Acute Compartment Syndrome Of Forearm Research Articles

Early diagnosis and treatment of acute impending compartment syndrome of forearm

Early diagnosis and treatment of acute impending compartment syndrome of forearm

Early-stage reconstruction of flexor pollicis longus using palmaris longus in a patient with compartment syndrome of forearm: a case report

BackgroundThe flexor pollicis longus is the most vulnerable muscle in acute compartment syndrome of the forearm. Reconstruction of a dysfunctional flexor pollicis longus is occasionally necessary following compartment syndrome of the forearm.Case presentationA 42-year-old Japanese man injured his left forearm in a motor vehicle accident. Open radial shaft fracture and acute compartment syndrome of the left forearm was diagnosed. We performed a fascial release of the forearm and debridement of the involved myonecrosis of the flexor pollicis longus. At second-look operation (3 days after the initial release), we performed palmaris longus tendon transfer to the flexor pollicis longus tendon. At 6-month follow-up, the patient had no complaints and returned to his job. At 2-year follow-up, the patient had achieved 88% of pinch strength, compared with the contralateral hand, and scored 11.4 on the QuickDASH score.ConclusionsPalmaris longus transfer performed immediately after injury is simple and does not require an additional surgical approach. Hence, early palmaris longus tendon transfer, which can provide satisfactory outcomes, could be considered as a potential choice for flexor pollicis longus reconstruction in patients with compartment syndrome of the forearm.

Acute compartment syndrome of forearm without facture in a toddler

Acute compartment syndrome is an orthopedic emergency. In pediatric population, there should be a high index of suspicion for its early detection, especially when it is not associated with a fracture. We present here a case of a toddler, who developed acute compartment syndrome of forearm following a trivial trauma without fracture. Pain out of proportion and increased analgesic requirement are fairly reliable signs and should raise the suspicion of compartment syndrome for the treating surgeon. Despite various methods being available for measurement of intracompartment pressure, the diagnosis largely remains clinical. Ability to actively contract the muscle in the presence of elevated compartment pressure is an indicator of the viability of muscle. The case has been presented to sensitize the young surgeons regarding the possibility of compartment syndrome following simple fall without fracture. The clinical condition was timely diagnosed, and immediate surgical decompression resulted in good functional recovery.

Acute compartment syndrome of forearm in a haemophiliac patient

Introduction: Haemophilia A and B are X-linked bleedingdisorders included among the rare diseases and causedby mutations in the factor VIII (FVIII) and factor IX(FIX) genes. Acute compartment syndrome (ACS) of the limb refersto a constellation of symptoms, which occur following a risein the pressure inside a limb muscle compartment. Here we are reporting a rare case of Haemophilia A patient presenting with Acute compartment syndrome and the sequential steps in the management which include emergency fasciotomy, debridement and flap cover.Conclusion: Haemophilia presenting as ACS is rare and a high index of suspicion is needed to diagnose it. The results are favourable when the diagnosis is made early.

Acute compartment syndrome of the forearm as a rare complication of toxic epidermal necrolysis: a case report

IntroductionToxic epidermal necrolysis lies within the spectrum of severe cutaneous adverse reactions induced by drugs, affecting skin and mucous membranes. Toxic epidermal necrolysis is considered a medical emergency as it is considered to be potentially fatal and carries a high mortality rate. To the best of our knowledge the association of toxic epidermal necrolysis and compartment syndrome has been rarely mentioned in the literature. In this case we treated the compartment syndrome promptly despite the poor general condition and skin status of our patient. Despite the poor skin condition, wound healing was uneventful with no complications.Case presentationA 62-year-old Caucasian man with a generalized macular-vesicular rash involving 90% of his body surface area and mucous membranes, as well as impaired renal and hepatic functions following ingestion of allopurinol for treatment of gout, was admitted to our hospital. Skin biopsies were taken and he was started on a steroid infusion. Within hours of admission, he developed acute compartment syndrome of the dominant forearm and hand.ConclusionsDespite its rare incidence, toxic epidermal necrolysis is a condition with a high incidence of complications and mortality. Patients with severe conditions affecting a large degree of the skin surface area should be treated as promptly and effectively as patients with burns, with close monitoring and the anticipation that rare musculoskeletal complications might arise. The association of compartment syndrome and toxic epidermal necrolysis might lead to a rapid deterioration and fatal systemic involvement and multiple organ failures.

Acute compartment syndrome of forearm and hand

The diagnosis and treatment of the acute compartment syndrome is of paramount importance. Unless the viscious cycle is intervened at an appropriately early time it will result in irreversible damage leading to disability. In this review article we are discussing the basic pathophysiological process through which the various aetiological factors causing increased compartmental pressure lead to the progressive death of muscles and nerves. We also discuss the various clinical features that aid in the diagnosis and the role of intracompartmental pressure measurements. Finally we hope to ascertain the basic principles and the surgical techniques for treating this condition effectively.

