Instructional course lectures
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The increasing number of hip fractures in the elderly constitutes a health care burden. The subset of unstable intertrochanteric hip fractures is important because the treatment of these fractures continues to be hampered by a moderate complication rate. Osteoporosis, fracture geometry, and the success of surgical treatment are strong predictors of outcome. The surgeon is in control of fracture reduction, implant selection, and implant placement, all of which must be optimized to ensure the success of surgical intervention.
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In some groups of polytrauma patients, particularly those with chest injuries, head injuries, and those with mangled extremities, early total care of major bone fractures may be potentially harmful. Delaying all orthopaedic surgery, however, is also not always the best approach. In these situations, damage control orthopaedics, which emphasizes the stabilization and control of the injury rather than repair will add little additional physiologic insult to the patient and is a treatment option that should be considered.
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Abnormal posttraumatic pain may delay recovery and severely impact health-related quality of life. The term complex regional pain syndrome describes abnormally intense and prolonged pain that is not related to tissue damage and is sometimes a sequela of injury. Various treatment strategies, including therapy, parental interventions, and peripheral surgery, are used to manage the condition.
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The principles and techniques used to reduce or eliminate blood transfusions can be applied to the standard practice of orthopaedic surgery. The overall goal is to enable orthopaedic surgeons who are interested in reducing allogeneic transfusions to find a method that fits their practice.
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Unstable pelvic ring injuries in hemodynamically unstable patients are life-threatening emergencies that many orthopaedic surgeons encounter in practice. Therefore, it is important to be up to date regarding current methods of evaluating, assessing, and treating patients with these complex and severe injuries. Surgeons should first determine whether patients have hemodynamic instability and identify the source of the hemorrhage. Patients should then be assessed for stabilization of unstable pelvic ring injuries.