore R,Provencher MTdoi
10.1097/00003086-200302000-00011subject
Has Abstractpub_date
2003-02-01 00:00:00pages
59-66issue
407eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract::Alterations in serum calcium fractions after trauma may be of clinical importance. For investigation of this problem, serum calcium fractions were studied prospectively in 42 patients with severe musculoskeletal injuries. The severity of trauma was assessed with the Apache II severity of disease classification system....
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::Management of nonunions requires careful and critical assessment of the true biologic status of the fracture. The mere radiographic persistence of a fracture line does not invariably indicate nonunion. Ten percent of fractures considered initially to be ununited in this series healed spontaneously without further trea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract::Autogenous implantation of nucleus pulposus or nucleus pulposus cells that were activated by coculture retards intervertebral disc degeneration, but harvesting such grafts causes disc degeneration at the donor site. This study examined whether nucleus pulposus allografts similarly retard disc degeneration and whether ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200108000-00015
更新日期:2001-08-01 00:00:00
abstract::The orthopedic surgeion should be an integral part of a medical team for evaluation and treatment of young children with cerebral palsy. Surgical procedures in this first three years of life are usually limited to the adductor releases about the hip. Stretching and plastic splints about the ankle and knee followed by ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00
abstract::This study aimed to provide anatomic data for the location of the vertebral artery and offer an optimal approach for lateral cervical decompression that minimizes the risk of injury to the vertebral artery. Anatomically, there has been little study documenting the safe zone to prevent vertebral artery injury during th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::The authors studied 10 consecutive patients with closed femoral shaft or supracondylar fractures who were nonambulatory and who were treated by reamed retrograde intramedullary nailing via an intercondylar notch approach. The study consisted of five women and five men with an average age of 60.7 years (range, 40-89 ye...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200004000-00026
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The innate immune system can recall previous immunologic challenges and thus respond more effectively to subsequent unrelated challenges, a phenomenon called trained immunity. Training the innate immune system before surgery might be a potential option to prevent bone and joint infection. QUESTIONS/PURPOSES...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001461
更新日期:2020-11-01 00:00:00
abstract::Stress fractures of the base of the second metatarsal are common in ballet dancers and essentially are unreported in nondancers. We presumed base of the second metatarsal stress fractures in nondancers occur in a wide variety of individuals regardless of demographics, are highly associated with athletic activities, an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e3180598ff2
更新日期:2007-08-01 00:00:00
abstract::Exogenous steroids are known to induce aseptic necrosis in the femoral head of adults. This case report of a 9-year-old girl with corticosteroid induced femoral head necrosis demonstrates effective treatment with an abduction device in a manner similar to that prescribed for the treatment of Legg-Calve-Perthes disease...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-06-01 00:00:00
abstract::Pigmented villonodular synovitis (PVNS) is rare in the foot; however, it developed in the subtalar joint extending around the ankle of a 24-year-old man. The diagnosis was made by a combination of clinical findings, most notably the aspiration of the synovial fluid. Magnetic resonance imaging was most useful in showin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-10-01 00:00:00
abstract::Bone tumors occurring in periarticular locations may cause a substantial risk of subchondral fracture and collapse. Poly-methylmethacrylate has been used for reconstruction in these instances because of its immediate structural stability. Allogeneic graft allows for biologic incorporation and remodeling, but it takes ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/blo.0b013e31804e8470
更新日期:2007-08-01 00:00:00
abstract::A histologic study of vertebral end plates was performed on young rats' tails subjected to intensive passive motion. Seven six-week-old rats had two-hour motion cycles daily, for two months. Histologic changes of proximal caudal vertebrae in the experimental group were compared with those of a control group of seven r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is controversy about the treatment of these lesions and there are few studies that have synthesized what is known and provided meaningful informat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-013-3345-4
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:High tibial osteotomy (HTO) has long been accepted as an effective treatment for unicompartmental osteoarthritis of the knee in young, active adults. For varus knees, the two most commonly performed valgus-producing HTOs are the lateral closing wedge and the medial opening wedge. Regardless of technique, som...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3040-5
更新日期:2014-01-01 00:00:00
abstract::Equinus foot disorder is a common problem for patients with cerebral palsy who are able to ambulate. Botulinum toxin A is a recommended method of treatment for temporary reduction of muscle tone. The efficacy of repeated botulinum toxin A injections in the calf muscles was evaluated in a clinical trial involving 21 ch...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1097/00003086-200201000-00021
