Compartment Syndrome Of Hand Research Articles

Etiology of Trauma-Related Acute Compartment Syndrome of the Hand: A Systematic Review.

Hand compartment syndrome is a limb-threatening emergency. Although it is a relatively uncommon condition, early diagnosis, and urgent fasciotomy can prevent irreversible ischemia, myonecrosis, nerve dysfunction, and subsequently permanent loss of hand functions. The occurrence of hand compartment syndrome is relatively infrequent, resulting in a limited amount of literature on its causes. As a result, we conducted a systematic review to provide the most comprehensive data regarding the etiology of traumatic hand compartment syndrome. This systematic review was conducted and reported in light of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We searched among Medline, and EBSCO Database, with no restriction on the dates (last date of the systematic search was done on April 28, 2022). We included all studies containing data regarding traumatic hand compartment syndrome. A total of 29 articles with 129 patients constituted the basis of this review. The etiology of traumatic hand compartment syndrome was classified into three groups: soft tissue injury-related, fracture-related, and vascular injury-related causes. The most common etiology of hand compartment was related to soft tissue injuries which constituted 86.8% of all etiologies, followed by fracture-related (5.4%), then vascular injury-related (1.5%). Further, burns were the most likely injury to lead to hand compartment syndrome which made up 63.4% of soft-tissue injuries, followed by animal bites (8.9%). Hand compartment syndrome can be caused by multiple etiologies that affect people of different ages. Therefore, identifying the most prevalent causes can help in early detection of compartment syndrome by frequent assessment of patients that present with the most prevalent causes like burn among soft tissue injuries and metacarpal bone fracture among fractures.

Favorable Outcome of Hand Compartment Syndrome Secondary to Extravasation of Intravenous Contrast Medium: A Case Report

Favorable Outcome of Hand Compartment Syndrome Secondary to Extravasation of Intravenous Contrast Medium: A Case Report

Hand compartment syndrome secondary to contrast media extravasation: A case report

IntroductionContrast media extravasation injury is a recognized complication of contrast media use. Compartmental syndrome of the hand secondary to contrast extravasation is exceptional. We describe a case of compartment syndrome of the hand secondary to contrast media extravasation.Case presentationWe present a 47-year-old woman with a history of pulmonary embolism who was diagnosed of compartment syndrome of the left hand after injection of contrast medium during a CT scan. Whose first diagnosis was mild contrast medium extravasation injury 24 h before the compartment syndrome. Standard radiography showed an accumulation of contrast medium in the left hand. The patient underwent a fasciotomy and secondary healing. Follow-up showed good radiographic, clinical, and hand function after 2 months.DiscussionThe occurrence of hand compartment syndrome secondary to contrast media extravasation is rare. Most of the time, they are initially diagnosed as medium extravasation before the worsening of symptoms. Because of its unknown incidence, treatment is not codified. The goal of treatment is to save the limb and restore function. This can be achieved rapidly with early surgery because of the unpredictable course.ConclusionContrast media injection is not a harmless gesture. Hand compartment syndrome after contrast extravasation is rare and is a severe injury, our experience with this case suggests that early surgery helps save the limb and restore function. Always fear a compartmental syndrome in case of extravasation of contrast medium.

Bi -Lateral Hand Compartment Syndrome Secondary to Autoimmune Disorder in a Former High School Multi-Sport Athlete

Bi -Lateral Hand Compartment Syndrome Secondary to Autoimmune Disorder in a Former High School Multi-Sport Athlete

