Professional Liability in Plastic Surgery: A Change of Scenario in Medical Professional Liability in Spain

Background:The epidemic of complaints and/or litigation, both in and out of court, for cases of alleged malpractice has increased dramatically. In Spain, claims related to plastic surgery are gaining more and more interest. Methods:The Council of Medical Associations of Catalonia database was used to analyze claims related to plastic surgery from 1986 to 2021. Results:1039 claims (9.8% over 10,567 total claims) were studied. Both the total number of claims (P = 0.016; R-2=0.16) and the number of claims for plastic surgery (P < 0.0005; R-2=0.732) showed an upward trend during the period of study. In the period from 2000 to 2021, the behavior was different; while the number of total claims stabilized (P = 0.352; R-2 = 0.043), plastic surgery claims continued to show a time-related tendency to increase (P < 0.0005; R-2=0.484). The distribution was 50.12% out of court. Ten unique procedures accounted for 84.5% of the total number of claims. Liability was observed in 21.46% of the closed claims, with differences between civil (20.34%), criminal (6.89%), and out-of-court (25.53%) procedures. Regarding compensation amounts, out-of-court cases had an average of 33,169.44 euros paid; civil cases, 29,153.37 euros; and criminal cases, 37,186.88 euros. Conclusions:The increase in the number of cases can only be related to an increase in the activity carried out by plastic surgeons. There has been a change in Spain in terms of the most sought-after medical specialty, with plastic surgery having displaced the perennially most sought-after specialty, orthopedic surgery and traumatology

First-ever ankle arthrodesis with the Capanna technique in an infected open fracture

Although bone transport by means of distraction osteogenesis has become the standard of care for massive segmental bone defects, the technique faces limitations such as the lengthy period of time during which patients must wear an external fixator. Thus, other techniques may be more appropriate in certain circumstances.Capanna developed a combination of vascularized fibular grafts and strut allografts in a way that the strut allograft provides with significant initial mechanical stability, which facilitates incorporation of a vascularized fibular graft and promotes long-term survival of the reconstruction.The case presented in this report is the first in the medical literature where a circular external fixator is used as a stabilization method in a patient with a structural bone deficiency treated by means of the Capanna technique. It is also one of the few reported cases where the underlying condition does not originate in a tumor and where the joint is involved