scholarly journals Acute Compartment Syndrome of the Extremities and Paraspinal Muscles

2021 ◽  
Author(s):  
Balaji Zacharia ◽  
Raj Vignesh Selvaraj
Keyword(s):  
Compartment Syndrome ◽  
Clinical Features ◽  
Older Patients ◽  
Young Patients ◽  
The Body ◽  
Acute Compartment Syndrome ◽  
Tissue Ischemia ◽  
Important Symptom ◽  
The Common ◽  
Conscious Patient

Acute compartment syndrome (ACS) occurs when the pressure within the closed osteo-fascial compartment raises above perfusion pressure leading to irreversible tissue ischemia and necrosis. Any closed compartment in the body can be affected by ACS. The leg is the commonest site. Trauma is the common cause of compartment syndrome in young patients. In older patients, medical causes can cause it. The diagnosis in a conscious patient can be made based on clinical features. Pain out of proportion to the injury is the most important symptom. Exacerbation of pain on stretching the affected muscles and paresthesia are the common signs. Compartment pressure measurement is important for the diagnosis in unconscious and uncooperative patients. The treatment of established ACS is emergency fasciotomy. Untreated compartment syndrome can lead to neurovascular injuries and muscle contractures. In this chapter, we will see the etiologies, clinical features, investigations, and management of acute compartment syndrome of the extremities and the paraspinal region.

Regional anesthesia and acute compartment syndrome: principles for practice

2021 ◽  
pp. rapm-2021-102735
Author(s):  
Tim Dwyer ◽  
David Burns ◽  
Aaron Nauth ◽  
Kaitlin Kawam ◽  
Richard Brull
Keyword(s):  
Compartment Syndrome ◽  
Regional Anesthesia ◽  
Clinical Symptoms ◽  
Motor Nerve ◽  
Acute Compartment Syndrome ◽  
Clinical Settings ◽  
Tissue Ischemia ◽  
Orthopedic Surgical Procedures ◽  
Cardinal Symptom ◽  
Symptoms And Signs

Acute compartment syndrome (ACS) is a potentially reversible orthopedic surgical emergency leading to tissue ischemia and ultimately cell death. Diagnosis of ACS can be challenging, as neither clinical symptoms nor signs are sufficiently sensitive. The cardinal symptom associated with ACS is pain reported in excess of what would otherwise be expected for the underlying injury, and not reasonably managed by opioid-based analgesia. Regional anesthesia (RA) techniques are traditionally discouraged in clinical settings where the development of ACS is a concern as sensory and motor nerve blockade may mask symptoms and signs of ACS. This Education article addresses the most common trauma and elective orthopedic surgical procedures in adults with a view towards assessing their respective risk of ACS and offering suggestions regarding the suitability of RA for each type of surgery.

Clinical features of young patients (below age 40) with pancreatic ductal adenocarcinoma.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 199-199
Author(s):  
Akihiro Ohmoto ◽  
Chigusa Morizane ◽  
Emi Kubo ◽  
Kazuaki Shimada ◽  
Takuji Okusaka ◽  
...  
Keyword(s):  
Family History ◽  
Clinical Features ◽  
Older Patients ◽  
Locally Advanced ◽  
Young Patients ◽  
Tumor Location ◽  
Ductal Adenocarcinoma ◽  
History Of ◽  
Almost All ◽  
Long Term Survivors

