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BMJ Case Rep 2022 May 19;15(5). Epub 2022 May 19.

Pulmonary, Critical Care, and Sleep Medicine, Hartford Hospital, Hartford, Connecticut, USA.

A man in his 30s with a history of cocaine and intranasal heroin use presented to the emergency department with severe leg pain and weakness. Physical examination findings were significant for tachycardia, absence of dorsalis pedis pulses, tense and painful calf muscles along with absence of plantar reflexes in bilateral lower extremities. Laboratory investigations were significant for positive urinary drug screen for cocaine, severe rhabdomyolysis and acute kidney injury. Read More

J Orthop 2022 May-Jun;31:134-139. Epub 2022 Apr 30.

Department of Orthopaedic Surgery, Detroit Medical Center, Detroit, MI, 311 Mack Ave 5th Floor, Detroit, MI, 48201, United States.

Purpose: To review published literature assessing clinical outcomes and complication rates of single incision fasciotomy in fractures of the lower leg.

Methods: We searched PubMed and EMBASE for articles published through July 5, 2021, using the terms "single incision fasciotomy", "acute compartment syndrome of the limbs", "compartment syndrome fasciotomy", and "(compartment syndrome fasciotomy) AND (incision)". The inclusion criteria were studies of Level I to IV evidence in English, published in 1970 or later, involving human subjects, reporting clinical outcomes of single incision fasciotomy performed in cases of acute compartment syndrome in lower leg fractures, including at least 1 patient. Read More

BMJ Case Rep 2022 May 17;15(5). Epub 2022 May 17.

Barts and the London HPB Centre, Barts Health NHS Trust, London, London, UK

A woman in her 50s was undergoing a repeat liver resection surgery for recurrence of liver metastasis when the intravenous fluid flow was noted to be sluggish on multiple occasions. On the third examination of the right hand where the intravenous cannula was located, surgery was halted as there was extensive swelling from the hand to the biceps and the hand had started turning blue. A diagnosis of acute upper limb compartment syndrome secondary to extravasation exacerbated by metaraminol was made by the anaesthetist and surgeon. Read More

J Clin Med Res 2022 Apr 30;14(4):170-173. Epub 2022 Apr 30.

Department of General Medicine, Saint Helena General Hospital, Jamestown, STHL 1ZZ Saint Helena, South Atlantic Ocean, UK.

Compartment syndrome usually occurs after trauma, fracture, or compression injuries. To the authors' best knowledge, this is the first reported case in the medical literature of a combined gluteal and posterior thigh compartment syndrome after an accidental fall without an associated fracture. A 65-year-old man attended the emergency department of the general hospital in a remote island complaining of a swollen painful thigh. Read More

Trauma Surg Acute Care Open 2022 13;7(1):e000776. Epub 2022 Apr 13.

Orthopaedic Surgery, Gunma University Graduate School of Medicine School of Medicine Faculty of Medicine, Gunma, Japan.

Objectives: Venoarterial extracorporeal membrane oxygenation is increasingly being used as a life-saving modality in critically ill patients. Despite its necessity, severe lower extremity ischemia associated with venoarterial extracorporeal membrane oxygenation remains a potentially devastating complication. We aimed to investigate the incidence and risk factors for severe lower extremity ischemia requiring fasciotomy or amputation following venoarterial extracorporeal membrane oxygenation. Read More

Clin Case Rep 2022 Apr 25;10(4):e05710. Epub 2022 Apr 25.

Division of Hematology/Oncology Department of Internal Medicine Harbor-UCLA Medical Center Torrance California USA.

Factor VII and XI deficiencies are rare bleeding disorders typically associated with mild or provoked bleeding. This case report describes a patient with factor VII and XI deficiencies with an unprovoked episode of lower extremity hematoma causing compartment syndrome requiring multiple surgeries, extensive transfusion of blood products, and ultimately amputation. Read More

J Perioper Pract 2022 Apr 29:17504589221092563. Epub 2022 Apr 29.

Department of Anesthesia, Jewish General Hospital, McGill University, Montreal, QC, Canada.

