The Chronic Compartment Syndrome of the Lower Leg: Results of Fasciotomy

Author(s):  
E. J. M. M. Verleisdonk ◽  
C. J. M. Helder ◽  
H. A. Hoogendoorn ◽  
Chr. van der Werken
Author(s):  
Andrea Schiavone ◽  
Michele Bisaccia ◽  
Luigi Meccariello ◽  
Giuseppe Rinonapoli ◽  
Luigi Piscitelli ◽  
...  

Author(s):  
Miodrag Vranjes ◽  
Tanja Lakić

<p class="abstract">Compartment syndrome occurs when the pressure within a defined compartmental space increases above a critical pressure threshold. Lung cancer is one of the world's most frequently diagnosed cancer whose metastases are rare cause of compartment syndrome. We present a 50 year old male patient who was admitted to our emergency department due to painful left lower leg, swelling and paresthesia of the medial side of the foot that lasted about 2 months back. The diagnosis of metastatic lung adenocarcinoma was set 9 months earlier. Physical examination revealed an ill-defined, tense, and tender swelling left calf and X-ray images confirmed periosteal reaction on all four cortices of both bones without osteolytic lesions. After an adequate laboratory analyses and preoperative preparation, debridement with biopsy and fasciotomy was performed. Histopathological evaluation showed necrotic tumor tissue that morphologically and immunohistochemically corresponds to lung cancer. We performed an above knee amputation and the next day, the patient was discharged home, due to his personal request.</p>


1994 ◽  
Vol 43 (1) ◽  
pp. 340-343
Author(s):  
Kazuhiko Imai ◽  
Akio Matsuzaki ◽  
Masayoshi Kido ◽  
Tetsuki Satoh

2021 ◽  
pp. 145749692110196
Author(s):  
P. Suomalainen ◽  
T.-K. Pakarinen ◽  
I. Pajamäki ◽  
M. K. Laitinen ◽  
H.-J. Laine ◽  
...  

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. Materials and Methods: We identified 359 consecutive patients with intramedullary nailed tibia fracture and complete medical records including outpatient data between April 2007 and April 2015 from electronic patient database of our institute. The use of the shoe-lace technique was compared to conventional one (in which wounds were first left open with moist dressings). Main outcome measurement is direct closure of fasciotomy wounds. Results: From 359 consecutive patients with intramedullary nailed tibia fracture, fasciotomy was performed on 68 (19%) patients. Of these, the shoe-lace technique was used in 47 (69%) patients while in 21 (31%) patients, the shoe-lace technique was not applied. Side-to-side approximation was successful in 36 patients (77%) in the shoe-lace+ group and 7 patients (33%) in the shoe-lace– group (p = 0.002). Conclusion: The main finding of our comparative study was that the shoe-lace technique seems to ease direct closure of lower leg fasciotomy wounds, and thus reduces the frequency of free skin grafts. Our finding needs to be confirmed in a high-quality randomized controlled trial.


2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
David Walmsley ◽  
Terry Axelrod ◽  
Sebastian Rodriguez-Elizalde

Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.


2017 ◽  
Vol 39 (01) ◽  
pp. 58-66 ◽  
Author(s):  
Johan de Bruijn ◽  
Aniek van Zantvoort ◽  
David van Klaveren ◽  
Michiel Winkes ◽  
Marike van der Cruijsen-Raaijmakers ◽  
...  

AbstractKnowledge about lower leg chronic exertional compartment syndrome (CECS) is largely obtained from highly selected populations. Patient characteristics may therefore not be appropriate for the general population. Our purpose was to describe a heterogeneous population of individuals suspected of lower leg CECS and to identify predictors of CECS. Charts of individuals who were analyzed for exercise-induced lower leg pain in a referral center between 2001 and 2013 were retrospectively studied. Patients were included if history and physical examination were suggestive of CECS and if they had undergone a dynamic intracompartmental pressure measurement. Six hundred ninety-eight of 1411 individuals were diagnosed with CECS in one or more of three lower leg muscle compartments (anterior tibial, deep flexor, lateral). Prevalence of CECS peaked around the age of 20–25 years and decreased thereafter, although a plateau around 50 years was found. Age, gender, bilateral symptoms, previous lower leg pathology, sports (running and skating) and tender muscle compartments were identified as independent predictors of lower leg CECS. The proposed predictive model has moderate discriminative ability (AUC 0.66) and good calibration over the complete range of predicted probabilities. The predictive model, displayed as a nomogram, may aid in selecting individuals requiring an invasive dynamic intracompartmental muscle pressure measurement.


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