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Fasciotomy

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https://www.readbyqxmd.com/read/28230629/point-of-injury-tourniquet-application-during-operation-protective-edge-what-de-we-learn
#1
Amir Shlaifer, Avraham Yitzhak, Erez N Baruch, Avi Shina, Alexandra Satanovsky, Amiram Shovali, Ofer Almog, Elon Glassberg
BACKGROUND: Hemorrhage is a leading cause of preventable death on the battlefield. Timely tourniquet application to massively bleeding extremity wounds is critical for casualty survival albeit with reported adverse effects to extremity integrity. The aim of this study was to describe the immediate and short term outcomes of point of injury (POI) tourniquet applications during 'Operation Protective Edge' (OPE). METHODS: A case series study regarding tourniquet application at the POI during OPE was collected...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224633/gluteal-compartment-syndrome-with-neurologic-impairment-report-of-two-cases-and-review-of-the-literature
#2
Greg D Kuhlman, Kelly G Gwathmey
INTRODUCTION: We describe two patients who developed gluteal compartment syndrome (GCS) in the context of drug overdose. One patient developed a sciatic neuropathy and one patient a lumbosacral plexopathy. METHODS: We reviewed the literature of atraumatic GCS and resultant neurological impairment. RESULTS: We review 26 cases (our two and 24 previously published) of GCS and neurological impairment. All patients developed GCS in the context of drug or alcohol overdose...
February 22, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28203508/deltoid-compartment-syndrome-a-rare-complication-after-humeral-intraosseous-access
#3
Kishan M Thadikonda, Francesco M Egro, Irene Ma, Alexander M Spiess
We present a case of a 65-year-old woman who developed a delayed deltoid compartment syndrome after resuscitation via humeral intraosseous access. Initially she was treated conservatively but then was taken emergently for a fasciotomy. After confirming the diagnosis with compartment pressures, a 2-incision approach was employed and a large hematoma was evacuated from the inferior margin of the anterior deltoid. The rest of the deltoid was inspected and debrided to healthy bleeding tissue. Her fasciotomy wounds were left open to heal on their own due to her tenuous clinical condition...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28198773/early-post-operative-results-of-percutaneous-needle-fasciotomy-in-451-patients-with-dupuytren-disease
#4
Sanne Molenkamp, Tanneke A M Schouten, Dieuwke C Broekstra, Paul M N Werker, J Daniel Moolenburgh
BACKGROUND: Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment modality for Dupuytren disease (DD). In this study we analyzed the efficacy and complication-rate of PNF using a statistical method that takes the multi-level structure of data, regarding multiple measurements from the same patients, into account. METHODS: The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy (PNF) were analyzed retrospectively...
February 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28194389/elastic-suture-shoelace-technique-for-fasciotomy-closure-after-treatment-of-compartmental-syndrome-associated-to-tibial-fracture
#5
Paulo Sergio Martins Castelo Branco, Mauricio Cardoso Junior, Isaac Rotbande, José Antonio Fraga Ciraudo, Celso Ricardo Correa de Melo Silva, Paulo Cesar Dos Santos Leal
This article reports the use of elastic suture as an adjuvant in surgical wound closure caused by decompressive fasciotomy after compartment syndrome associated with a compound fracture of the tibia. Widely used in other medico-surgical specialties, this technique is unusual in orthopedics surgery, but the simplicity of the procedure and the successful outcome observed in this case allows for its consideration as indicated for situations similar to that presented in this study.
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28193445/endovascular-management-for-peripheral-arterial-trauma-the-new-norm
#6
Anand Ganapathy, Ahmed F Khouqeer, S Robb Todd, Joseph L Mills, Ramyar Gilani
BACKGROUND: Endovascular therapy is well studied in atraumatic conditions; and there appears to be a growing interest in its application to traumatic injuries. The objective of this study is to compare open and endovascular techniques in the management of peripheral arterial trauma. METHODS: This is a retrospective review of patients admitted to a Level I Trauma Center sustaining injuries to the subclavian, axillary, superficial femoral, and popliteal arteries. Demographics, surgical interventions, complications, and clinical outcomes were evaluated in patients requiring open or endovascular repair between 2009 and 2015...
February 4, 2017: Injury
https://www.readbyqxmd.com/read/28178774/a-retrospective-review-of-rattlesnake-bites-in-100-children
#7
Norberto Sotelo-Cruz, Norberto Gómez-Rivera
BACKGROUND: A retrospective review of clinical features and treatment of children hospitalized for rattlesnake bite. METHODS: One hundred clinical records were reviewed. Variables included: age, gender, season of the year, signs, symptoms, poisoning grade, complications, treatment and sequelae. RESULTS: Fifty-nine percent were males and 37% were less than 5 years of age; 87% occurred in rural areas; 63% of the snakebites occurred during the summer, of them, 39% occurred within the perimeter of the domicile and 8% within the home...
