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Fasciotomy

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https://www.readbyqxmd.com/read/28634595/role-of-repeat-muscle-compartment-pressure-measurements-in-chronic-exertional-compartment-syndrome-of-the-lower-leg
#1
Aniek P M van Zantvoort, Johan A de Bruijn, Michiel B Winkes, Adwin R Hoogeveen, Joep A W Teijink, Marc R Scheltinga
BACKGROUND: The diagnostic gold standard for diagnosing chronic exertional compartment syndrome (CECS) is a dynamic intracompartmental pressure (ICP) measurement of the muscle. The potential role of a repeat ICP (re-ICP) measurement in patients with persistent lower leg symptoms after surgical decompression or with ongoing symptoms after an earlier normal ICP is unknown. PURPOSE: To study whether re-ICP measurements in patients with persistent CECS-like symptoms of the lower leg may contribute to the diagnosis of CECS after both surgical decompression and a previously normal ICP measurement...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28630850/anterior-dislocation-of-elbow-with-neurovascular-injury-a-rare-case-report
#2
S Kailash, S Shanmuganathan
INTRODUCTION: Anterior elbow dislocation is an infrequent lesion, produced by direct trauma to the proximal ulna after a fall on the elbow in flexion and injury to the neurovascular bundle is not infrequent. Authors report a case of acute anterior dislocation of the elbow joint with neurovascular injury. CASE REPORT: A 30-year-old male admitted with a history of accidental fall followed by pain, swelling over his left elbow. Clinical, radiological, Doppler investigations revealed anterior dislocation of the elbow with brachial artery injury with posterior interosseous nerve palsy without any bony injury...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28622832/management-of-war-related-vascular-wounds-in-french-role-3-hospital-during-the-afghan-campaign
#3
REVIEW
Fabien Beranger, Henri De Lesquen, Olivier Aoun, Cédric Roqueplo, Léon Meyrat, Claudia Natale, Jean-Philippe Avaro
OBJECTIVES: To describe the management of war-related vascular injuries in the Kabul French military hospital. METHODS: From January 2009 to April 2013, in the Kabul French military hospital, we prospectively included all patients presenting with war-related vascular injuries. We collected the following data: site, type, and mechanism of vascular injury, associated trauma, type of vascular repair, amputation rate and complications. RESULTS: Out of the 922 soldiers admitted for emergency surgical care, we recorded 45 (5%) patients presenting with vascular injuries: 30 (67%) gunshot-related, 11 (24%) explosive device-related, and 4 (9%) due to road traffic accident...
June 10, 2017: Injury
https://www.readbyqxmd.com/read/28617517/selective-fasciotomy-for-chronic-exertional-compartment-syndrome-detected-with-exercise-magnetic-resonance-imaging
#4
Sehan Park, Ho Seong Lee, Sang Gyo Seo
Chronic exertional compartment syndrome that is refractory to conservative management should be treated with surgical fasciotomy. However, owing to the limitations of intracompartmental needle manometry in reaching a definite diagnosis, the appropriate timing for fasciotomy and on which compartment remain unclear. The authors report the case of a 22-year-old male military cadet who reported pain in his left calf when running or walking for long distances. The pain was located at the lateral aspect of the calf, from the mid-calf level to the ankle...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28595814/extremity-compartment-syndrome-following-blunt-trauma-a-level-i-trauma-center-s-5-year-experience
#5
Daniel Zuchelli, Nicholas Divaris, Jane E McCormack, Emily C Huang, Neeta D Chaudhary, James A Vosswinkel, Randeep S Jawa
BACKGROUND: Extremity compartment syndrome is a recognized complication of trauma. We evaluated its prevalence and outcomes at a suburban level 1 trauma center. METHODS: The trauma registry was reviewed for all blunt trauma patients aged ≥18 years, admitted between 2010 and 2014. Chart review of patients with extremity compartment syndrome was performed. RESULTS: Of 6180 adult blunt trauma admissions, 83 patients developed 86 extremity compartment syndromes; two patients had compartment syndromes on multiple locations...
May 10, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28589655/cannulation-related-complications-on-veno-arterial-extracorporeal-membrane-oxygenation-prevalence-and-effect-on-mortality
#6
Joshua K Wong, Amber L Melvin, Devang J Joshi, Candice Y Lee, William J Archibald, Ron E Angona, Vakhtang Tchantchaleishvili, Howard T Massey, George L Hicks, Peter A Knight
Cannulation-related complications are a known source of morbidity in patients supported on veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Despite its prevalence, little is known regarding the outcomes of patients who suffer such complications. This is a single institution review of cannulation-related complications and its effect on mortality in patients supported on VA-ECMO from January 2010-2015 using three cannulation strategies: axillary, femoral, and central. Complications were defined as advanced if they required major interventions (fasciotomy, amputation, site conversion)...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28587568/ultrasonographic-examination-of-the-ruptured-cord-after-collagenase-treatment-or-needle-fasciotomy-for-dupuytren-s-contracture
#7
J Strömberg, P Vanek, J Fridén, Y Aurell
Local treatment of Dupuytren's contracture, either by collagenase or needle fasciotomy, allows disruption of the pathological cord during forced extension. The purpose of this study was to investigate the cord before and after both treatments by ultrasound. A total of 39 patients with a minimum of 20° contracture in the metacarpophalangeal joint were included and randomized to treatment with either collagenase (20 patients) or needle fasciotomy (19 patients). The distance between the distal and the proximal parts of the ruptured cord was measured by ultrasound and the difference in passive joint movement before and after treatment was measured with a goniomenter...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28586577/pattern-and-profile-of-electric-burn-injury-cases-at-a-burn-centre
#8
Saeed Ashraf Cheema
BACKGROUND: Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. METHODS: This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28567342/functional-outcome-of-tibial-fracture-with-acute-compartment-syndrome-and-correlation-to-deep-posterior-compartment-pressure
#9
Saumitra Goyal, Monappa A Naik, Sujit Kumar Tripathy, Sharath K Rao
AIM: To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome. METHODS: Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year...
