American family physician
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The family pedigree record must be carefully recorded and reviewed on an annual basis. Review allows a continuting opportunity to identify new genetic risk factors. Physicians should be familiar with the pedigree patterns of autosomal dominant inheritance, sex-linked dominant inheritance, autosomal recessive inheritance, sex-linked recessive inheritance and polygenic inheritance. This understanding provides the basis for genetic counseling, prenatal diagnosis and improved therapy.
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The status of the fibula is an index of the severity of injury. Open tibial fracture with associated fractured fibula is more likely to develop complications. Antibiotics should be started promptly. ⋯ When there is any question about contamination, the wound is best left open. Rigid occlusive dressings promote epithelial ingrowth. Fracture distraction and plate fixation are associated with a high incidence of complications.