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Fasciotomy

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https://www.readbyqxmd.com/read/28504777/dengue-fever-with-compartment-syndrome-of-the-right-arm
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28443568/the-compartment-syndrome-associated-with-deep-vein-thrombosis-due-to-rattlesnake-bite-a-case-report
#6
Radu Ciprian Tincu, Zoie Ghiorghiu, Dana Tomescu, Radu Alexandru Macovei
BACKGROUND: Snakebite is a health issue specific to some parts of the world, especially in the tropical area, where it produces many victims. The main clinical damage caused by snake bite involves hemotoxic, neurotoxic and myotoxic reactions. It is also established that the importance of systemic impairment varies according to individual factors and are related to organ dysfunction, shock or hypotension. We report the case of a young woman suffering from snakebite who developed deep vein thrombosis and compartment syndrome...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28435149/regional-anesthesia-did-not-delay-diagnosis-of-compartment-syndrome-a-case-report-of-anterior-compartment-syndrome-in-the-thigh-not-masked-by-an-adductor-canal-catheter
#7
Arissa Torrie, Jyoti Sharma, Mark Mason, Hillenn Cruz Eng
BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter...
April 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28423444/-comment-on-the-technique-of-enhanced-percutaneous-needle-fasciotomy-pnf-for-dupuytren-s-contracture
#8
Martin Richter
No abstract text is available yet for this article.
February 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28423443/-the-extended-percutaneous-needle-fasciotomy-technique-pnf-for-dupuytren-s-contracture
#9
Wolfgang Paul Lenze
The extended percutaneous needle fasciotomy (PNF+) is a minimal invasive technique especially suitable for treating severe Dupuytren's contractures and recurrences. The familiar needle fasciotomy is complemented by a spontaneous tearing of the skin and a full-thickness graft to cover the defect. Skin tears in fingers and palm are not a complication, but an integral part of the PNF+. The neurovascular bundles remain intact. This surgical procedure may be repeated as often as required.
February 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28403726/gastrocnemius-recession-a-cadaveric-study-of-surgical-safety-and-effectiveness
#10
Eva M Hoefnagels, Stephen M Belkoff, Bart A Swierstra
Background and purpose - Many methods of gastrocnemius lengthening have been described, with different surgical challenges, outcomes, and risks to the sural nerve. Our aims were (1) to locate the gastrocnemius muscular-tendinous junction in relation to the mid-length of the fibula (from here on designated the mid-fibula), (2) to compare the dorsiflexion achieved with dorsal recession or ventral recession, and (3) to determine the risk of injury to the sural nerve during gastrocnemius recession. Methods - In 10 pairs of fresh-frozen adult cadaveric lower extremities transected above the knee, we measured dorsiflexion, performed dorsal or ventral gastrocnemius recession at the mid-fibula, and then measured the increase in dorsiflexion and fasciotomy gap...
April 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28376020/head-camera-video-recordings-of-trauma-core-competency-procedures-can-evaluate-surgical-resident-s-technical-performance-as-well-as-co-located-evaluators
#11
Colin F Mackenzie, Jason Pasley, Evan Garofalo, Stacy Shackelford, Hegang Chen, Nyaradzo Longinaker, Guinevere Granite, Kristy Pugh, George Hagegeorge, Samuel A Tisherman
BACKGROUND: Unbiased evaluation of trauma core competency procedures is necessary to determine if residency and pre-deployment training courses are useful. We tested whether a previously validated Individual Procedure Score (IPS) for individual procedure vascular exposure and fasciotomy (FAS) performance skills, could discriminate training status, by comparing IPS of evaluators co-located with surgeons to blind video evaluations. METHODS: Performance of axillary (AA), brachial (BA) and femoral artery (FA) vascular exposures and lower extremity FAS on fresh cadavers by 40 PGY 2-6 residents was video recorded from head- mounted cameras...