543 Acute Carpal Tunnel Syndrome from a Solar Panel Electrical Injury: A Case Report and Literature Review

Abstract Introduction The utilization of solar panels for residential and industrial purposes is increasing. Electrical injury from solar panels has not been well defined. Most of the literature on electrical burns is predominately from alternating current (AC) injuries instead of direct current (DC) as seen in solar panels. The implication of solar panel electrical injury in the pathogenesis of acute carpal tunnel syndrome has yet to be reported. Methods A retrospective chart review of a patient presenting to our burn unit following a solar panel electrical injury was performed. Results The patient was a 46 year old otherwise healthy male who presented after 5–10 seconds of high voltage (~7500V) direct current injury to his right forearm. The patient had deep partial thickness burns to his right hypothenar eminence and a full thickness defect with exposed muscle on his right volar forearm. On admission he had complete function, but within hours developed an inability to move his hand. He was taken for exploration on hospital day 2 because of mildly elevated compartment pressures, pain, and paresthesia. The hypothenar injury was noted to have converted to full thickness injury and a distal right volar forearm fasciotomy and carpal tunnel release was performed. On hospital day 3, the patient’s pain and neurologic examination improved. At 3 month follow-up, the patient had some restored function of his hand, but reduced grip strength, and mild persistent pain and paresthesia in the volar wrist and hand. Conclusions Solar panel injuries are expected to rise. The use of high voltage direct current energy has the potential to cause serious harm and appropriate awareness can lead to thorough management and better outcomes of burn victims. With electrical injuries to the hand, providers should have a low threshold for carpal tunnel syndrome, whose symptoms may be complicated by concomitant compartment syndrome of the hand and/or forearm. Lastly, as with most burn injuries a multidisciplinary approach should be established with focus on long term care. Applicability of Research to Practice We suspect that this new etiology of electrical burn is on the rise as we see more solar panels being utilized. Physician should be familiar with potential complications in this complex patient population.

Impending hand compartment syndrome in an infant: is clinical evaluation enough to perform a fasciotomy?

The purpose of this case report is to raise awareness of the early diagnosis and treatment of compartment syndrome in children. Late diagnosis can lead to irreversible outcomes, including myonecrosis, neurologic injury, functional problems, and even amputation. In this age group, clinical judgment may be enough to proceed with fasciotomy.

Pediyatrik Bir Hastada Elin Akut Kompartman Sendromu: Suçlu Olarak İntravenöz İnfiltrasyon ve Kanül Tespiti

Pediyatrik Bir Hastada Elin Akut Kompartman Sendromu: Suçlu Olarak İntravenöz İnfiltrasyon ve Kanül Tespiti

Capabilities and limitations of antibacterial and complex surgical treatment of inflammation-purulent limb lesion

Purpose of the study. The effectiveness of limb inflammation-purulent lesions (LIPL) treatment on the base of own experience was estimate.Material and methods. 190 patients were treated for LIPL, including:1. Acute LIPL – 142 cases, namely: acute complication of diabetes mellitus (phlegmon, arthrosteopathy, tissue necrosis) was found in 119, acute thrombophlebitis against the background of post-thrombophlebitis syndrome 5, lymphangitis against the background of a chronic limb wound in 5, erysipelas in 4, inflammation after manicure/pedicure at 4, scratching a cat at 3, an injection of fish bone at 3, a bite of a parasite in 2 and a bite of a dog in 2 patients.2. Chronic LIPL was observed in 48 patients who were followed up for 4 months to 13 years. The cause of repeated visits was the formation of a chronic wound/ulcer of the foot or lower leg (35 cases), the re-occurrence of acute inflammation – 13 cases. The background disease was diabetes mellitus in18 post-thrombophlebitis syndrome complicated by lymphostasis in 17, cancer in 7, systemic collagenosis in 4, and HIV infection in 2 patients.Results and discussion. Complicated wound healing occurs in 39,5% cases of surgeries on acute inflammation and in 37% cases in chronic. Among 104 patients with foot surgery antibiotic treatment was ineffective in 48,1%, high amputation incidence estimates 3,8%. After primary high amputation complicated wound healing estimates 21,7%. By combination of aimed and prolonged antibacterial treatment and full-fledged fasciotomy it was possible to ceased anaerobic non gas producing infection and hand compartment-syndrome.Conclusions. 1. In the case of non-effective antibacterial treatment of the LIPL requires reassessment of the pathogen and the appointment of an appropriate antibiotic, while determining the need for surgical intervention.2. Dangerous to patient’s life are anaerobic non gas producing infection, which demands instant clindamycin treatment, and sepsis, which demands clindamycin or/and carbapenem treatment.In-time surgery, fasciotomy or limb amputation in the case of such infections needed beside of this.3. Slow wound cleansing and granulations formation, which lead to prolonged infection and its antibiotic resistance supposed to patient extra examination for revealing concomitant disease and it stabilization.

