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Fasciotomy

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https://www.readbyqxmd.com/read/28730321/age-and-dressing-type-as-independent-predictors-of-post-operative-infection-in-patients-with-acute-compartment-syndrome-of-the-lower-leg
#1
Mark E Hake, Jordan Etscheidt, Vivek P Chadayammuri, Jacob M Kirsch, Cyril Mauffrey
PURPOSE: The purpose of this study was to determine independent factors, including timing of fasciotomy, that confer an increased risk of post-operative surgical site infection (SSI) in patients presenting with acute compartment syndrome (ACS) of the lower extremity. METHODS: A retrospective analysis was performed on a consecutive cohort of 53 adult patients requiring fasciotomy for lower-extremity fractures complicated by ACS presenting to a single Level I trauma center over a seven-year study period...
July 20, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28706822/endoscopic-fasciotomy-of-the-superficial-and-deep-posterior-compartments-of-the-leg
#2
Tun Hing Lui
Chronic exertional compartment syndrome is a rare cause of lower leg pain incurred during sports activities and typically affects young athletes who need to return to their activity level as quickly as possible. Nonoperative treatments are often unsuccessful and fasciotomy of the involved compartment is the treatment of choice. Endoscopically assisted release of the anterior and deep compartments is proven to be safe and effective. Endoscopically assisted deep posterior compartment release via an incision 1 to 3 cm behind the medial tibial border has high risk of injury to the great saphenous and perforating veins and the saphenous nerve...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706812/mini-open-posterior-compartment-release-for-chronic-exertional-compartment-syndrome-of-the-leg
#3
Kyle P Lavery, Michael Bernazzani, Kevin McHale, William Rossy, Luke Oh, George Theodore
Chronic exertional compartment syndrome (CECS) is a well-recognized cause of leg pain in endurance athletes. Surgical fasciotomy for posterior leg CECS historically has inferior clinical results compared with anterior and lateral compartment release. Poor surgical technique with inadequate release may contribute to less reliable outcomes. In this Technical Note with accompanying video, we describe a mini-open approach for posterior CECS of the leg.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28697090/extensile-fasciotomy-for-compartment-syndrome-of-the-forearm-and-hand
#4
Stefan C Turkula, David A Fuller
PURPOSE: The purpose of this video is to demonstrate the technique of an extensile fasciotomy of the forearm and hand. METHODS: A patient presented to our hospital with a rapidly progressing infection of the right upper extremity and clinical signs and symptoms of compartment syndrome. The patient was immediately taken to the operating room for decompressive fasciotomy, debridement, drainage, and irrigation of what cultures subsequently revealed to be a virulent streptococcal infection...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697076/acute-compartment-syndrome-of-the-leg
#5
Sanjit R Konda, Benjamin S Kester, Nina Fisher, Omar A Behery, Alexander M Crespo, Kenneth A Egol
INTRODUCTION: Acute compartment syndrome (ACS) is well known among orthopaedic surgeons. The timely diagnosis and management of ACS is crucial to avoiding its sequelae, including renal failure, ischemic contractures, and limb loss. Despite its relative importance, ACS poses a challenge to many residents and clinicians as diagnosis relies largely on clinical judgment. METHODS: Timely diagnosis and thorough compartment release are essential to optimizing outcomes in ACS...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28691512/the-incidence-of-complex-regional-pain-syndrome-in-simultaneous-surgical-treatment-of-carpal-tunnel-syndrome-and-dupuytren-contracture
#6
Mitchell Buller, Steven Schulz, Morton Kasdan, Bradon J Wilhelmi
BACKGROUND: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. METHODS: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment...
July 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28685094/treatment-of-high-grade-osteoblastic-osteosarcoma-of-the-humerus-in-a-5-year-old-boy-with-cystic-fibrosis-a-case-report
#7
Kenichi V Okuda, Jutta Hammermann, Björn S Lange, Jana C Fischer, Falk Thielemann, Ralf Knöfler, Meinolf Suttorp
Antineoplastic treatment of osteoblastic osteosarcoma in a patient with cystic fibrosis (CF) may harbor a high risk of neutropenia-associated complications, and, to the best of our knowledge, has not been previously reported. Diagnosis of CF was confirmed in a 6-week-old boy following pathological newborn screening. The patient had a stable course of CF under standardized continuous therapy. At the age of 5 years, osteosarcoma of the left proximal humerus was diagnosed without evidence of metastases. Neoadjuvant chemotherapy, including doxorubicin, cisplatin and methotrexate, was administered for 10 weeks...
July 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28677871/well-leg-compartment-syndrome-after-laparoscopic-low-anterior-resection-for-lower-rectal-cancer-in-the-lithotomy-position-a-case-report
#8
Masaya Nishino, Miho Okano, Junji Kawada, Yongkook Kim, Mami Yamada, Toshimasa Tsujinaka
A 64-year-old man underwent laparoscopic low anterior resection for lower rectal cancer. Because he was overweight (BMI, 28.1 kg/m(2) ) with rich visceral fat and a narrow pelvic cavity, the operation was technically difficult and the operation time was 686 min. Postoperatively, the patient immediately complained of pain and swelling of the left lower limb. Laboratory examination showed that serum creatinine kinase was markedly increased and urine myoglobin was positive on postoperative day 1. He was diagnosed with well-leg compartment syndrome and was transported to the trauma and critical care center for emergency fasciotomy...
July 5, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28664769/raised-compartment-pressures-are-frequently-observed-with-tibial-shaft-fractures-despite-the-absence-of-compartment-syndrome-a-prospective-cohort-study
#9
Kelvin Lor Kah Ho, Nicholas Yeoh Ching Sing, Khai Phang Wong, Andy Wee Teck Huat
PURPOSE: To measure the intracompartmental pressures surrounding tibial fractures not exhibiting any clinical evidence of compartment syndrome. Our hypothesis was that pressures often exceed the recommended threshold of fasciotomy despite the absence of compartment syndrome, and hence diagnosis based on pressure measurements alone is unreliable. METHODS: Thirteen consecutive patients with closed tibial shaft fractures without clinical suspicion of compartment syndrome, and who were planned for intramedullary nailing, were prospectively enrolled...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28634595/role-of-repeat-muscle-compartment-pressure-measurements-in-chronic-exertional-compartment-syndrome-of-the-lower-leg
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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