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Fasciotomy

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https://www.readbyqxmd.com/read/29766123/orthopaedic-traumatology-fundamental-principles-and-current-controversies-for-the-acute-care-surgeon
#1
REVIEW
Shad K Pharaon, Shawn Schoch, Lucas Marchand, Amer Mirza, John Mayberry
Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29741424/morphological-patterns-of-the-pretendinous-cord-in-dupuytren-s-disease-a-predictor-of-clinical-outcome
#2
P Vanek, J Strömberg, J Fridén, Y Aurell
The morphology of the pretendinous cord in Dupuytren's disease is poorly described in vivo and especially with respect to recurrence after treatment. This prospective study was designed to describe the morphology of Dupuytren's cords by ultrasound and to identify possible correlation between the ultrasonographic characteristics of these cords and the clinical outcomes two years after treatment. Thirty-nine patients with a contracture of at least 20° in the metacarpophalangeal (MCP) joint, who were scheduled for local treatment by either injectable collagenase clostridium histolyticum (CCH) or percutaneous needle fasciotomy (PNF), were examined by ultrasound...
May 9, 2018: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/29734573/hyperbaric-oxygen-therapy-as-treatment-for-bilateral-arm-compartment-syndrome-after-crossfit-case-report-and-literature-review
#3
Adriano Fernando Mendes, José da Mota Neto, Erica Maciel Heringer, Leandro Furtado de Simoni, Diego Demolinari Pires, Pedro José Labronici
Introduction: CrossFit is a physical fitness program characterized by high-intensity workouts that can be associated with serious injury. Acute compartment syndrome in the upper limbs is a rare occurrence. It may occur after intense physical exercise, and its usual treatment is surgical. Hyperbaric oxygen therapy is a treatment described as adjunctive in cases of compartmental syndrome. Presentation: We describe the case of a CrossFit practitioner who, after intense training, developed progressive symptoms of rhabdomyolysis and acute bilateral arm compartment syndrome, who was successfully treated with hyperbaric oxygen therapy and required no fasciotomy as surgical treatment...
March 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29733906/cadaver-based-trauma-procedural-skills-training-skills-retention-30-months-after-training-among-practicing-surgeons-in-comparison-to-experts-or-more-recently-trained-residents
#4
Colin F Mackenzie, Mark W Bowyer, Sharon Henry, Samuel A Tisherman, Adam Puche, Hegang Chen, Valerie Shalin, Kristy Pugh, Evan Garofalo, Stacy A Shackelford
BACKGROUND: Long-term retention of trauma procedural core-competency skills and need for re-training after a one-day cadaver-based course remains unknown. We measured and compared technical skills for trauma core competencies mean 14 months (38 residents), 30 months (35 practicing surgeons) and 46 months (10 experts) after training to determine if skill degradation occurs with time. Technical performance during extremity vascular exposures and lower-extremity fasciotomy in fresh cadavers measured by validated individual procedure score (IPS) was primary outcome...
May 4, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29727872/postoperative-complications-in-equine-elective-clean-orthopaedic-surgery-with-without-antibiotic-prophylaxis
#5
Sabita Diana Stöckle, Klaus Failing, Marc Koene, Kerstin Fey
OBJECTIVE: Retrospective analysis of postoperative complications in equines after clean, orthopaedic surgical procedures in order to detect differences between animals treated with antibiotics and horses without receiving these drugs. MATERIAL AND METHODS: Details on 652 patients, surgical procedures and surgery-associated complications were compiled from horses being operated between June 2011 and January 2015. Antibiotic-receiving patients (n = 259) were tested for differences in complication rates and characteristics to controls (n = 393)...
April 2018: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/29716475/contemporary-management-and-outcome-after-lower-extremity-fasciotomy-in-non-trauma-related-vascular-surgery
#6
Charlotte Wesslén, Carl-Magnus Wahlgren
INTRODUCTION: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. METHODS: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29701338/arterial-vascular-complications-in-peripheral-venoarterial-extracorporeal-membrane-oxygenation-support
#7
Rita Augusto, Marisa Passos Silva, Jacinta Campos, Andreia Coelho, Nuno Coelho, Ana Carolina Semião, Evelise Pinto, Daniel Brandão, Alexandra Canedo
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) has been evolved as a life-saving measure for patients requiring emergent support of respiratory and cardiac function.The femoral artery is the standard site for vascular access when initiating adult venoarterial (VA) ECMO.Cannulation-related complications are a known source of morbidity and it has been speculated that patients undergoing ECMO via femoral arterial cannulation are more likely to develop peripheral vascular complications (up to 70%)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701102/the-indications-and-donor-site-morbidity-of-tibial-cortical-strut-autografts-in-the-management-of-defects-in-long-bones
#8
O Lauthe, M Soubeyrand, A Babinet, V Dumaine, P Anract, D J Biau
Aims The primary aim of this study was to determine the morbidity of a tibial strut autograft and characterize the rate of bony union following its use. Patients and Methods We retrospectively assessed a series of 104 patients from a single centre who were treated with a tibial strut autograft of > 5 cm in length. A total of 30 had a segmental reconstruction with continuity of bone, 27 had a segmental reconstruction without continuity of bone, 29 had an arthrodesis and 18 had a nonunion. Donor-site morbidity was defined as any event that required a modification of the postoperative management...