Acute compartment syndrome is a surgical emergency that, if unrecognised, leads to tissue and muscle ischaemia, necrosis, multi-organ failure and even death. Gluteal compartment syndrome is a rare type of compartment syndrome that typically occurs as a sequela of trauma, and its presentation may be difficult to recognise. We describe a case of a patient who developed gluteal compartment syndrome following a prolonged renal surgery in lateral decubitus position. Read More

J Med Invest 2022 ;69(1.2):145-147

Department of Urology, Nippon Medical School, Tokyo, Japan.

Robot-assisted laparoscopic prostatectomy (RALP) for prostate cancer was introduced in 2000 and rapidly gained popularity. The Da Vinci Surgical System? can ensure improved local control of cancer and fewer perioperative complications. However, RALP is performed in the steep-Trendelenburg position (a combination of lithotomy and head-down tilt position/Lloyd-Davies position) to obtain a good surgical view, and as a result, well leg compartment syndrome (WLCS) can become a serious complication of RALP. Read More

S Afr J Surg 2022 Mar;60(1):49-54

Department of Family and Community Medicine, Benghazi University, Libya.

Background: The start of the armed conflicts in Libyan society in 2011 led to a dramatic increase in the incidences of unusual types of brachial artery injuries, which were previously uncommon. In this study, the postoperative outcomes have been compared prospectively between patients who have had injuries at the proximal anatomical half of the brachial artery with those who suffered injuries at the distal anatomical half.

Methods: A cohort study was undertaken to compare patients who had an injury at the proximal anatomical half of the brachial artery (considered as the first group) and patients who had an injury at the distal anatomical half of the brachial artery (considered as the second group). Read More

Am Surg 2022 Apr 17:31348221088968. Epub 2022 Apr 17.

Department of Surgery, 12258Louisiana State University Health Science Center, New Orleans, LA, USA.

Background: Combat applications of tourniquets for extremity trauma have led to increased civilian prehospital tourniquet use. Studies have demonstrated that appropriate prehospital tourniquet application can decrease the incidence of arrival in shock without increasing limb complications. The aim of this study was to examine outcomes of prehospital tourniquet placement without definitive vascular injury. Read More

J Emerg Trauma Shock 2022 Jan-Mar;15(1):56-59. Epub 2022 Apr 4.

Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.

Even if the vascular repair is successful, the frequency of limb loss is still high when popliteal artery injury is associated with postischemic syndrome due to blunt trauma or a prolonged ischemic time. Because prolonged ischemia interferes with an injured foot rescue, shortening of the ischemic time is a major aim of surgeons. We present two types of transient external arterial bypass and two cases of ischemic extremities due to main arterial injury. Read More

J Pediatr Orthop 2022 Apr 15. Epub 2022 Apr 15.

Department of Orthopaedics, Seattle Children's Hospital & University of Washington, Seattle, WA.

Background: Acute compartment syndrome (ACS) is a well-described condition that merits emergent surgical decompression. Peripheral arterial cannulation can increase the likelihood of ACS in patients requiring extracorporeal membranous oxygen (ECMO). Comorbidities in these critically ill patients may portend negative consequences of decompressive fasciotomy. Read More

BMJ Case Rep 2022 Apr 12;15(4). Epub 2022 Apr 12.

Trauma and Orthopaedics, Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, UK.

Acute compartment syndrome (ACS) of the thigh following femoral fracture has been rarely reported in previous literature. This condition must be diagnosed quickly to prevent the affected limb becoming ischaemic. We document the management of ACS of the thigh in a healthy male patient who suffered a proximal femur fracture following a high-speed road traffic accident. Read More

Front Pediatr 2022 23;10:843643. Epub 2022 Mar 23.

General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, University of Padua Medical School, Padua, Italy.

Background: Central venous catheters (CVCs) represent one of the main risk factors for venous thrombotic events (VTEs) in children.

Methods: We studied the Italian Registry of Pediatric Thrombosis (RITI) with regard to systemic radiologically confirmed CVC-related VTEs (CVC-VTEs) occurred during 6.5 years in children aged 29 days to 18 years. Read More

Ann Med Surg (Lond) 2022 May 2;77:103574. Epub 2022 Apr 2.

Anesthesia and Critical Care Department, Pediatric Intensive Care Unit, CHU Mohamed VI, Marrakesh, Morocco.

Introduction: Snakebites are a leading cause of mortality and permanent disabilities especially among children in tropical countries and rural areas such as Morocco. Thus, a nationwide management protocol including specific antivenom therapy along with prevention strategies was implemented to reduce the overall snakebites morbimortality.

