Adult patients with high-grade spondylolisthesis not responding to nonoperative treatment can be stabilized in situ with posterior instrumentation from L4 to S1. The use of adjunctive fixation with iliac screws and/or transvertebral screws is recommended for the adult patient, particularly in revision or unstable cases. Reduction of the slipped vertebrae remains controversial for all grades of spondylolisthesis and more so for the adult patient. Partial reduction of the slip angle, decreasing the lumbosacral kyphosis, should be considered if significant sagittal malalignment is present or to improve arthrodesis success. Anterior column support should be performed, particularly when reduction has been obtained. Anterior column support can be performed, anteriorly or posteriorly, either by using inter vertebral body structural strut support or with a transsacral fibular dowel to improve stability and success of arthrodesis.

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Pediatric trauma injuries account for 11 million hospitalizations annually with a significant percentage related to the musculoskeletal system. Nursemaid's elbow is a common injury in young children that can often be prevented. This injury occurs when the radial head subluxates from its normal position at the elbow joint. Activities such as swinging a child by the hands or pulling on the pronated upper extremity can cause nursemaid's elbow. Prevention of nursemaid's elbow in children may be accomplished with education of parents, daycare workers, and teachers on the mechanism of this common injury.