更新日期:2002-01-01 00:00:00
abstract::Do X-rays adequately reflect the strength of callus post fracture? Eleven rabbit tibiae were manually fractured and allowed to heal in plaster. At varying times post fracture, the rabbits were sacrificed and the tibiae were removed. AP and lateral X-rays of each tibia were obtained and shown to 27 orthopedists and rad...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:A subgroup of patients undergoing TKA is unhappy with the outcome of surgery and preoperative psychological factors may play a role in their dissatisfaction. QUESTIONS/PURPOSES:We asked whether (1) psychological factors, as measured by preoperative self-reported questionnaires, predicted poor outcome after ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-015-4234-9
更新日期:2015-08-01 00:00:00
abstract::Primary total hip arthroplasties were performed in 108 patients (116 hips) using a porous coated anatomic (PCA) hip system. Nineteen (22 hips) of 108 patients (116 hips) who had a subsidence of a PCA femoral stem more than 3 mm were studied for the time onset, the amount of stem subsidence, and outcomes. A minimum fol...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Although several types of culture medium have been used for preservation of osteochondral allografts, the viability of chondrocytes decreases with increasing storage duration. We previously showed the University of Wisconsin solution is more suitable for graft preservation than culture medium. QUESTIONS/PUR...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2182-6
更新日期:2012-10-01 00:00:00
abstract::Failed treatment of infected total knee replacement presents few attractive surgical options. Knee arthrodesis is challenging surgically and can be complicated by nonunion, malunion, or recurrent infection. Recently, a modular titanium intramedullary nail has been used in an attempt to reduce the incidence of nonunion...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Psychological distress can negatively influence disability, quality of life, and treatment outcomes for individuals with hip and knee osteoarthritis (OA). Clinical practice guidelines recommend a comprehensive disease management approach to OA that includes the identification, evaluation, and management of p...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001520
更新日期:2020-12-01 00:00:00
abstract::Operative treatment of inadequately or imperfectly treated fractures of the distal radius can improve wrist and hand function substantially, but rarely restores the limb to normal. Patients with malunion of the distal radius present either with poor radiographic alignment before complete healing of the fracture (nasce...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000152442.66083.ff
更新日期:2005-02-01 00:00:00
abstract::Nonconsolidated particles of ultra high molecular weight polyethylene are believed to be defects that adversely can affect the wear performance of total joint prostheses. The present study was done to determine the number, size, and distribution of these particles and to determine if their presence correlated with wea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-10-01 00:00:00
abstract::Three patients were treated for pathologic fractures of the thoracolumbar spine causing progressive neurologic deficit. An anterior decompression with partial removal of the diseased vertebra was performed with improvement of neurologic function in each patient. Active tumor was not found, but necrotic bone with colla...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::There are no data in the literature concerning the outcome of Colles' fracture beyond six years. One hundred consecutive patients with displaced Colles' fractures were reviewed ten years after the injury. Function, radiographic anatomy, osteoarthrosis, and reflex sympathetic dystrophy (algodystrophy) were all objectiv...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::The purpose of this study is to clarify the clinical features of the knee affected by multiple epiphyseal dysplasia. Thirty-one cases of multiple epiphyseal dysplasia were reviewed. Of the patients, 11 were male and 20 were female. The average age at onset of symptoms was 22.5 years. The average age at initial visit t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200011000-00025
更新日期:2000-11-01 00:00:00
abstract::Low fibular fractures that were associated with deltoid ligament disruption and inferior tibiofibular syndesmotic disruption were studied. All of the patients had a Type B Weber fibular fracture associated with a deltoid ligament injury. It was difficult to detect the syndesmosis disruption on the initial assessment o...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000052935.71325.30
更新日期:2003-04-01 00:00:00
abstract::Dislocation is a well documented complication after a two-stage revision arthroplasty for a deep periprosthetic hip infection. We are aware of no reports specifically evaluating the risk factors for dislocation after reimplantation for infection. We hypothesized greater age, increase in the number of operations on the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000218747.92118.3a
更新日期:2006-06-01 00:00:00
abstract::Twenty-eight joints with heterotopic ossification in 16 head-injured adults were forcefully manipulated 39 times under general anesthesia. The etiology of the heterotopic bone was trauma in seven joints and idiopathic (neurogenic) in 21. Indications for manipulation were inability to participate in therapy due to a lo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract::Residual coxa vara is a common complication of femoral neck fracture in a child. Factors favoring the development of this complication are delayed reduction and avascular necrosis. The present case report is a 10-year follow-up of spontaneous correction of traumatic coxa vara in a child. This is of interest because re...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00