May 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28562573/predictors-of-secondary-amputation-in-patients-with-grade-iiic-lower-limb-injuries-a-retrospective-analysis-of-35-patients
#10
Wenhao Song, DongSheng Zhou, Jinlei Dong
The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries.A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation).Grade IIIC lower limb injuries were identified in 41 patients. Primary amputation was performed in 6 patients (15%) as the initial procedure...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28561900/muscle-changes-in-patients-with-diabetes-and-chronic-exertional-compartment-syndrome-before-and-after-treatment-with-fasciotomy
#11
David S Edmundsson, Göran L Toolanen, Per S Stål
INTRODUCTION: Muscle changes in patients with diabetes and lower leg pain due to chronic exertional compartment syndrome (CECS) were investigated before and after fasciotomy. METHODS: The tibialis anterior muscle was analyzed with histochemical and morphological techniques in 7 patients with diabetes and CECS before fasciotomy, and in 5 of them 1-year after fasciotomy. Non-diabetic patients with CECS and healthy subjects served as references. RESULTS: Before treatment, walking distance until occurrence of pain was limited (<0...
May 31, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28553450/calf-compartment-syndrome-associated-with-the-use-of-an-intra-osseous-line-in-an-adult-patient-a-case-report
#12
R Malhotra, W L Chua, G O'Neill
We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28539673/compartment-syndrome-and-regional-anaesthesia-critical-review
#13
Jozef Klucka, Petr Stourac, Alena Stouracova, Michal Masek, Martin Repko
Acute compartment syndrome (ACS) is a potential orthopaedic/traumatology emergency. Without prompt, precise diagnosis and immediate treatment with surgical decompressive fasciotomy it can lead to neurological dysfunction and disability. The role of regional anaesthesia (RA) in patients at risk for ACS/ and in those with developed ACS is controversial. The aim of this critical review was to answer the question, whether regional anaesthesia can delay the diagnosis. The authors use an evidence-based approach to discuss these high risk patients in considering RA as a method of choice for effective analgesia...
May 24, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28538569/early-postoperative-results-of-percutaneous-needle-fasciotomy-in-451-patients-with-dupuytren-disease
#14
Sanne Molenkamp, Tanneke A M Schouten, Dieuwke C Broekstra, Paul M N Werker, J Daniel Moolenburgh
BACKGROUND: Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. METHODS: The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#15
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28504777/dengue-fever-with-compartment-syndrome-of-the-right-arm
#16
C Khoo, G Chu, M S Rosaida, S K Chidambaram
A 44-year-old woman was admitted to our hospital with dengue fever. She developed a haematoma in the right arm at the site of a previous arterial line insertion. Due to coexisting thrombocytopenia, the bleeding was severe enough to cause compartment syndrome. An emergency fasciotomy was performed and her limb salvaged. The case illustrates one important potential complication of this common infectious disease.
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28473158/injectable-collagenase-versus-percutaneous-needle-fasciotomy-for-dupuytren-contracture-in-proximal-interphalangeal-joints-a%C3%A2-randomized-controlled-trial
#17
Simon Toftgaard Skov, Therkel Bisgaard, Per Søndergaard, Jeppe Lange
PURPOSE: Collagenase Clostridium histolyticum (CCH) injection was introduced commercially as a treatment for Dupuytren contracture following initial phase-3 investigations in 2009 with promising results. However, the efficacy of CCH has not been prospectively investigated in a direct comparison to other active treatments of Dupuytren contracture with more than 1-year follow-up, despite a wide and increasing clinical use. METHOD: In this prospective, independent, open-label, randomized controlled trial, (Clinicaltrials...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#18
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28453344/pediatric-hereditary-angioedema-as-a-cause-of-acute-compartment-syndrome-of-the-hand-and-forearm-a-case-report
#19
Chelsea Venditto, Zachary Jager, John LoGiudice, Hani Matloub
BACKGROUND: Compartment syndrome of the upper extremity is a surgical emergency that, when left untreated, can have dire consequences. Its causes are numerous, one of which is the uncommon entity hereditary angioedema, an autosomal dominant disease resulting in edema in a variety of potential locations, including the extremities. This is only the second time hereditary angioedema has been mentioned in the literature as a cause of compartment syndrome. METHODS: We present a case of hereditary angioedema leading to hand and forearm compartment syndrome in a 13-year-old pediatric patient...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28449851/acute-compartment-syndrome
#20
Andrew H Schmidt
Acute compartment syndrome is a well-known complication of tibial fractures, yet it remains difficult to diagnose and the only effective treatment is surgical fasciotomy. Delayed fasciotomy is the most important factor contributing to poor outcomes, and as a result, treatment is biased towards performing early fasciotomy. Current diagnosis of ACS is based on clinical findings and intramuscular pressure (IMP) measurement, and is targeted at identifying safe thresholds for when fasciotomy can be avoided. Since clinical findings are variable and difficult to quantify, measurement of IMP - ideally continuously - is the cornerstone of surgical decision - making...
April 24, 2017: Injury
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