199 Background: The median age of pancreatic ductal adenocarcinomas (PDAC) patients is approximately 70 years. We investigated clinical features of PDAC occurring in young patients (< 40 years) in order to determine if any difference exists in comparison to older patients. Methods: We reviewed a single-institution database of 785 patients with pathologically proven PDAC between 2001 and 2012. We examined the clinical features in patients with PDAC below 40 years of age and compared it to those in older patients (≥ 40 years). Results: Of these 785 patients, a total of 10 patients (1.3%) under the age of 40 were identified, with a range of 28 to 37 years. Clinical features in young and older patients have been summarized (table). There are no differences between groups in terms of sex, smoking, tumor location, UICC stage, a family history of PDAC and a family history of any cancer. In the young patients group, three of them were diagnosed with localized diseases, two others with locally advanced diseases, and five others with metastatic diseases. Two of the three patients with localized diseases underwent curative operation. The five patients with metastatic diseases received chemotherapy, and only one patient achieved a partial response treated with FOLFIRINOX regimen. Two of the patients were long-term survivors, having survived over three years. Six of the patients had a family history of other cancers in first-degree relatives. Unexpectedly and most importantly, only one patient had a family history of PDAC. Conclusions: Cases of patients with PDAC below 40 years of age are rare. The clinical features in young patients were generally similar to those in older patients. Almost all young patients had no family history of PDAC, which suggests that hereditary genetic factors have a weak relationship with cases of onset of PDAC at a young age in Japan. [Table: see text]

scholarly journals Acute Compartment Syndrome of the Limbs: Current Concepts and Management

2012 ◽  
Vol 6 (1) ◽  
pp. 535-543 ◽  
Author(s):  
Nigel Tapiwa Mabvuure ◽  
Marco Malahias ◽  
Sandip Hindocha ◽  
Wasim Khan ◽  
Ali Juma
Keyword(s):  
Compartment Syndrome ◽  
Clinical Features ◽  
Current Knowledge ◽  
Diagnostic Procedures ◽  
Adverse Outcomes ◽  
Acute Compartment Syndrome ◽  
Clinical Anatomy ◽  
Intracompartmental Pressure ◽  
Life Threatening ◽  
Muscle Compartment

Acute compartment syndrome (ACS) of the limb refers to a constellation of symptoms, which occur following a rise in the pressure inside a limb muscle compartment. A failure or delay in recognising ACS almost invariably results in adverse outcomes for patients. Unrecognised ACS can leave patients with nonviable limbs requiring amputation and can also be life–threatening. Several clinical features indicate ACS. Where diagnosis is unclear there are several techniques for measuring intracompartmental pressure described in this review. As early diagnosis and fasciotomy are known to be the best determinants of good outcomes, it is important that surgeons are aware of the features that make this diagnosis likely. This clinical review discusses current knowledge on the relevant clinical anatomy, aetiology, pathophysiology, risk factors, clinical features, diagnostic procedures and management of an acute presentation of compartment syndrome.

scholarly journals Acute Compartment Syndrome

2020 ◽  
Vol 63 (3) ◽  
pp. 124-127
Author(s):  
Jana Cepková ◽  
Leoš Ungermann ◽  
Edvard Ehler
Keyword(s):  
Case Report ◽  
Compartment Syndrome ◽  
Clinical Findings ◽  
Acute Compartment Syndrome ◽  
Tissue Ischemia ◽  
Chemical Damage ◽  
Frequent Finding ◽  
Muscle Necrosis

Acute compartment syndrome occurs most frequently in connection with injuries, terminal or chemical damage of tissues, ischemia, the activity of toxins or in patients with tissue ischemia or muscle necrosis. Clinical findings have found pronounced pain, followed by paresthesias, pallor, and paresis. Decreased pulsation of arteries has also been a frequent finding. In severe forms decompressive fasciotomy has been indicated within the first 12–24 hours after diagnosis. In the following paper, the authors present the case report of a 68-year woman who swallowed 1500 mg of trazodone as an attempt at suicide. After 12 hours her husband found her lying on the carpet with compression of the left arm under the trunk. The patient was treated conservatively and followed clinically, examined by ultrasonography, EMG and finally MRI.

