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JBJS Case Connect 2021 Jun 11;11(2). Epub 2021 Jun 11.

Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois.

Case: A 34-year-old man presented to the emergency department with rhabdomyolysis, acute kidney injury, and pain in the gluteal region after falling asleep on his side after heroin and alcohol use. On examination, he had swollen gluteal compartment musculature; however, he tolerated full passive range of motion with minimal pain. Intercompartmental pressure measured >110 mm Hg; therefore, emergent fasciotomy of the gluteal compartment musculature was performed. Read More

World J Emerg Surg 2021 Jun 10;16(1):32. Epub 2021 Jun 10.

Department of Gastrointestinal Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029 HUS, Helsinki, Finland.

Background: Selection of patients for open abdomen (OA) treatment in severe acute pancreatitis (SAP) is challenging. Treatment related morbidity and risk of adverse events are high; however, refractory abdominal compartment syndrome (ACS) is potentially lethal. Factors influencing the decision to initiate OA treatment are clinically important. Read More

BMC Musculoskelet Disord 2021 Jun 9;22(1):531. Epub 2021 Jun 9.

Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.

Background: Surgical site infection (SSI) occurs in 3-10 % of patients with surgically treated tibial plateau fractures. This study aimed to evaluate the impact of SSI on patients' outcome after fixation of tibial plateau fractures.

Methods: We conducted a retrospective multicenter study in seven participating level I trauma centers between January 2005 and December 2014. Read More

J Am Acad Orthop Surg 2021 Jun 9. Epub 2021 Jun 9.

From the Departments of Orthopaedics and Vascular Surgery, Sports Medicine Reseach Institute, The Ohio State University Wexner Medical Center, Columbus, OH.

Popliteal artery entrapment syndrome (PAES) is an uncommon condition that causes recurrent posterior leg pain and foot paresthesia in running athletes. This condition occurs most commonly due to an accessory or abnormal implant of the medial head of the gastrocnemius muscle. It may mimic or coincide with other chronic conditions of the lower extremity including chronic exertional compartment syndrome but is most consistent with vascular claudication. Read More

Graefes Arch Clin Exp Ophthalmol 2021 Jun 7. Epub 2021 Jun 7.

Department of Ophthalmology, Cantonal Hospital Aarau, 5000, Aarau, Switzerland.

Background: Diagnosis of orbital compartment syndrome is mainly based on clinical findings, such as intraocular pressure and proptosis, which try to estimate the orbital compartment pressure. However, the reliability of these surrogates is unclear. Current techniques for the direct measurement of orbital compartment pressure are widely experimental and impractical in the clinical setting. Read More

J Pediatr Orthop 2021 Jul;41(Suppl 1):S33-S38

Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital, Nashville, TN.

Introduction: Tibial shaft fractures are common injuries in the adolescent age group. Potential complications from the injury or treatment include infection, implant migration, neurovascular injury, compartment syndrome, malunion, or nonunion.

Methods: Published literature was reviewed to identify studies which describe the management options, complications, and outcome of tibial shaft fractures in adolescents. Read More

Anaesthesia 2021 Jun 7. Epub 2021 Jun 7.

Department of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh and Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, UK.

Anaesthesia 2021 Jun 7. Epub 2021 Jun 7.

Department of Anaesthesia, Mediclinic City Hospital, Dubai Healthcare City, Dubai, UAE.

Anaesthesia 2021 Jun 6. Epub 2021 Jun 6.

Department of Anaesthesia, Norfolk and Norwich University Hospital NHS Trust, Past-President, Regional Anaesthesia UK (RA-UK), Norwich, UK.

Pain resulting from lower leg injuries and consequent surgery can be severe. There is a range of opinion on the use of regional analgesia and its capacity to obscure the symptoms and signs of acute compartment syndrome. We offer a multi-professional, consensus opinion based on an objective review of case reports and case series. Read More

J Vasc Bras 2021 Apr 2;20:e20200094. Epub 2021 Apr 2.

Hospital Regional Tarcísio Maia - HRTM, Departamento de Cirurgia Geral e Vascular, Mossoró, RN, Brasil.

In areas that are not commonly affected by compartment syndrome because they have a good content/container ratio, diagnosis of the condition can be a challenge, since surgeons will find it difficult to make a diagnosis on the basis of an isolated sign or symptom. As a result, the correct treatment can very often be delayed, causing harm to the patient. In this case, the patient was a 29-year-old woman who was seen for a painful left hand secondary to a large burn injury to the area anterior of the anatomical snuffbox. Read More

J Vasc Surg Venous Lymphat Disord 2021 Jun 3. Epub 2021 Jun 3.

Division of Vascular surgery, Stony Brook medicine, Stony Brook, United States. Electronic address:

Objectives: The clinical presentation of venous malformations (VMs) is variable and not well documented. This study was designed to determine the clinical characteristics and outcomes in association with the type and extent of VM in the extremities.