Patients And Methods: Our retrospective study aimed to describe the clinical aspects of snakebite envenomation before and after the implementation of this protocol in children admitted to the pediatric intensive care unit (PICU) in Marrakesh-Morocco for a period of 11 years. Read More

J Orthop Res 2022 Apr 5. Epub 2022 Apr 5.

Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA.

Serial examination and direct measurement of intracompartmental pressure (ICP) are suboptimal strategies for the detection of acute compartment syndrome (CS) because they are operator-dependent and yield information that only indirectly reflects intracompartmental muscle perfusion. As a result, instances of unnecessary fasciotomy and unrecognized CS are relatively common. Recently, near-infrared spectroscopy (NIRS)-based systems for compartment monitoring have generated interest as an adjunct tool. Read More

Medicine (Baltimore) 2022 Feb;101(7):e28865

Kabul University of Medical Sciences, Kabul, Afghanistan.

Rationale: Expanded dengue syndrome (EDS) is the phenomenon coined by the World Health Organization for cases of dengue fever (DF) with rare but dangerous consequences. EDS mainly leads to complications involving the vital organs, thus is also associated with a higher mortality rate. This case report presents the first-ever case where a patient developed EDS with both rhabdomyolysis-induced acute kidney injury and compartment syndrome of the limbs. Read More

Chirurg 2022 Mar 29. Epub 2022 Mar 29.

Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistrasse 100, 8091, Zürich, Schweiz.

Acute compartment syndrome of the extremities is a surgical emergency and a rapid diagnosis and immediate surgical treatment are essential for the outcome. The cause is an increase in the tissue pressure inside a muscle compartment enclosed by fasciae and the resulting disruption of microperfusion. This can have potentially disastrous consequences, such as loss of the extremity due to extensive tissue necrosis or a threat to life due to infectious complications. Read More

Case Rep Neurol 2022 Jan-Apr;14(1):31-37. Epub 2022 Feb 7.

Department of Radiology, Vaasa Central Hospital, Vaasa, Finland.

When used appropriately, buprenorphine and oxycodone are safe drugs. They are, however, widely abused in combination with other drugs. Here we describe a case series of 8 patients with cervical myelopathy and rhabdomyolysis of the adjacent deep neck muscles after using an opioid in combination with other drugs. Read More

Cureus 2022 Feb 8;14(2):e22033. Epub 2022 Feb 8.

Accident and Emergency, Rehman Medical Institute, Peshawar, PAK.

Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. Symptoms usually include intense pain, tenderness in the affected area, tingling or burning sensation, and in severe cases, numbness or weakness and limb amputation due to ischemia from compression of the blood vessels, respectively. This case report describes a 19-year-old female who presented with complaints of severe pain and swelling in her right forearm. Read More

J Foot Ankle Surg 2022 Feb 24. Epub 2022 Feb 24.

Department of Surgery, Máxima MC, Veldhoven, DB, The Netherlands.

Patients with lower leg chronic exertional compartment syndrome are impaired due to exercise-related pain. Fasciotomy is the surgical gold standard. However, it is unknown whether number of simultaneously opened compartments affects outcome. Read More

Case Rep Orthop 2022 6;2022:5449913. Epub 2022 Mar 6.

Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA.

Acute compartment syndrome is a difficult diagnosis to make due to its wide range of clinical presentations. Delay or misdiagnosis can cause devastating consequences such as Volkmann's ischemic contracture, permanent nerve damage, amputation, and death. Lower extremity compartment syndrome is more common than upper extremity compartment syndrome, with the forearm being the most common location for upper extremity compartment syndrome. Read More

BMJ Case Rep 2022 Mar 15;15(3). Epub 2022 Mar 15.

School of Sport and Exercise Science, University of Worcester, Worcester, UK.

A case study of acute compartment syndrome in the anterior lateral thigh of a professional Rugby Union Flanker with no history of trauma is presented. The report covers all details from initial occurrence; medical history; investigations and surgical treatment; manual stimulus and rehabilitation; return to play; challenges and considerations-resulting in a positive outcome. Resultant observations/recommendations are that investigations should be swift and carefully considered to facilitate surgical intervention via decompressive fasciotomy as required. Read More

OTA Int 2022 Mar 10;5(1 Suppl):e163. Epub 2022 Mar 10.

