The Orthopedic clinics of North America
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Compartment syndrome is a devastating consequence of extremity trauma that is preventable with early recognition and treatment. A high index of suspicion and careful clinical evaluation will detect most impending or established compartment syndromes. ⋯ The functional and cosmetic results of fasciotomy are always acceptable if done early. The results of inadequate treatment of compartment syndrome are never satisfactory.
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The prognosis of patients with thoracolumbar spine fractures and neurologic deficits has improved in terms of survival and quality of life since principles of timely fracture reduction, decompression, and stabilization have been implemented. In patients with incomplete spinal cord injuries, acute intervention has been shown to lead to improved neurologic recovery rates. The type of surgical treatment and timing depends upon the fracture type and neurologic status of the patient.
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High-energy tibial plateau fractures are often the result of blunt trauma. In addition to extensive bony injuries, soft-tissue problems are very common. ⋯ When extensive comminution and damaged soft tissues prohibit their use, the circular external fixator provides an excellent option for management of these complex injuries. Whether internal or external fixation techniques are used, appropriate management of the soft tissues is also a factor in the successful management of these severe injuries to the knee.