Forearm Compartment Syndrome following Thrombolytic Therapy for Massive Pulmonary Embolism: A Case Report and Review of Literature

Use of thrombolytic therapy in pulmonary embolism is restricted in cases of massive embolism. It achieves faster lysis of the thrombus than the conventional heparin therapy thus reducing the morbidity and mortality associated with PE. The compartment syndrome is a well-documented, potentially lethal complication of thrombolytic therapy and known to occur in the limbs involved for vascular lines or venepunctures. The compartment syndrome in a conscious and well-oriented patient is mainly diagnosed on clinical ground with its classical signs and symptoms like disproportionate pain, tense swollen limb and pain on passive stretch. However these findings may not be appropriately assessed in an unconscious patient and therefore the clinicians should have high index of suspicion in a patient with an acutely swollen tense limb. In such scenarios a prompt orthopaedic opinion should be considered. In this report, we present a case of acute compartment syndrome of the right forearm in a 78 years old male patient following repeated attempts to secure an arterial line for initiating the thrombolytic therapy for the management of massive pulmonary embolism. The patient underwent urgent surgical decompression of the forearm compartments and thus managed to save his limb.

Acute compartment syndrome of the dorsal forearm following noncontact injury

Acute compartment syndrome is a limb-threatening condition in which early diagnosis and surgical consultation for fasciotomy are required to preserve functional outcome. The diagnosis is typically considered in patients with traumatic mechanisms of injury such as a direct blow and crush to the compartment, particularly when there is a fracture in the same compartment. We report the case of a patient with acute compartment syndrome of the dorsal forearm that occurred as a result of an atypical noncontact traumatic mechanism. Establishing the diagnosis of compartment syndrome was complicated in this patient, as some of the signs and symptoms of acute compartment syndrome could have been attributed to the presence of a coexisting rupture of the extensor digitorum muscle. This report serves to remind emergency physicians that, although rare, acute compartment syndrome can result from exertional and noncontact traumatic mechanisms.

Acute compartment syndrome of the forearm following manipulation under anaesthesia for atypical wrist injury

Acute compartment syndrome of the forearm may arise from various causes. The aetiology, diagnosis and treatment have been the subject of several reviews. However, isolated wrist injury leading to acute compartment syndrome is rare. We report an unusual combination of bony and soft tissue trauma to the wrist leading to acute compartment syndrome in a young male. A combination of a high index of suspicion and prompt intervention was used to prevent the devastating sequel that could have arisen from this condition.

Acute Compartment Syndrome Of The Upper Arm

Acute compartment syndrome of lower limb and forearm is quite well-known pathology. However its occurrence in upper arm is very rare and only a few cases have been described in medical literature. We want to share our experience of managing this condition especially in semiconcious or obtunded patient after heavy binge drinking. High suspicion should be considered due to reduced response to pain because of impaired conscious level.

Acute compartment syndrome after transradial coronary angioplasty

In the May 15, 1998 issue of Int. J. Cardiol., HildickThe injured radial artery was repaired. She was discharged 1 Smith et al. [1] demonstrated the high success rate of coronary angiography from the radial artery. Transradial cardiac catheterization is widely accepted now. The nearly absence of local vascular complication is one of its characteristics. The use of enoxaparin in patients with acute coronary syndrome became more and more popular. In the August 2001 issue of Int. J. Cardiol., Collet et al. [2] suggested that the dosage of subcutaneous low molecular weight heparin enoxaparin should be reduced in patients with severe renal failure. We reported a case of acute compartment syndrome within 24 h after transradial coronary intervention. Enoxaparin was prescribed in this patient. This 84-year-old female patient had hypertension and diabetes mellitus for 20 years. She was admitted for acute non-ST elevation myocardial infarction on March 24, 2002. Balloon angioplasty was performed smoothly by right radial artery approach on March 28, 2002. The arterial sheath was removed immediately after angioplasty. The puncture site was compressed by the hemostasis device SteptyP (Nichiban) for 6 h and plastic bandage till the next morning. We gave 60 mg enoxaparin every 12 h after angioplasty. Her body weight was only 45 kg. However, local swelling and hematoma at puncture site developed abruptly the next morning. Patient complained of right forearm pain. Even under the direct manual compression and administration of fresh frozen plasma, it progressed and extended to the elbow. Hypotension developed later. Under the diagnosis of radial artery bleeding with acute compartment syndrome of right forearm, she received fasciotomy. The operative finding confirmed the diagnosis.

Acute compartment syndrome. Who is at risk?

We have analysed associated factors in 164 patients with acute compartment syndrome whom we treated over an eight-year period. In 69% there was an associated fracture, about half of which were of the tibial shaft. Most patients were men, usually under 35 years of age. Acute compartment syndrome of the forearm, with associated fracture of the distal end of the radius, was again seen most commonly in young men. Injury to soft tissues, without fracture, was the second most common cause of the syndrome and one-tenth of the patients had a bleeding disorder or were taking anticoagulant drugs. We found that young patients, especially men, were at risk of acute compartment syndrome after injury. When treating such injured patients, the diagnosis should be made early, utilising measurements of tissue pressure.