[The actual verdict: compensation for surgical errors].
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In postoperative follow-ups in a large number of patients who underwent Hallus valgus surgery according to Brandes, residual pain was found due to insufficient resection of the proximal phalanx. It is pointed out that the results of this frequent and beneficial Hallux valgus surgery can be improved by using a more subtile surgical technique. Figs. 1-5 show that errors continue to be made. If these errors can be avoided in the future this report will have fulfilled its purpose.
It is necessary to distinguish between complications that cannot be avoided and those that can through knowledge of the special risks of the surgical procedure. Special complications that cannot be avoided include bleeding in the saphenous channel, loss of sensitivity, damage of lymphatic vessels, pigmentation of the leg, and the very rare postoperative pulmonary embolization. A preoperative diagnosis based on a careful physical examination, phlebography and Doppler ultrasound will help avert unnecessary mistakes.
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34 children with congenital hydronephrosis, operated upon for erroneosly diagnosed acute appendicitis (17), malignant tumor (11), and ileus (8), were under observation. To prevent from unwarranted surgical interventions in dubious cases excretory urography and other x-ray and instrumental methods of examination must be used widely. After the removal of an unchanged vermiform process in children, suffering from abdominal pain, the examination of the urinary tract is indicated. Such patients should be under dispensary observation of a children's surgeon.
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Case histories of dead patients were analyzed in whose life-time errors were made in diagnosis of acute abdomen. It was established that in 90 patients acute abdomen was hypodiagnozed, in 10 cases the abdominal catastrophe was hyperdiagnozed, in 4 patients the localization of the injured organ was not determined properly. The error found mainly resulted from atypical course of the disease due to age of the patients, medication effects and abnormal disposition of the injured organ, as well as to concomitant diseases and complications. The role of the attention factor in the genesis of errors is emphasized.
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Poor issues in the most cases concerned were due to gastric resection either not adeqately indicated of performed with technical shortcomings. It is quite possible to reduce considerably the number of poor late results if the resection is performed on strict indications with proper accomplished of its technical details.
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