Clinical Case of Acute Non-Traumatic Hand Compartment Syndrome and Systematic Review for the Upper Extremity.

Background: While trauma to the upper extremity is known to cause acute compartment syndrome (ACS), nontraumatic causes of ACS of the upper extremity are rare. Nontraumatic ACS of the upper extremity can lead to adverse outcomes if not recognized early. There are limited reports of spontaneous ACS published in the literature. The aim of this comprehensive systematic review is to increase awareness among plastic surgeons and hand surgeons of this acute event and provide an algorithmic approach to management in the acute setting through an illustrative case example. Methods: A comprehensive systematic review of published literature was conducted in the Medline/PubMed database with the search terms, "compartment syndrome," "extremity," "spontaneous," "nontraumatic," and "atraumatic" without timeframe limitations. Articles were identified and included in this review based on ACS localization in the upper extremity and etiology of nontraumatic, spontaneous origin. Results: Sixteen publications and 19 total cases of nontraumatic ACS of the upper extremity from 1993 to 2016 met our search criteria. A bleeding disorder was the etiology in three cases, systemic anticoagulation in three cases, infection in six cases, and unknown in three cases. The remaining four cases included systemic sclerosis, Ehlers-Danlos syndrome, rhabdomyolysis, and McArdle disease. Conclusions: Nontraumatic causes of ACS of the upper extremity include infection, anticoagulation therapy, and bleeding disorders. Even though trauma is the most common cause of ACS, clinicians should be aware of these other potential causes of ACS in the nontraumatic setting. Appropriate medical and surgical intervention should be done to avoid potential adverse outcomes.

Compartment Syndrome of the Hand after Laparoscopic Gynecologic Surgery

Acute compartment syndrome of the hand is a potentially devastating and infrequent condition observed after trauma, arterial injury, or prolonged compression of the upper limb. We present the case of a patient diagnosed with compartment syndrome of the hand after laparoscopic surgery for epithelial ovarian cancer. The patient is a 42-year-old woman with incidental finding of high-grade ovarian serous carcinoma after an emergency surgery. On imaging evaluation, the patient was found to have evidence of residual retroperitoneal adenopathy and was taken to the operating room for a staging procedure by laparoscopy. In the immediate postoperative period, she developed compartment syndrome of the right hand that required multiple fasciotomies and multidisciplinary management by plastic surgery, orthopedics, and rehabilitation medicine. The patient was discharged from the hospital 7 days after laparoscopic surgery to undergo rehabilitation. Three months after surgery, she is continuing to recover, with near complete recovery of hand function. The patient has completed a total of 3 cycles of chemotherapy with carboplatin/paclitaxel. Compartment syndrome of the hand is an uncommon event, but it can generate major functional deficits and even death if it is not diagnosed and treated in a timely manner. Strict criteria for patient positioning in laparoscopy surgery may avoid or reduce this complication. To date, this is the first case reporting such complications associated with laparoscopic gynecologic surgery.

Compartment Syndrome of the Hand: A Little Thought about Diagnosis.

Compartment syndrome of the forearm is a well described entity but there have been relatively few case reports in the emergency medicine literature of hand compartment syndromes (HCS). Prompt recognition and treatment of this potential limb threat are essential to minimize morbidity and mortality. Presented is a case of a documented hand compartment syndrome following a motor vehicle collision.

Profile of Hand Compartment Syndrome in Dr. Hasan Sadikin General Hospital, West Java, 2008−2012

Background : Compartment syndrome is a serious disorder caused by elevated pressure in a muscle compartment that can progress to muscle and nerve damage. This disorder can happen to anyone but more frequently in young adults. The occurrence frequency of hand compartment syndrome is relatively low. The aim of this study is to identify the profile of compartment syndrome in patients hand Methods : A descriptive study was perfomed to 15 cases that were collected from medical records from 2008-2012, in Dr. Hasan Sadikin General Hospital. The profile of the case consisted of age, sex, symptoms and signs, etiology, facsiotomy schedule after admission, length of stay and patient’s outcome. The collected data were presented using tables. Results : The study showed that 12 out of 15 cases were males and 7 out of 15 cases were 20−39 years old patients. The common clinical findings were swelling, pain, limited range of motion and normal sensibility. The faciotomy procedure was conducted 1 day after the admission with length of stay more than 1 week. The patients condition were improved after operation. Conclusions: Hand compartment syndrome is a rare case, mostly affects younger adults and male. Most of the symptoms and signs are swelling, limitation of movement, pain in the location area with normal sensibility. The faciotomy procedure is conducted 1 day after admission. The length of stay is more than 1 week with an improved outcome. [ AMJ .2015;2(4):497–501] DOI: 10.15850/amj.v2n4.634