May 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29699733/acute-compartment-syndrome-do-guidelines-for-diagnosis-and-management-make-a-difference
#9
D Bodansky, A Doorgakant, J Alsousou, H J Iqbal, B Fischer, G Scicluna, M Bowers, B Narayan
BACKGROUND: The best outcomes following Acute Compartment Syndrome (ACS) are attributed to early diagnosis and treatment. National guidelines were issued in the United Kingdom in 2014 (BOAST 10) to standardise and improve management. We analysed standards of diagnosis and management before and after the introduction of the guidelines. METHODS: We retrospectively reviewed the data of all patients with ACS requiring fasciotomy between March 2010 and May 2015 across four Major Trauma Centres (MTCs) in the Northwest of England...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29694265/too-hot-to-handle-a-case-report-of-extreme-pyrexia-after-mdma-ingestion
#10
Fritz-Patrick Jahns, Antonine Pineau Mitchell, Georg Auzinger
Hyperpyrexia is a well-documented adverse effect of 3,4-methylenedioxymethamphetamine (MDMA) and is associated with a poor prognosis. There are currently limited published records of patients surviving a pyrexia of or greater than 43°C after MDMA intake. Rapid cooling and multiorgan support in an intensive care setting may offer patients the best chance of recovery. We present the case of a 16-year-old male who was admitted to our tertiary, adult intensive care unit (ICU) for unrecordable pyrexia (>43°C) after self-reported ecstasy intake...
April 25, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29691307/effects-of-anterior-compartment-fasciotomy-on-intramuscular-compartment-pressure-in-patients-with-chronic-exertional-compartment-syndrome
#11
David Roscoe, A J Roberts, D Hulse, A F Shaheen, M P Hughes, A N Bennet
BACKGROUND: Patients with chronic exertional compartment syndrome (CECS) have pain during exercise that usually subsides at rest. Diagnosis is usually confirmed by measurement of intramuscular compartment pressure (IMCP) following exclusion of other possible causes. Management usually requires fasciotomy but reported outcomes vary widely. There is little evidence of the effectiveness of fasciotomy on IMCP. Testing is rarely repeated postoperatively and reported follow-up is poor. Improved diagnostic criteria based on preselection and IMCP levels during dynamic exercise testing have recently been reported...
April 24, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29690533/snakebite-when-the-human-touch-becomes-a-bad-touch
#12
REVIEW
Bryan G Fry
Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood...
April 21, 2018: Toxins
https://www.readbyqxmd.com/read/29675441/acute-bilateral-lower-extremity-paralysis-secondary-to-acute-thrombosis-of-an-infrarenal-abdominal-aortic-aneurysm
#13
T Joseph Watson, W Kurtis Childers, Lindsey Haga, John Calaitges
We present the case of a 64-year-old male who presented to the emergency department with bilateral limb ischemia and paralysis for approximately 1 hour. Computed tomographic angiography demonstrated occlusion of the infrarenal aorta beginning just above the patient's known abdominal aortic aneurysm (AAA) and extending into both common iliac arteries. He was emergently treated via open repair of the AAA with a Gore-Tex tube graft, bilateral common iliac thrombectomies, and bilateral lower extremity four-compartment fasciotomies...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29664881/tibial-fracture-nonunion-and-time-to-healing-following-reamed-intramedullary-nailing-risk-factors-based-on-a-single-centre-review-of-1003-patients
#14
Hannah L Dailey, Katherine A Wu, Ping-Shi Wu, Margaret M McQueen, Charles M Court-Brown
OBJECTIVE: To determine factors associated with nonunion of adult tibial fractures. DESIGN: Retrospective review with data collection for logistic regression and survival analysis. SETTING: Scottish Level I trauma centre, 1985 to 2007. PATIENTS: During this period, 1,590 adult tibial fractures were treated by reamed nailing and 1,003 met all inclusion criteria for the chosen analysis. INTERVENTION: Reamed intramedullary nailing...
