Orthopaedic Complications (Subscribe)  

This website anonymously collects information about critical incidents and complications in anaesthesia and how to avoid and manage them.
Critical Incidents Reporting System CIRS

Authors: Peter B. Rauh, FRCS, Matthew C. Solan, FRCS, and Riyaz H. Jinnah, M.D. Orthopaedic patients undergoing lower limb surgery are recognized as a group at especially high risk of DVT/PE. Prevention is therefore of great importance. Treatment of established DVT or PE is beyond the scope of this text. This chapter...

Clinical Signs for DVT:
- exam may be unreliable but positive findings should not be ignored;
- calf tenderness, swelling, fever, & increased pulse rate may be present
- suggestive exam features for pulmonary embolism:
...

A simple technique for cutting the suture if a drain has been sewn into the wound. For use when the suture penetrates the drain.

Exertional Compartment Syndrome of the Leg: Steps for Expedient Return to Activity Peter Edwards, MD; Mark S. Myerson, MD THE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 4 - APRIL 96 In Brief: The pain and swelling associated with exertional compartment syndrome is caused by raised intracompartmental pressures possibly induced by muscle...

eMedicine 2005 Compartment syndrome (CS) is a limb-threatening and life-threatening condition observed when perfusion pressure falls below tissue pressure in a closed anatomic space. The current body of knowledge unequivocally reflects that untreated CS leads to tissue necrosis, permanent functional impairment, and, if severe, renal failure and death.

Mr Gurd Shergill and Mr Harish Parmar Archive copy from fractures.com
Fat embolism and the associated fat embolism syndrome is a serious and potentially life threatening complication of long bone trauma, blunt trauma and intramedullary manipulation. However, some seemingly unrelated conditions have also resulting in fat embolism, such as diabetes, burns, severe...

eMedicine Article (2004) by Lisa Kirkland MD (Internist)
Synonyms and related keywords: fat embolism syndrome, FES, fat emboli, fat embolus, fat droplet in venous system, blunt trauma, fracture complication, blunt trauma complication, altered mental status

Wheeless' Textbook of Orthopaedics
FES results when embolic marrow fat macroglobules damage small vessel perfusion leading to endothelial damage in pulmonary capillary beds leading to respiratory failure and ARDS like picture;

Fat Embolism syndrome: A review giving most importance on its clinical manifestations, diagnosis and therapy.

Case Report Four Recurrent Periprosthetic Knee Fractures from Medscape Orthopaedics & Sports Medicine eJournal[TM] 2001 Arne-Lembit Kööp, MD, Andres Kööp, MD, Irja Kiisküla, MD Introduction Periprosthetic fractures of the knee are challenging for the orthopaedist, but recurrent periprosthetic fractures are even more challenging. In this case, a 61-year-old female patient with a diagnosis of gonarthrosis...

The British Medical Association undertook a wide-ranging consultation exercise, which confirmed the need for guidance on decisions to withhold or withdraw artificial nutrition and hydration. The British Medical Asociation Medical Ethics Committee has now published guidelines in this area.

Prophylaxis using heparin and low molecular weight heparin
Heparins and some mechanical pumping devices may help prevent blood clots forming in the legs after surgery for hip fracture
Patients with hip fracture may develop blood clots (thrombosis) in their legs. Some of these blood clots may travel to the lungs and cause...

Wheeless' Textbook of Orthopaedics
may present w/ signs of localized inflammation or pain, elevated skin temp, etc.
- tends to occur after thr, spinal injury, head injury (11%), burns, bruises;

Archive copy
Implant Wear in Total Joint Replacement: Clinical and Biologic Issues, Material and Design Considerations Edited by Timothy M. Wright, PhD and Stuart B. Goodman, MD, PhD A symposium held in October 2000 Table of Contents Clinical Issues Chapter 1 What is the clinical scope of implant wear in the hip and how has it changed...