Instructional course lectures
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Compression of the spinal cord and nerve roots caused by spondylotic changes or disk herniations is the most common etiology for cervical myelopathy, radiculopathy, or myeloradiculopathy. Surgical intervention in treating these conditions has been very successful. Anterior approaches to the cervical spine are being used for the treatment of cervical radiculopathy and myelopathy. The technical aspects of anterior diskectomy and corpectomy, methods of fusion, and the use of instrumentation are important treatment considerations.
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The treatment of open fractures of the tibial shaft continues to be a challenging problem for the orthopaedic surgeon. The basic principles of treatment for open fractures have changed little over the past decade; urgent wound débridement, early use of antibiotic therapy, skeletal stabilization, and early wound coverage remain the primary goals of treatment. However, the methods used to achieve these goals of treatment have evolved. Recent advances in the treatment of open fractures focus on the treatment of open fractures of the tibial shaft.
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Review
Fractures of the distal aspect of the radius: changes in treatment over the past two decades.
Fractures of the distal end of the radius are among the most common orthopaedic injuries, and treatment of these fractures has changed over the course of time. Many fractures of the distal radius are in fact relatively uncomplicated and are effectively treated by closed reduction and casting. However, fractures that are either unstable and/or involve the articular surfaces can jeopardize the integrity of the articular congruence and/or the kinematics of these articulations. ⋯ The fracture pattern, degree of displacement, the stability of the fracture, and the age and physical demands of the patient determine the best treatment option. Over the past 20 years, there has been a development of more sophisticated internal and external fixation techniques and devices for the treatment of displaced fractures of the distal radius. The use of percutaneous pin fixation, external fixation devices that permit distraction and palmar translation, low profile internal fixation plates and implants, arthroscopically-assisted reduction, and bone grafting techniques including bone graft substitutes all have contributed to improving fracture stability and outcome.
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In contrast to adult femoral fractures, there are many ways to treat a child's femoral fracture. The differences mainly involve ease of postoperative care and small rates of various complications. The surgeon should be familiar with at least one of the options for each age range and be adept at performing them to provide the best care for children of all ages.