The Common as Body Without Organs

2010 ◽  
Vol 4 (supplement) ◽  
pp. 46-63
Author(s):  
Vidar Thorsteinsson
Keyword(s):  
The Body ◽  
Fundamental Importance ◽  
Recent Book ◽  
Social Production ◽  
Deleuze And Guattari ◽  
Political Thinking ◽  
Conceptual Apparatus ◽  
Body Without Organs ◽  
Social Factory ◽  
The Common

The paper explores the relation of Michael Hardt and Antonio Negri's work to that of Deleuze and Guattari. The main focus is on Hardt and Negri's concept of ‘the common’ as developed in their most recent book Commonwealth. It is argued that the common can complement what Nicholas Thoburn terms the ‘minor’ characteristics of Deleuze's political thinking while also surpassing certain limitations posed by Hardt and Negri's own previous emphasis on ‘autonomy-in-production’. With reference to Marx's notion of real subsumption and early workerism's social-factory thesis, the discussion circles around showing how a distinction between capital and the common can provide a basis for what Alberto Toscano calls ‘antagonistic separation’ from capital in a more effective way than can the classical capital–labour distinction. To this end, it is demonstrated how the common might benefit from being understood in light of Deleuze and Guattari's conceptual apparatus, with reference primarily to the ‘body without organs’ of Anti-Oedipus. It is argued that the common as body without organs, now understood as constituting its own ‘social production’ separate from the BwO of capital, can provide a new basis for antagonistic separation from capital. Of fundamental importance is how the common potentially invents a novel regime of qualitative valorisation, distinct from capital's limitation to quantity and scarcity.

Our Bodies, Whose Property?

2013 ◽  
Author(s):  
Anne Phillips
Keyword(s):  
Labor Markets ◽  
Personal Autonomy ◽  
The Body ◽  
Body Parts ◽  
Complex Issue ◽  
Human Organs ◽  
Property Owners ◽  
The Common ◽  
The Difference ◽  
The Right

No one wants to be treated like an object, regarded as an item of property, or put up for sale. Yet many people frame personal autonomy in terms of self-ownership, representing themselves as property owners with the right to do as they wish with their bodies. Others do not use the language of property, but are similarly insistent on the rights of free individuals to decide for themselves whether to engage in commercial transactions for sex, reproduction, or organ sales. Drawing on analyses of rape, surrogacy, and markets in human organs, this book challenges notions of freedom based on ownership of our bodies and argues against the normalization of markets in bodily services and parts. The book explores the risks associated with metaphors of property and the reasons why the commodification of the body remains problematic. The book asks what is wrong with thinking of oneself as the owner of one's body? What is wrong with making our bodies available for rent or sale? What, if anything, is the difference between markets in sex, reproduction, or human body parts, and the other markets we commonly applaud? The book contends that body markets occupy the outer edges of a continuum that is, in some way, a feature of all labor markets. But it also emphasizes that we all have bodies, and considers the implications of this otherwise banal fact for equality. Bodies remind us of shared vulnerability, alerting us to the common experience of living as embodied beings in the same world. Examining the complex issue of body exceptionalism, the book demonstrates that treating the body as property makes human equality harder to comprehend.

Acute Compartment Syndrome of the Thigh in Combat Casualties

2013 ◽  
Vol 22 (01) ◽  
pp. 42-49 ◽  
Author(s):  
Brendan D. Masini ◽  
Adam W. Racusin ◽  
Joseph C. Wenke ◽  
Tad L. Gerlinger ◽  
Joseph R. Hsu
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Combat Casualties

scholarly journals Does the shoe-lace technique aid direct closure of fasciotomy wounds after acute compartment syndrome of the lower leg? a retrospective case-control study

2021 ◽  
pp. 145749692110196
Author(s):  
P. Suomalainen ◽  
T.-K. Pakarinen ◽  
I. Pajamäki ◽  
M. K. Laitinen ◽  
H.-J. Laine ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Lower Leg ◽  
Conventional Technique ◽  
Tibia Fracture ◽  
Acute Compartment Syndrome ◽  
Retrospective Case ◽  
Direct Closure ◽  
Patient Database

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.

Sign in / Sign up

Export Citation Format

Share Document