This case takes place in Alabama and involves a male patient with a past medical history of bunions, which failed to resolve following conservative treatments. As a result, the patient underwent an aggressive surgical procure to correct the issue, which involved significant alterations to several areas of bone and soft tissue within the foot . No complications were reported by the operating surgeon, however, it later became apparent that the surgeon had damaged ligaments in the patient’s foot. The damaged that was caused during the surgery required several additional surgeries to repair, as well as extensive physical therapy.
Question(s) For Expert Witness
- 1. How often do you perform the surgery in question?
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2. How do you prevent injuring ligaments during surgery?
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3. How soon after one injures a ligament should it be noticed and taken care of?
Expert Witness Response E-000500
This is an unfortunate complication of this type of surgery. When you don’t have a good surgical assistant or scrub tech, or if you are not “keeping your eye on the ball” the saw or osteotomy (sharp tools) can sever structures in the foot. If that’s unavailable, you use a self-retainer retractor called a Weitlaner and protect the structures in question and pull them out of the operative site. It is easy to retract and keep out of the way. If it is inadvertently cut, it should be repaired with a graft, special suture technique called Bunnell or Krackow and cast with the foot in an upward position to allow the structures to heal. The patient should be notified of the iatrogenic cut of the structure. I perform the type of procedure this patient underwent 2-3 times per week on average.
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