Morbidity and Mortality Conference 4242007

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Morbidity and Mortality Conference 4/24/2007

• LSU Hospital
• March 2007

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• Total joints 18
• Sports medicine 14
• Hand 22
• Trauma 96
• Spine 1
• Foot and Ankle 2
• General 10
• Tumor 0
• Infection 13
• Total cases 176
• Complications 6

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Total Joints

• Primary TKA 8
• Revision TKA 1
• Primary THA 7
• Revision THA 2
• Infected TKA 1
• Infected THA 2
• deep infection 1
• superficial infection 1

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Sports Medicine

• Open shoulders 1
• Arthroscopic shoulders 3
• Knee Arthroscopy 7
• Knee ligament repair 2
• Patellar tendon repair 1

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Hand Surgery

• Hand surgery 22
• Tendon/nerve repair 3
• Soft tissue 11
• Fractures 6
• Joint fusion 1
• Dislocations 1

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Trauma

• Fracture care 76
• Spine 1
• Proximal humerus 1
• Humerus/distal humerus 8
• Elbow 4
• Forearm/wrist 11
• Pelvis 2
• Acet 3
• Hip 0
• Femur 13
• Patella 1
• Tibial plateau 5
• Tibial shaft 10
• Ankle 11
• Talus 1
• Calcaneus 1
• Foot/lisfranc 4

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Trauma

• Compartment syndrome 1
• Wound care/L and D 19

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Spine

• Lumbar fusion 1

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Foot and Ankle

• Hallux valgus 1
• Ankle fusion 1

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General Ortho

• HWR 7
• Malunion/nonunion 2
• SCFE 1

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Infection

• Acute/Chronic Osteo 9
• Pyarthrosis 1
• Hand puss 3

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Complications

• Post op wound infection 5
• Acet 1
• THA 2
• Ankle 1
• Tibial plateau 1
• TKA dislocation 1

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J.W.

• 29 yo woman with R Acet PW fx dslc
• Severe morbid obesity and poor nutrition
• Treated with ORIF 3/15/2007
• 1 month out pt presented to clininc with with
  postop wound abscess and fat necrosis.
• Hardware not involved
• Now being treated with serial L and D and vac

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D.H.

• 41 yo man who fell over a rock while running 1
  year ago. Sustained closed schatzker VI tibial
  plateau fx. Hx of ETOH and smoking.
• Treated with ORIF 10 days post injury
• Developed painful nonuion and postraumatic DJD
• 2 stage TKA planned
• Developed post op infection 2 months after HWR

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A.W.

• 63yo female with hx of multiple rev TKA. Just
  completed 2 stage Reimplantation for infection
  after two 6 week courses of IV abx.
• patella baja from 1st revision 2-3 years ago
• Returned to two week f/u visit with TKA
  dislocation
• Flexion/extension gap mismatch.

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S.H.

• 36 yo woman presented to LSU 2 weeks s/p L ankle
  fx from NO.
• ORIFd
• 6 weeks postop laterl wound eschar debrided,
  plate exposed under eschar
• HWR and IV Abx, fx nearly united at time of HWR.

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L.M.

• 53 yo female Pmhx of RA, R femoral neck fx tx
  with high angle hip screw. Had HWR and THA.
• Pt discharge to rehab, placed in NH at discharge
  for rehab. PT fell at rehab had hip dslc. LSU
  not notified.
• Presented to clinic with Decubitus ulcer over GT
  with subsequent THA Infection
• Poly/femoral head removed, abx beads placed
• Non-ST elevated MI at time of removal.

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V.M.

• 51 yo female L THA developed suture spit at 2-3
  weeks
• Treated with local wound care and po abx
• At 4 weeks taken to OR for formal excision of
  wound with closure 2 weeks IV abx
• No deep infection, only one positive cx MSSE
• 8 weeks out no AD, no pain, wound healed