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.

Objective: Extremity compartment syndrome (ECS) is a morbid condition resulting in permanent myoneural damage. Currently, the diagnosis of compartment syndrome relies on clinical symptoms and/or intracompartment pressure measurements, both of which are poor predictors of ECS. Animal models have been used to better define cellular mechanisms, diagnosis, and treatment of ECS. Read More

J Spec Oper Med 2022 ;22(1):81-86

Background: Acute compartment syndrome (ACS) following extremity trauma requires rapid fasciotomy to avoid significant morbidity and limb loss. Four-compartment fasciotomy of the leg is a surgical procedure typically performed in the operating room; however, casualties who cannot be rapidly transported may need fasciotomies in the prehospital setting. In the absence of traditional operating instruments (e. Read More

JBJS Case Connect 2022 03 9;12(1). Epub 2022 Mar 9.

NYU Langone Hospital, Department of Orthopedic Surgery, New York, New York.

Case: A 17-year-old adolescent boy presented with continued knee pain, swelling, and mechanical symptoms after anterior cruciate ligament (ACL) reconstruction with partial meniscectomy. The patient eventually underwent ACL revision surgery that was without complications. Postoperatively, the well leg grew firm with associated neurological deficits, and physical examination confirmed compartment syndrome of the lower leg compartments that resolved with emergency fasciotomy. Read More

Proc (Bayl Univ Med Cent) 2022 15;35(2):254-255. Epub 2021 Nov 15.

Department of Emergency Medicine, Baylor Scott and White Medical Center - Temple, Temple, Texas.

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic condition that can cause significant morbidity and mortality. Patients may present with a range of symptoms, including abdominal pain and distention, nausea, and vomiting that can rapidly progress to hemodynamic instability, renal failure, severe electrolyte derangements, thromboembolism, large-volume ascites, pleural effusion, and respiratory failure. We present a case of an 18-year-old woman who developed OHSS after egg donation with subsequent lower-extremity arterial thrombosis and compartment syndrome requiring fasciotomy and vascular intervention. Read More

Radiographics 2022 Mar-Apr;42(2):E50-E67

From the Division of Trauma and Emergency Radiology (D.D., E.B.S.), Department of Diagnostic Radiology and Nuclear Medicine (D.D., E.B.S., K.C.), and Department of Vascular Surgery (J.J.M.), University of Maryland and R Adams Cowley Shock Trauma Center, 655 W Baltimore St, Baltimore, MD 21201.

Extremity arterial injuries account for up to 50% of all arterial traumas. The speed, accuracy, reproducibility, and close proximity of modern CT scanners to the trauma bay have led to the liberal use of CT angiography (CTA) when a limb is in ischemic jeopardy or is a potential source of life-threatening hemorrhage. The radiologist plays a critical role in the rapid communication of findings related to vessel transection and occlusion. Read More

J Am Acad Orthop Surg Glob Res Rev 2022 02 21;6(2). Epub 2022 Feb 21.

From the Beth Israel Deaconess Medical Center-Harvard Medical School (Dr. Merchan, Ingalls, and Garcia); the Department of Orthopaedic Trauma, Beth Israel Deaconess Medical Center-Harvard Medical School (Dr. Wixted); the Department of Hand and Upper Extremity Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School (Dr. Rozental, and Dr. Harper); and the Department of Hand and Upper Extremity Surgery, Harvard Medical School (Dr. Dowlatshahi), Boston, MA.

Introduction: Fasciotomy is the standard of care to treat acute compartment syndrome (ACS). Although fasciotomies often prevent serious complications, postoperative complications can be notable. Surgical site infection (SSI) in these patients is as high as 30%. Read More

Zhonghua Shao Shang Za Zhi 2022 Jan;38(1):77-80

Department of Burns and Reconstructive Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To explore the effects of clinical application of free anterolateral thigh perforator lobulated flap in repair of electrical burn wounds on head based on the concept of donor site protection. A retrospective observational study was conducted. Eight patients with electrical burns with huge scalp defects and exposed skulls were admitted to the First Affiliated Hospital of Zhengzhou University, from May 2017 to December 2019, who were all males, aged 21-57 (39±13) years, sustaining multiple deep partial thickness to full-thickness electrical burns to 5%-14% total body surface area. Read More