This Article is unavailable. Contact Us
There may be more to the complaint than meets the eye. There may be obvious issues, such as a failed component resulting in a fall, a skin breakdown that on the surface appears that it was as a result of overuse or a rough area within the prosthetic socket.
Foot and ankle injuries due to motor vehicle accidents (MVAs) present unique challenges to the astute foot and ankle physician. Even more challenging than the pathology, however, is ability to return to pre-injury level. Published medical literature provides strong evidence for risk of post-traumatic arthritis after a heel bone (calcaneus) fracture - this post-MVA condition can manifest as residual deformity and resulting arthritis, thus precluding the ability to rapidly return to pre-accident levels. Hence it is imperative that an erudite foot and ankle clinician ascertain the appropriate treatment and long-term prognosis of foot and ankle injuries due to MVAs.
Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typi- cally idiopathic, but also is characterized as a common form of posttraumatic headache. Typical treatments include nerve blocks with local anesthetic, nerve stimulation, pulsed radiofrequency, and cryoablation. OnabotulinumtoxinA (ONA) has recently been utilized in nerve blocks to treat occipital neuralgia, with the potential for a longer duration of pain relief than local anesthetic.
Occipital neuralgia, while typically idiopathic in presentation, is a common form of posttraumatic headache. It is associated with severe pain in the greater, lesser, and/or third occipital nerves, and often accompanied by tenderness or trigger points in the surrounding musculature. OnabotulinumtoxinA (ONA) has been recently utilized in nerve blocks to treat occipital neuralgia, but current literature supporting such use is scarce. We describe a case of occipital neuralgia in a patient following C1 fracture and vertebral artery dissection due to gunshot injury. Successful treatment with bilateral ONA nerve blocks led to an 80% - 90% improvement in pain, with decreased Visual Analog Scale (VAS) pain scores immediately following treatment and upon follow-up 1 month later.
1986: Crocket, Dolsky, Lack, Leventhal, Nathanson and Jackson visited London, France and Italy, observing surgeons using different modalities at that time and then brought back their information and openly taught liposuction in the United States under the auspices of the AACS. Other early teachers were Elam, Fenno, Tobin and others.
As part of their educational process, practitioners of manipulative procedures are made aware of the possible association between neck manipulation and cerebrovascular accidents[i] (CVAs) as well as what to do in the event a CVA occurs during treatment.[ii] For any litigation considered regarding a stroke that closely follows spinal manipulation, the starting point for retained counsel is to ask what else could have caused or contributed to the stroke. Screening issues to consider include the following:
Lawsuits pertaining to injuries from laser treatments gone awry or just not as expected are on the rise. Part of the issue is the lack of objective training protocols. There is relatively vague legal language across many state medical boards and often lax regulation of these procedures, who is allowed to perform them, and what training and supervision is required.
Following a neurological event such as a traumatic brain injury, cerebrovascular event, multiple sclerosis, etc., the medical needs of the person are of primary importance initially, for purposes of survival. As medical treatment proceeds and the survival needs of the person are met, the team of rehabilitation professionals will be established in an attempt to improve upon function performance in order to sustain quality of life. The rehabilitation team may be composed of a physician, physical therapist, occupational therapist, speech therapist, recreational therapist, vocational specialist, case manager, the psychologist, social worker, and nurse, to name several. It is often during this tim e that additional medical and rehabilitative needs are identified through diagnosis or observation by member s of the rehabilitation team.
"For the physician to grow a cosmetic injectable practice, both a variety of products as well as a mastery of technique are key ingredients in the recipe for success. If one had to choose between variety and technique, I believe that it is the technique that will ultimately provide desired results and thus create many happy return visits from patients. Repeat business is the goal.
"Has the standard of care been violated?" is the basic question in all medical malpractice cases, the answer to which may be difficult to determine because the standard of care is often unwritten, can be ever changing, and is a blend of academic and private practice opinions. In addition to having a broad base of experience with both private practice and academic medicine the expert witness must be current with the medical literature, knowledgeable about solid tumors such as cancer of the breast, lung, colon, thyroid, tongue, larynx, head and neck, esophagus, stomach, colon, rectum, anus, skin, melanoma, liver, kidneys, bladder, pancreas, ovary, testicle, hepatoma, and sarcoma, as well as soft tissue malignancies such as non-Hodgkin's and Hodgkin's lymphoma, the acute and chronic leukemia's, multiple myeloma, anemias, leukopenia, thrombocytopenia, and pancytopenia.