April 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28342510/arterial-protocol-including-prophylactic-distal-perfusion-catheter-decreases-limb-ischemia-complications-in-patients-undergoing-extracorporeal-membrane-oxygenation
#12
Kathleen M Lamb, Paul J DiMuzio, Adam Johnson, Philip Batista, Neil Moudgill, Megan McCullough, Joshua A Eisenberg, Hitoshi Hirose, Nicholas C Cavarocchi
OBJECTIVE: Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complications (10%-70%). This study evaluates the results of a distal limb perfusion arterial protocol designed to reduce associated complications. METHODS: We conducted a retrospective institutional review board-approved review of consecutive patients requiring ECMO via femoral cannulation (July 2010-January 2015)...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#13
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28323801/predicting-acute-compartment-syndrome-pacs-the-role-of-continuous-monitoring
#14
Andrew H Schmidt, Michael J Bosse, Katherine P Frey, Robert V OʼToole, Daniel J Stinner, Daniel O Scharfstein, Vadim Zipunnikov, Ellen J MacKenzie
The diagnosis of acute compartment syndrome (ACS) is a common clinical challenge among patients who sustain high-energy orthopaedic trauma, largely because no validated criteria exist to reliably define the presence of the condition. In the absence of validated diagnostic standards, concern for the potential clinical and medicolegal impact of a missed compartment syndrome may result in the potential overuse of fasciotomy in "at-risk" patients. The goal of the Predicting Acute Compartment Syndrome Study was to develop a decision rule for predicting the likelihood of ACS that would reduce unnecessary fasciotomies while guarding against potentially missed ACS...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323644/pediatric-acute-compartment-syndrome
#15
Kristin S Livingston, Michael P Glotzbecker, Benjamin J Shore
Pediatric acute compartment syndrome (PACS) is a clinical entity that must be carefully differentiated from the adult version (ie, acute compartment syndrome). Healthcare providers must understand the variable etiologies of PACS, of which trauma is the most common but can also include vascular insult, infection, surgical positioning, neonatal phenomena, overexertion, and snake and insect bites. In addition to the unique etiologies of PACS, providers must also recognize the different signs and symptoms of PACS...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#16
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28303472/chronic-exertional-compartment-syndrome-in-the-forearm-of-a-collegiate-softball-pitcher
#17
REVIEW
Austin Cole, John L Hiatt, Christopher Arnold, Terry Sites, Ramon Ylanon
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a recognized condition in the lower limb, with many reports in the literature. However, very few instances include CECS of the upper limb. This article presents the case of a collegiate softball pitcher presenting with CECS in her right forearm. To our knowledge, this is the first case report of a softball player with CECS, with only one similar incident in a major league baseball player. PURPOSE: The rarity of this condition normally places it low on the differential diagnosis...
December 2017: Sports Medicine—Open
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#18
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28301396/can-hyper-realistic-physical-models-of-peripheral-vessel-exposure-and-fasciotomy-replace-cadavers-for-performance-assessment
#19
Jeremy Holzmacher, Babak Sarani, Adam Puche, Guinevere Granite, Valerie Shalin, Kristy Pugh, William Teeter, Samuel Tisherman, Stacy Shackelford, Colin F Mackenzie
BACKGROUND: Work-hour restrictions have reduced operative experience for residents. The Advanced Surgical Skills for Exposure in Trauma course fills this training gap. Cadaver use has limitations including cost and availability. Hyper-realistic synthetic models may provide an alternative to cadavers. We compared same surgeon performance between synthetic and cadaveric models to determine interchangeability for formative evaluation. METHODS: 40 residents (<4wks after ASSET) and 35 faculty (mean 2...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28291440/-gluteal-compartment-syndrome-developing-after-nephrectomy-and-incisional-hernia-surgery
#20
Mustafa Karakaplan, Gökay Görmeli, Mehmet Fatih Korkmaz, Emre Ergen
Gluteal compartment syndrome is a rather rare syndrome often leading to severe sequelae, sepsis, renal failure, and even death due to delayed diagnosis. Establishing early diagnosis is essential to prevent complications associated with ischemia. In this article, we report a 56-year-old male patient who developed gluteal compartment syndrome after incisional hernia and nephrectomy surgery in lateral decubitus position. Gluteal muscle insufficiency developing after fasciotomy and Trendelenburg gait improved within two years...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
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