April 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28177973/monomicrobial-klebsiella-pneumoniae-necrotizing-fasciitis-with-liver-abscess-a-case-report-and-literature-review
#8
Ching-En Chen, Yu-Chung Shih
BACKGROUND: Necrotizing fasciitis is one of the most life-threatening soft tissue infections and usually follows a major or minor trauma. Published reports regarding single microorganism liver abscess caused by Klebsiella pneumoniae in Taiwan indicate a septic metastasis rate about 12%. Although a hematogenous origin of necrotizing fasciitis from a liver abscess is rare in Taiwan, it remains possible in our clinical practice. CASE PRESENTATION: A 75-year-old man with a history of diabetes and liver abscess had a status of postdrainage 5 years earlier...
February 8, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28176601/fasciotomy-closure-techniques
#9
Julio J Jauregui, Samantha J Yarmis, Justin Tsai, Kemjika O Onuoha, Emmanuel Illical, Carl B Paulino
We evaluated the risks and success rates of the three major techniques for compartment syndrome fasciotomy closure by reviewing all literature published to date. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically evaluated the Medline (PubMed) database until July 2015, utilizing the Boolean search sting "compartment syndrome OR fasciotomy closure." Two authors independently assessed all studies published in the literature to ensure validity of extracted data...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28156206/heparin-induced-thrombocytopenia-presenting-as-unilateral-lower-limb-paralysis-following-lumbar-spine-surgery-case-report
#10
Brandon W Smith, Jacob R Joseph, Paul Park
Heparin-induced thrombocytopenia (HIT) is a state of thrombocytopenia with a paradoxically elevated thrombotic potential after exposure to heparin. Severe cases can present with multiorgan involvement with direct and secondary effects. Although HIT has been reported following other surgeries, to the authors' knowledge there has not been a report of HIT after spinal surgery. The present case details the course of a patient who underwent elective lumbar surgery followed by delayed presentation of shortness of breath due to multiple pulmonary embolisms and right lower-extremity paralysis due to extensive iliofemoral clot burden with acute compartment syndrome...
February 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28125467/near-infrared-spectroscopy-monitoring-for-early-detection-of-limb-ischemia-in-patients-on-veno-arterial-extracorporeal-membrane-oxygenation
#11
Dong Jung Kim, Young-Jae Cho, Sang Hon Park, Cheong Lim, Kay-Hyun Park, Sang-Hoon Jheon, Jun Sung Kim
This study aimed to investigate the effectiveness of near-infrared spectroscopy (NIRS) monitoring for the early detection of limb ischemia in patients who were placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via femoral artery. We prospectively used NIRS monitoring for the early detection of limb ischemia in 28 adult patients, who were supported with peripheral VA-ECMO between August 2013 and August 2014 (NIRS group). A decision to perform distal perfusion catheterization was made in accordance to the regional oxygen saturation (rSO2) values provided by the NIRS system...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28123920/spinning-out-of-control-a-19-year-old-female-with-spinning-related-exertional-thigh-compartment-syndrome
#12
Daniel J Gould, Ido Badash, Sukgu Han, Alex K Wong
Thigh compartment syndrome (TCS) is a rare condition caused by high pressures within the fascial compartments of the thigh, impeding capillary flow and leading to decreased perfusion, tissue hypoxia, and necrosis. TCS is most frequently associated with trauma and anticoagulation but has also rarely been associated with exercise-related injury. We present the case of a 19-year-old female who reported painful swelling in her thighs and darkening of her urine after participating in a spinning class. On physical examination, the patient was found to have tight, painful thigh compartments with extreme tenderness on passive motion...
