Orthowertz Surgical Consent Form printable pdf download

OrthoWertz Surgical Consent Form

PLEASE RETURN THIS FORM TO THE

OFFICE

FOLLOWING SIGNING THE

LAST

PAGE.****

ORTHOPAEDIC SURGERY is the surgery of bones, joints,

muscles,

tendons,

and sometimes nerves in the skeletal

system.

This

consent form is an attempt to assist you in becoming as well informed as possible. Oral communication is not adequate for consent.

There are several things that you should understand prior to your surgery:

There is almost always an option not to undergo

surgery.

Many of the operations in orthopaedic surgery are not emergency

operations. This means

that,

unlike appendicitis or a heart attack which makes treatment absolutely

necessary,

you have the

choice of living with your condition. Even though you have pain or arthritis or some

injury,

you have the option of accepting

that problem. Surgery should be undertaken

only if it is a better way of obtaining relief of

pain,

improved function or your health goals.

However,

even if something does

not function well, you do not have to correct

it;

it is still the individual's choice whether or not to have surgery. Never feel

that you have to have surgery.

You should understand

fundamentally

what your surgery is intended to

accomplish.

3. You should not undergo

surgery

until you have had all your questions answered.

COMPLICATIONS:

How often do complications occur? Fortunately not very often. Most complications are

rare.

However,

we are obligated to inform you

of the most common complications. If a problem should

occur,

it would most

likely

be something mentioned here. There are two

types of complications that can develop: complications involving the actual area operated

on,

and complications having nothing to do

with the operative site that can arise from any kind of

surgery.

LOCAL SURGICAL COMPLICATIONS:

Infection: Infection is one of the worst complications. Statistically it occurs in less than 1 % of orthopaedic operations. Yet

it can be a very serious problem, requiring prolonged hospitalization with IV antibiotics to treat the

infection,

and it can ruin

the type of surgery that you have had. To try to prevent

infection,

we take all general

precautions,

including several scrubs

of the involved area for surgery and use of prophylactic antibiotics. It is not clear

why

some infections occur. The health of

the

individual,

resistance of that

individual to

bacteria,

and bacteria in the air may be contributing factors.

The operation may fail. On occasion the desired result is not obtained. It is accepted that a certain percentage of surgeries

don't work. There is a possibility that you would have to undergo a re-operation or some procedure to amend a surgery when

the intended result is not achieved.

Phlebitis and blood clots: With any

surgery,

blood clots can develop in the veins of the legs. There is no known prevention

for this. Developing blood clots can be a minor nuisance or have very

serious,

even fatal consequences. Blood clots that form

in the legs can travel to the heart through the

veins.

Support

stockings,

inflatable sequential leg compression

devices,

and

blood-thinning medications can be used to decrease the likelihood of blood clots. Fortunately, they occur rarely in those

under age 25.

Wound healing: Sometimes the wound does not heal as desired. Unless there is

infection, however,

the

consequences may be minor.

Nerve and blood vessel injury: While nerves and blood vessels are in

every

operative

site,

surgical injury to these

structures is quite rare. Usually the injury has already been sustained due to

fracture,

dislocation or other injury the patient

experienced. However, it is possible that an injury to a blood vessel or nerve could result in impaired function which could

be permanent. It is

very

common for the skin around incisions to have altered sensation.

Reflex

sympathetic dystrophy: This problem

both rare and obscure. It is a form of over-reaction of one's sympathetic

nervous system which causes increased pain. There is no known medical cause or prevention for this rare complication. It is

combated with intensive physical therapy and "sympathetic blocks," or injections of local anesthetic into the

nerves,

which

help reduce symptoms.

Orthowertz Surgical Consent Form

Related Articles

Related forms

Related Categories