The Orthopedic clinics of North America
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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.
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Orthop. Clin. North Am. · Jul 1994
ReviewTibial osteotomy for genu varum. Indications, preoperative planning, and technique.
Valgus osteotomy of the proximal tibia remains the treatment of choice for the young active patient with a progressively symptomatic varus knee and mild to moderate secondary osteoarthritis. Although the natural history of the varus knee is not well established, it is widely accepted that patients with varus malalignment who develop meniscal injuries or progressive cartilage wear will inevitably develop more severe medial compartment osteoarthritis unless the abnormal mechanics of the knee are corrected.
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Orthop. Clin. North Am. · Jul 1994
ReviewNew concepts in high tibial osteotomy for medial compartment osteoarthritis.
Medial compartment osteoarthritis remains a clinical challenge for the orthopedic surgeon. Accurate preoperative planning is an integral part of management. MCOA with genu varum is not a single condition but a family of related deformities. ⋯ In total knee replacement, the important emphasis has been on achieving correct bony alignment and soft-tissue balance. With osteotomy, the emphasis has been on bony alignment. However, soft-tissue balance should also be considered an important element in preserving the knee in osteotomy surgery.
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Orthop. Clin. North Am. · Apr 1994
ReviewThe Galveston technique using Luque or Cotrel-Dubousset rods.
The Galveston technique for pelvic fixation in long fusions to the sacrum in neuromuscular and adult scoliosis is an effective technique to help obtain a solid fusion. With careful technique and accurate rod bending, rod insertion, rod contouring, and wire tightening, excellent fixation is obtained that maximizes the fusion rate.