December 24, 2016: Curēus
https://www.readbyqxmd.com/read/28093811/routine-use-of-distal-arterial-perfusion-in-pediatric-femoral-venoarterial-extracorporeal-membrane-oxygenation
#13
Christine A Schad, Brian P Fallon, Julie Monteagudo, Shunpei Okochi, Eva W Cheung, Nicholas J Morrissey, Angela V Kadenhe-Chiweshe, Gudrun Aspelund, Steven Stylianos, William Middlesworth
Lower-extremity ischemia is a significant complication in children on femoral venoarterial extracorporeal membrane oxygenation (VA ECMO). Our institution currently routinely uses distal perfusion catheters (DPCs) in all femoral arterial cannulations in attempts to reduce ischemia. We performed a single-center, retrospective review of pediatric patients supported with femoral VA ECMO from January 2005 to November 2015. The outcomes of patients with prophylactic DPC placement at cannulation (prophylactic DPC) were compared to a historical group with DPCs placed in response only to clinically evident ischemic changes (reactive DPC)...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28076996/a-serious-case-of-anthrax-associated-with-compartment-syndrome
#14
Seyran Kılınç, Mehmet Vakıf Keskinbıçkı, Murat Şengül, Semra Nergiz, Abdurrahman Örtücü, Okay Bulut
Compartment syndrome linked to skin anthrax is a rare complication that may develop and it should be noted that the disease may progress in spite of medical drug treatment. Our case was a farmer who was exposed after slaughtering a dead animal, a time delay for treatment hided this history and then developed compartment syndrome. In anthrax cases with delayed treatment and aggressive progression, circulation in the extremities should be carefully noted. We believe that the cases with compartment syndrome progressing in spite of medical drug treatment may be assessed for fasciotomy as a treatment approach...
January 11, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28072649/is-early-definitive-fixation-of-bicondylar-tibial-plateau-fractures-safe-an-observational-cohort-study
#15
Florence Unno, Kelly A Lefaivre, Georg Osterhoff, Pierre Guy, Henry M Broekhuyse, Piotr A Blachut, Peter OʼBrien
OBJECTIVES: The optimal treatment protocol for bicondylar plateau fractures remains controversial. Contrary to popular practice which favors a staged protocol in many high-energy fracture patterns, we have used early single-stage open reduction and internal fixation (ORIF) to treat these injuries whenever possible. The purpose of this study was to determine the complication rate and the functional and radiographic outcomes of this strategy. DESIGN: Retrospective cohort study and prospective data collection...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28043728/acute-compartment-syndrome-caused-by-uncontrolled-hypothyroidism
#16
Anar Modi, Hari Amin, Matthew Salzman, Farah Morgan
Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures...
December 23, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28027611/ultrasound-guided-fasciotomy-for-anterior-chronic-exertional-compartment-syndrome-of-the-leg
#17
Ramon Balius, David A Bong, Jordi Ardèvol, Carles Pedret, David Codina, Antonio Dalmau
Chronic exertional compartment syndrome is characterized by exertional pain and elevated intracompartmental pressures affecting the leg in physically active young people. In patients who have failed conservative measures, fasciotomy is the treatment of choice. This study presents a new method for performing fasciotomy using high-resolution ultrasound (US) guidance and reports on the clinical outcomes in a group of these patients. Over a 3-year period, 7 consecutive patients with a total of 9 involved legs presented clinically with anterior compartment chronic exertional compartment syndrome, which was confirmed by intracompartmental pressure measurements before and after exercise...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28003319/hypothyroid-induced-acute-compartment-syndrome-in-all-extremities
#18
Matthew C Musielak, Jung Hee Chae
Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed...
December 20, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27988791/semimembranosus-muscle-herniation-a-rare-case-with-emphasis-on-muscle-biomechanics
#19
Lena Naffaa, Hicham Moukaddam, Mohammad Samim, Aaron Lemieux, Edward Smitaman
Muscle herniations are rare and most reported cases involve muscles of the lower leg. We use a case of muscle herniation involving the semimembranosus muscle, presenting as a painful mass in an adolescent male after an unspecified American football injury, to highlight a simple concept of muscle biomechanics as it pertains to muscle hernia(s): decreased traction upon muscle fibers can increase conspicuity of muscle herniation(s)-this allows a better understanding of the apt provocative maneuvers to employ, during dynamic ultrasound or magnetic resonance imaging, in order to maximize diagnostic yield and, thereby, limit patient morbidity related to any muscle herniation...
December 17, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27980886/a-case-review-series-of-christiana-care-health-system-s-experience-with-negative-pressure-wound-therapy-instillation
#20
Robert Felte, Kathy E Gallagher, Glen H Tinkoff, Mark Cipolle
Acute and chronic wounds afflict a multitude of patients to varying degrees. Wound care treatment modalities span the spectrum of technological advancement and with that differ greatly in cost. Negative pressure wound therapy (NPWT) can now be combined with instillation and dwell time (NPWTi-d). This case review series of 11 patients in a community hospital setting provides support for the utilization of NPWTi-d. Additionally, current literature on the use of NPWTi-d in comparison to NPWT will be reviewed.  We highlight three specific cases...
November 7, 2016: Curēus
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