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https://www.readbyqxmd.com/read/28093811/routine-use-of-distal-arterial-perfusion-in-pediatric-femoral-venoarterial-extracorporeal-membrane-oxygenation
#1
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
#2
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
#3
Florence Unno, Kelly A Lefaivre, Georg Osterhoff, Pierre Guy, Henry M Broekhuyse, Piotr A Blachut, Peter O'Brien
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 as well as the functional and radiographic outcomes of this strategy. DESIGN: Retrospective Cohort study and prospective data collection...
December 28, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28043728/acute-compartment-syndrome-caused-by-uncontrolled-hypothyroidism
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27964899/reversed-palmaris-longus-muscle-causing-volar-forearm-pain-and-ulnar-nerve-paresthesia-a-case-report
#9
Abhiram R Bhashyam, Carl M Harper, Matthew L Iorio
A case of volar forearm pain associated with ulnar nerve paresthesia caused by a reversed palmaris longus muscle is described. The patient, an otherwise healthy 46-year-old male laborer, presented after a previous unsuccessful forearm fasciotomy for complaints of exercise exacerbated pain affecting the volar forearm associated with paresthesia in the ulnar nerve distribution. A second decompressive fasciotomy was performed revealing an anomalous "reversed" palmaris longus, with the muscle belly located distally...
December 10, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27914662/surgical-site-infection-in-tibial-plateau-fractures-with-ipsilateral-compartment-syndrome
#10
Andrew G Dubina, Ebrahim Paryavi, Theodore T Manson, Christopher Allmon, Robert V O'Toole
AIM: The aim of this study was to investigate the effects of compartment syndrome and timing of fasciotomy wound closure on surgical site infection (SSI) after surgical fixation of tibial plateau fractures. Our primary hypothesis was that SSI rate is increased for fractures with compartment syndrome versus those without, even accounting for confounders associated with infection. Our secondary hypothesis was that infection rates are unrelated to timing of fasciotomy closure or fixation...
October 18, 2016: Injury
https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#11
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#12
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27901277/negative-pressure-wound-therapy-for-prevention-and-treatment-of-surgical-site-infections-after-vascular-surgery
#13
REVIEW
S Acosta, M Björck, A Wanhainen
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27893637/timing-of-presentation-of-pediatric-compartment-syndrome-and-its-microsurgical-implication-a-retrospective-review
#14
Natalia I Ziolkowski, Leanne Zive, Emily Ho, Ronald Zuker
BACKGROUND: Forearm compartment syndrome in the pediatric population can lead to severe functional disability. Although it is known that earlier presentation with decompression leads to better outcomes, it is not known when presentation post-injury leads to significant loss of function requiring microsurgical intervention. AIM: To describe the rate of microsurgical reconstruction after forearm compartment syndrome in pediatric patients as related to timing of presentation...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27885102/technique-tip-single-incision-endoscopic-plantar-fasciotomy
#15
Zachary M Thomas, Kristin J Thomas
: Two-incision endoscopic plantar fasciotomy (EPF) is an accepted surgical technique in the treatment of recalcitrant plantar fasciitis. Single-incision plantar fasciotomy is a relatively new technique in the surgeons' armamentarium; however, it is not without pitfalls, specifically poor visualization. This article aims to help the foot and ankle surgeon make a smooth transition from 2-incision EPF to single-incision EPF while maintaining optimum visualization. LEVELS OF EVIDENCE: Level V: Expert opinion...
November 23, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27872901/reperfusion-and-compartment-syndrome-after-flexible-ureteroscopy-in-a-patient-with-an-iliac-vascular-graft
#16
Esteban Emiliani, Michele Talso, Edgar Beltrán-Suárez, Steeve Doizi, Olivier Traxer
Background: Flexible ureteroscopy (fURS) is one of the main treatment options for urolithiasis less than 2 cm. Although fURS has no relative contraindication, some anatomical factors may need to be considered, as not all patients are suitable for the regular lithotomy position (LP). We report the case of a patient with a right iliac vascular graft that after an fURS without intraoperative incidences developed a reperfusion syndrome of the right lower limb. Case Presentation: A 46-year-old male patient was referred for treatment and follow-up in the cystinuric clinic after being found to have a 3 cm pelvic stone with a Double-J catheter in place after two failed sessions of shockwave lithotripsy...
2016: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/27869621/ponseti-treatment-of-rigid-residual-deformity-in-congenital-clubfoot-after-walking-age
#17
Massimiliano Dragoni, Pasquale Farsetti, Giuseppe Vena, Diego Bellini, Pierluigi Maglione, Ernesto Ippolito
BACKGROUND: There is no established treatment for rigid residual deformity of congenital clubfoot (CCF) after walking age. Soft-tissue procedures, osseous procedures, and external fixation have been performed with unpredictable results. We applied the Ponseti method to patients with this condition in order to improve the outcomes of treatment. METHODS: We retrospectively reviewed the cases of 44 patients (68 feet) with congenital clubfoot whose mean age (and standard deviation) at treatment was 4...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27857494/osteofascial-compartment-pressure-measurement-in-closed-limb-injuries-whitesides-technique-revisited
#18
Rajendra Kumar Beniwal, Abhishek Bansal
INTRODUCTION: Regular monitoring of tissue compartmental pressures and hence a timely intervention in patients with impending compartment syndrome has been shown to prevent morbidity and permanent disability. MATERIAL AND METHODS: Intra-compartmental pressure in flexor compartment of forearm and various compartments of legs following recent trauma presenting within 6 h of injury was carried out in 30 subjects using Whitesides' technique and patients were classified into 3 categories for treatment purposes i...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27848904/-a-postpartum-woman-with-toxic-shock-syndrome-group-a-streptococcal-infection-a-much-feared-postpartum-complication
#19
K Abbink, J C Kortekaas, M P Buise, J Dokter, S M I Kuppens, T H M Hasaart
BACKGROUND: The development of toxic shock syndrome (TSS) after an invasive group A streptococcal (GAS) infection in the postpartum period is a much feared complication. The mortality rate of TSS with necrotizing fasciitis is 30 to 50%. CASE DESCRIPTION: We present the case of a woman with atypical pelvic pain which was the first symptom of toxic shock syndrome as a consequence of a GAS infection. Clinical deterioration necessitated a hysterectomy. Also a fasciotomy was performed as consequence of lower extremity compartment syndrome...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27834057/lower-limb-ischemia-caused-by-resuscitative-balloon-occlusion-of-aorta
#20
Yohei Okada, Hiromichi Narumiya, Wataru Ishi, Iiduka Ryoji
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure to manage severe hemorrhagic shock from torso injury but can cause severe ischemia of the lower extremities. However, lower extremity ischemia occurring as a complication of REBOA has been rarely reported. We describe the severe lower extremity ischemia caused by REBOA with a 12-Fr sheath in a small-built patient. CASE REPRESENTATION: The patient was a 16-year-old male who developed severe hemorrhagic shock due to abdominal blunt trauma...
December 2016: Surgical Case Reports
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