Methods: Patients diagnosed by ultrasound, CT or MRI were included. Read More

Clin Neurol Neurosurg 2021 May 27:106714. Epub 2021 May 27.

Department of Biomedicine, University Hospital Basel, Hebelstrasse 20, 4031 Basel, Switzerland.

Int J Surg Case Rep 2021 May 26;83:106012. Epub 2021 May 26.

Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan. Electronic address:

Introduction: Neurofibromatosis type 1 (NF-1) or von Recklinghausen's disease, an autosomal dominant genetic disorder, is characterized by a café au lait spot and cutaneous neurofibromas. It typically involves the skin, nerves, bones, muscles, and eyes, and occasionally involves vascular complications and can lead to life-threatening hemorrhage.

Case Presentation: We present the case of a 77-year-old female with a posterior tibial artery rupture with NF-1. Read More

BMJ Case Rep 2021 Jun 2;14(6). Epub 2021 Jun 2.

Pediatric Critical Care, Shaikh Khalifa Medical City, Abu Dhabi, UAE.

Abdominal compartment syndrome (ACS) is an infrequently encountered life-threatening disorder characterised by elevated abdominal pressure with evidence of new organ dysfunction. It is rarely reported in paediatrics. We describe an extremely unusual presentation of a 13-year-old boy with long-standing constipation who developed ACS complicated by refractory septic shock and multiorgan failure. Read More

Endosc Int Open 2021 Jun 27;9(6):E848-E852. Epub 2021 May 27.

Endoscopy Service, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione) Palermo, Italy.

During extracorporeal membrane oxygenation (ECMO), intra-abdominal hypertension (IAH) can impair ECMO venous drainage, reducing its ability to provide an adequate oxygenated blood flow. When medical therapy is ineffective in managing IAH, guidelines recommend a decompressive laparotomy (DL), though the procedure is associated with several complications and poor outcomes. This was a case series of IAH in patients affected with acute respiratory distress syndrome (ARDS) on veno-venous (V-V) ECMO, in whom we performed total water-assisted colonoscopy (t-WAC) to treat IAH. Read More

Scand J Surg 2021 Jun 2:14574969211019639. Epub 2021 Jun 2.

Department of Orthopaedics and Traumatology, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland.

Background & Aim: Tibia fractures are relatively common injuries that are accompanied with acute compartment syndrome in approximately 2% to 20% of cases. Although the shoe-lace technique, where vessel loops are threaded in a crisscross fashion and tightened daily, has been widely used, no studies have compared the shoe-lace technique with the conventional one. The aim of this study was to compare the shoe-lace technique with the conventional technique. Read More

Clin Pract 2021 May 24;11(2):327-331. Epub 2021 May 24.

Electrophysiology Division, White River Health System, Batesville, AR 72501, USA.

A 68-year-old female patient with a past medical history of atrial fibrillation on anticoagulation regimen with Apixaban and Clopidogrel presented for her scheduled Watchman device implantation. The device was indicated as patient was high risk for falling. Successful implantation of the left atrial appendage device was carried out, and the patient was sent to the floor. Read More

Pathogens 2021 May 23;10(6). Epub 2021 May 23.

Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

is the causative agent of anthrax, primarily a disease of herbivorous animals, which can be accidentally transmitted to humans. Three cases of cutaneous human anthrax were recorded in August 2020 in Dolj county, Romania. These cases included livestock farmers (husband and wife, as well as a man from their entourage). Read More

Biosensors (Basel) 2021 May 14;11(5). Epub 2021 May 14.

Department of Biomedical Engineering, National University of Singapore, Singapore 117575, Singapore.

Intra-abdominal pressure (IAP) is closely correlated with intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) diagnoses, indicating the need for continuous monitoring. Early intervention for IAH and ACS has been proven to reduce the rate of morbidity. However, the current IAP monitoring method is a tedious process with a long calibration time for a single time point measurement. Read More

Int J Mol Sci 2021 May 4;22(9). Epub 2021 May 4.

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, 56126 Pisa, Italy.

Primary Sjögren's syndrome (pSS) is a complex heterogeneous disease characterized by a wide spectrum of glandular and extra-glandular manifestations. In this pilot study, a SWATH-MS approach was used to monitor extracellular vesicles-enriched saliva (EVs) sub-proteome in pSS patients, to compare it with whole saliva (WS) proteome, and assess differential expressed proteins between pSS and healthy control EVs samples. Comparison between EVs and WS led to the characterization of compartment-specific proteins with a moderate degree of overlap. Read More

PLoS One 2021 1;16(6):e0251775. Epub 2021 Jun 1.

Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.

