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TRENDS IN ORTHOPEDIC SURGERY

ALVIN J. INGRAM, M.D.
AMA Arch Surg. 1954;69(1):119-121. doi:10.1001/archsurg.1954.01270010121018.
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ORTHOPEDIC SURGERY IN CEREBRAL PALSY  A RECENT but definite trend in the orthopedic treatment of the cerebral palsied has been clearly and concisely stated by Baker.1Twenty years ago the therapeutic pendulum had swung to the extreme end of the operative scale, and orthopedic teachings were replete with various procedures to lengthen tendons, capsulotomies, and total and subtotal neurectomies of peripheral nerves. Approximately 10 years ago the pendulum swung to the opposite extreme and operative treatment was deplored except as a final resort in the correction of deformities which had been treated by manipulative means over a long period of time with no improvement. Generally speaking, orthopedic surgery was considered to be contraindicated in cases with athetosis or tremor, rarely indicated in cases with ataxia, and seldom needed in the spastic or rigidity types of cerebral palsy.The therapeutic pendulum has now swung away from these two extremes and

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