Osteomyelitis
– Discussion: – predisposing conditions: – open fracture (traumatic tibia infections) – sickle cell anemia – septic arthritis – in children, distinguishing between metaphyseal osteomyelitis and … Read more
Medications
Osteomyelitis: Debridement of Sequestra
– See: tibial infection and debridement of tibial fractures – Discussion: – see cierny classifcation – a sequestrum is infected dead bone resulting from osteomyelitis; – it is secluded from host immune system and is secluded from antibiotics; – result is a chronic and persistent of infection; … Read more
Orthopaedic Anesthesia
– See: – Anesthesia and Timing for Femoral Neck Fractures: – Anesthesia in the Spinal Cord Injured Patient: – Cardiac Orders / Meds: – Malignant Hyperthermia: – Risk Assessment: – Anesthetic Agents: – Lidocaine: … Read more
Orthopaedic Care of the Diabetic Patient
– See: General Orders – Effects on Musculoskeletal System: – see importance of glucose control in the surgical patient – diabetic foot pathology: – vascular pathology: – diabetic charcot foot and ankle: – neuropathic ulceration: – diabetic osteomyelitis – experimental evidence that suggests that gram positive bacteria thrive in hyperglycemic state and that gram negative … Read more
Ofloxacin / Floxin
– Dosing: – usual dose is 200 mg to 400 mg q 12 hr; – 30-40% of drug will be excreted in to urine; – there is some evidence for higher tissue concentrations than seen with other antibiotics, and with a 800 mg dose the tissue concentrations are at … Read more
Nutrition Menu
– Caloric Requirements – Composition of Elemental Diets – Enteral Formulas and Tube Feedings – Lipids Requirements – Pediatric Nutrition – Protein Requirements & Nitrogen Balance: – arginine – glutamine – Total Parental Nutrition Changes in Diet and … Read more
NSAIDS: Non-Steroidal Anti-Inflammatory Drugs
– Discussion: – non steroidals exert their actions by inhibiting isoforms of cyclo-oxygenase 1 and 2; – cox 1: expressed in the stomach and kidneys; – cox 2: – cox 2 receptor is not normally expressed in synovial tissue; – regulates inflammatory response and is responsible for disease symptoms; – Specific Agents: – Aspirin – … Read more
Non Union of Humeral Fractures
– Discussion: – Non Union – General Discussion: – definition of fracture union: defined as bridging callus (ideally both cortices) on 2 orthogonal views with the disappearance of fracture lines – care must be taken not to mistake a pseudoarthrosis for a simple hypertrophic nonunion; – treatment of … Read more
Neuro
– Discussion: – decrease phenothiazines (reversible Parkinson’s dz); – may find defects in mentation, neuritis of myelinated long nerves (restless leg syndrome), and MS changes; – uremic polyneuropathy, w/ decr electric conduction along myelinated nerve fibers; – conduction may be as low as 15 to 20/sec in renal failure; … Read more
Nafcillin/Uniipen
– See Penicillin Family – For penicillinase producing Staph; – Adult: 50-200 mg/kg/24hr; IV: 500 mg – 1gm q4h for severe infections; IM: 500 mg q4-6hr for severe infections; PO: 250 – 500mg q4-6hr – Peds: 100-200 mg/kg/day q6hr; – Poorly absorbed orally, … Read more