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Ethics in Practice   |    
Poor Clinical Results
James D. Capozzi, MD; Rosamond Rhodes, PhD
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Case submitted by David E. Attarian, MD
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2001 Oct 01;83(10):1595-1597
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Extract

A forty-three-year-old woman presented with problems following ankle surgery. The initial diagnosis was idiopathic avascular necrosis of the talus. An arthrodesis of the ankle was performed with external fixation and an iliac crest bone graft. A nonunion developed at the fusion site, and the patient reported persistent pain and an inability to bear weight. She sought a second opinion and was told that the attempt at fusion had failed. The treatment options were explained to her. She underwent débridement of the nonunion and a tibiocalcaneal arthrodesis with internal fixation. Postoperatively, the patient had a solid fusion and was able to bear full weight without pain. Although ultimately satisfied with the result, she repeatedly expressed anger about the original care and asked if malpractice had been committed.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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