The Orthopedic clinics of North America
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A review of conditions producing shoulder pain in the adult indicates the diverse nature of the various processes. Particularly important are diseases leading to articular abnormalities of the glenohumeral, acromioclavicular, and sternoclavicular articulations as well as surrounding structures such as the rotator cuff. Accurate diagnosis of the conditions requires careful radiographic examination supplemented with specialized techniques, including fluoroscopy, arthrography, and conventional or computed tomography.
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Common injuries to the hand and wrist of athletes have been discussed under the headings of ligament injuries, fractures, tendon injuries, and neurovascular injuries. Although the frequency and mechanisms of certain injuries may be different in the athlete than in the nonathlete, the principles of proper early diagnosis and adequate treatment are the same whether the patient is an athlete or not.
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Femoral fractures in the subtrochanteric and proximal shaft regions require special management because of the great stresses inflicted on the area. Stability is best achieved with intramedullary fixation when there is adequate control of both proximal and distal fragments. ⋯ When the major fracture is subtrochanteric, an intramedullary device should be used to permit stability of the bone by impaction. Experience with a special device composed of an intramedullary rod and triflanged nail indicates that this appliance performs well in the fixation of subtrochanteric fractures.
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Orthop. Clin. North Am. · Jul 1980
A reproducible approach to the internal fixation of adult ankle fractures: rationale, technique, and early results.
1. Open treatment of ankle fractures is discussed. 2. It is our opinion that operative treatment affords the most predictable way to carry out an absolutely anatomic reduction of the fractures. ⋯ The recommendation for open reduction of S-ER II fractures has been made. 6. It has been suggested that the deltoid ligament does not need to be repaired when fibular reduction is anatomic and fixation is stable. 7. Syndesmosis screws are rarely indicated, except in high C fractures when corrected by indirect methods.