Objective: The term Idiopathic Systemic Capillary Leak Syndrome (ISCLS) refers to an uncommon condition of severe distributive shock, resulting from an abrupt shift of fluids and proteins from the intravascular to the interstitial compartment. We hypothesise that the autonomic nervous system (ANS) fails in regulating the response to hypovolemia in acute ISCLS and that ANS variables characterise the progression to the recovery.

Design: Prospective cohort study of patients admitted to ICU for severe ISCLS flares. Read More

Anaesth Crit Care Pain Med 2021 May 28:100862. Epub 2021 May 28.

Soins Intensifs, Hôpitaux Universitaires de Genève, Genève, Suisse.

Goal: To provide healthcare professionals with comprehensive multidisciplinary expert recommendations for the acute care of severe limb trauma patients, both during the prehospital phase and after admission to a Trauma Centre.

Design: A consensus committee of 21 experts was formed. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. Read More

J Vis Exp 2021 May 11(171). Epub 2021 May 11.

Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine;

Intra-abdominal pressure (IAP) is increasingly being recognized as an indispensable and significant physiological parameter in intensive care units (ICU). IAP has been measured in a variety of ways with the development of many techniques in recent years. The level of intra-abdominal pressure under normal conditions is generally equal to or less than 12 mmHg. Read More

Injury 2021 Jun 17;52(6):1336-1340. Epub 2020 Oct 17.

University of Alabama at Birmingham, Department of Orthopedic Surgery, AL, USA; Children's Hospital of Alabama, Department of Pediatric Orthopaedics, AL, USA. Electronic address:

Introduction: Open reduction and internal fixation (ORIF) is considered the standard care for displaced tibial tubercle fractures, but closed reduction and internal fixation (CRIF) can also be successful. Our aim was to compare outcomes between ORIF and CRIF for tibial tubercle fractures.

Materials And Methods: Children younger than 18 years presenting for a tibial tubercle fracture at a single institution. Read More

World J Orthop 2021 May 18;12(5):320-328. Epub 2021 May 18.

Division of Orthopaedic Surgery, McGill University Health Centre, Montreal H3G-1A4, Quebec, Canada.

Background: Endoscopic fasciotomy of the forearm for chronic exertional compartment syndrome (CECS) has gained popularity recently.

Aim: To systematically review the literature of endoscopic fasciotomy for CECS of the forearm, aiming to assess the outcomes and complications of the different endoscopic fasciotomy techniques described in the literature.

Methods: On January 18, 2021, PubMed and EMBASE were searched by 3 reviewers independently, and all relevant studies published up to that date were considered based on predetermined inclusion/exclusion criteria. Read More

JBJS Essent Surg Tech 2020 Oct-Dec;10(4). Epub 2020 Dec 24.

C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, Michigan.

Background: Elastic intramedullary nailing of both-bone pediatric forearm fractures is used to treat unstable fractures that fail conservative management with closed reduction and casting, open injuries, or injuries with neurovascular compromise.

Description: Small incisions are used to enter the medullary canal of the distal end of the radius and proximal part of the ulna, avoiding injury to the adjacent physis. The elastic nail is advanced to the fracture site under fluoroscopic guidance. Read More

JBJS Essent Surg Tech 2020 Oct-Dec;10(4). Epub 2020 Nov 19.

Washington University in St. Louis, St. Louis, Missouri.

Background: Most pediatric tibial shaft fractures (75%) can be treated nonoperatively; however, unstable and open fractures require surgical intervention. Titanium elastic nails have become a popular technique for fixation of pediatric tibial shaft fractures. They act as internal splints that impart relative stability to the fracture, promoting callus formation at the fracture site. Read More

Case Rep Crit Care 2021 6;2021:5519812. Epub 2021 May 6.

Orthopedic Anaesthesia and Intensive Care Compartment, Emergency County Hospital Cluj-Napoca, Romania.

Fat embolism syndrome (FES) is a multiple organ disorder that can appear after pelvic and long bone fractures. The most common clinical finding is hypoxia, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, polypnea, and tachycardia. We present a mild FES case on a 32-year-old man with no medical history admitted for an orthopedic procedure, following both tibia and fibulae fractures. Read More

Front Immunol 2021 14;12:664209. Epub 2021 May 14.

Center for Experimental and Molecular Medicine, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.

Rationale: Systemic activation of procoagulant and inflammatory mechanisms has been implicated in the pathogenesis of COVID-19. Knowledge of activation of these host response pathways in the lung compartment of COVID-19 patients is limited.

Objectives: To evaluate local and systemic activation of coagulation and interconnected inflammatory responses in critically ill COVID-19 patients with persistent acute respiratory distress syndrome. Read More

Int J Angiol 2021 Jun 26;30(2):98-106. Epub 2020 Nov 26.

College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.

This study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Read More