April 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29655809/acute-limb-ischemia-in-an-8-year-old-patient-case-report
#15
Young Erben, Samuel M Miller, Brandon J Sumpio, Brian J Dillon, Alfred I Lee, Peter Blume, Bauer E Sumpio, Carlos Mena-Hurtado
We report the case of an 8-year-old patient with a history of nephrotic syndrome (NS), who presented to the emergency department (ED) with right foot pain. The patient's mother described intermittent pain that woke her son from sleep and was accompanied by the foot turning purple and becoming cold to touch. Physical exam revealed capillary refill of over ten seconds in the right and less than two seconds in the left foot. Ankle-brachial indices (ABI) were 0.0 on the right and 0.96 on the left. The patient was admitted and started on therapeutic intravenous heparin...
April 12, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29644299/surgical-management-of-compartment-syndrome-and-the-gradual-closure-of-a-fasciotomy-wound-using-a-dermaclose-device
#16
Gregory C Manista, Andrew Dennis, Matthew Kaminsky
The immediate recognition and timely response of compartment syndrome due to damage caused by penetrating trauma has immense clinical outcomes. The following is a case report of a complicated fasciotomy in a 33-year-old male who suffered a gunshot wound to his left lower extremity and the surgical management leading to adequate limb salvage and recovery.
April 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29616640/treatment-of-elephantiasis-of-the-leg-by-fasciotomy-and-lymphangiectomy-with-skin-preservation-in-a-resource-limited-setting-a-case-report-and-review
#17
K Kibadi
The author reports the surgical management of a patient with elephantiasis of the leg in the Democratic Republic of Congo. A fasciotomy and lymphangiectomy with skin preservation, combined with compression therapy, resulted in significant cosmetic, functional, and social improvement. Although challenging in a resource-limited setting, development of surgical management may make it possible to reduce beliefs that elephantiasis is incurable or due to witchcraft and may reduce time to consultation.
February 1, 2018: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29610114/two-cases-of-unidentified-acute-compartment-syndrome
#18
Shinsuke Takeda, Masahiro Tatebe, Atsushi Sakai, Hitoshi Hirata
Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. We report two cases of unidentified ACS, which did not result from traumatic injuries such as fractures or crush injury, iatrogenic injury or diseases such as haematological malignancies. Both patients complained of severe pain and swelling of their extremity. No bite marks, blisters or skin necrosis was noted. They also complained of marked symptoms of third cranial nerve injury, including divergent squint and diplopia...
April 1, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29600212/upper-limb-phlegmasia-cerulea-dolens-secondary-to-heparin-induced-thrombocytopenia-a-case-study
#19
Matthew Gaines, Mike Grant, Simon Robinson, Helene Stevenson
Introduction: Phlegmasia cerulea dolens (PCD) is a rare pathology with a very high morbidity and mortality rate, which usually occurs in the lower limb. There is very little literature available to aid management. Case Report: We present a case of upper limb PCD in a 67-year-old female secondary to heparin-induced thrombocytopenia caused by warfarin bridging. She presented to the orthopedic team with upper limb compartment syndrome from a bleed around a peripherally inserted central catheter, for which she was urgently taken to the theater for fasciotomies...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29599391/dupuytren-treatment-effectiveness-trial-detect-a-protocol-for-prospective-randomised-controlled-outcome-assessor-blinded-three-armed-parallel-1-1-1-multicentre-trial-comparing-the-effectiveness-and-cost-of-collagenase-clostridium-histolyticum-percutaneous-needle
#20
Mikko P Räisänen, Teemu Karjalainen, Harry Göransson, Aleksi Reito, Hannu Kautiainen, Antti Malmivaara, Olli V Leppänen
INTRODUCTION: Dupuytren's contracture (DC) is a chronic fibroproliferative disorder of the palmar fascia which leads to flexion contracture in one or more fingers. There is no definitive cure for DC, and treatment aims at relieving symptoms by releasing the contracture using percutaneous or operative techniques. METHODS AND ANALYSIS: We planned a prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of (1) collagenase clostridium histolyticum injection followed by limited fasciectomy in non-responsive cases, (2) percutaneous needle fasciotomy followed by limited fasciectomy in non-responsive cases and (3) primary limited fasciectomy during short-term and long-term follow-up for Tubiana I-III stages DC...
March 28, 2018: BMJ Open
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