Vascular Conditions of the Hand

Treating vascular conditions of the hand requires a thorough understanding of the vascular anatomy of the hand and upper extremity. Treatment options include both operative and nonoperative modalities, and may involve a multidisciplinary team including vascular surgeons, hand surgeons, interventional radiologists, medical internists, and hand therapists. This review discusses the vascular anatomy, patient evaluation, and treatment of vascular conditions of the hand. Figures show the large blood vessels of the arm, locations of the bifurcation of the radial and ulnar arteries, the vascular branches of the arm, the vascular anatomy of the hand and wrist, the location of the superficial palmar arch, upper extremity angiography, the clinical appearance and venograms of phlegmasia cerulean dolens, a high-flow arteriovenous malformation involving the right long finger, images of a patient who experienced blunt trauma to his distal palm from a wood splinter, a 28-year-old male who developed forearm compartment syndrome, volar and dorsal appearance of the left hand of a 56-year-old male with Raynaud phenomenon secondary to scleroderma, and intraoperative images of a patient who underwent digital palmar sympathectomies. A video shows a periarterial digital sympathectomy. Tables list the distinction between Raynaud disease and Raynaud phenomenon, comparison of investigational modalities of vascular conditions, interpretation of segmental arterial pressures, Wake Forest classification of vasospastic and vaso-occlusive disease, and Jones classification of vein bypass graft configurations in upper extremity vascular reconstruction. This review contains 12 figures, 1 video, 5 tables, and 66 references.

Copperhead Envenomation Resulting in a Rare Case of Hand Compartment Syndrome and Subsequent Fasciotomy

Summary:Copperhead bites account for nearly 40% of all snakebites in the United States. Although common, these bites are rarely severe, and most are treated with supportive care and antivenom. We describe the first reported case of a copperhead envenomation resulting in a hand compartment syndrome with measured elevated compartment pressures that necessitated fasciotomy of the hand. Our case underscores the importance of vigilance in the diagnosis and management of copperhead envenomation.

Factors associated with unplanned reoperation in perilunate dislocations and fracture dislocations.

Background Perilunate injuries are complex and uncommon injuries that are typically the result of a high-energy injury and are nearly always treated operatively. Little is known about factors associated with unplanned reoperations after surgery for perilunate injuries. Purpose To assess the rate and types of unplanned reoperation after operative treatment of a perilunate dislocation. Patients and Methods We reviewed 115 patients of all ages with unplanned reoperations after operative treatment of perilunate injuries at five hospitals. Planned removal of implants were not considered as unplanned reoperations. Results Sixteen patients had an unplanned reoperation, including four for compartment syndrome (three hand, one forearm); three for deep infection; three for malalignment or an errant screw; two for early salvage procedures; and four for other reasons. We considered seven unplanned reoperations necessary (forearm compartment syndrome, infection, loss of alignment, errant screw) and nine debatable or unnecessary (hand compartment syndrome, early salvage procedures, suspected malunion, etc.). Patients who had an unplanned reoperation were younger (median age 24 versus 34 years; p = 0.0034); had earlier surgery (median days to surgery 0 versus 3; p = 0.0068); and were more likely injured in a motor vehicle collision (50% versus 17%; p = 0.0070). Accounting for interaction among the variables using multivariable analysis, the factors independently associated with unplanned reoperation were young age (odds ratio 0.92) and motor vehicle collision accidents (odds ratio 4.1). Conclusion We conclude that higher-energy injuries may be at greater risk for unplanned reoperation, but more than half of the unplanned reoperations were for debatable indications. Level III Retrospective Cohort Review.

Radial artery pseudoaneurysm as an extremely rare complication associated with transradial catheterisation

The transradial approach has recently been recommended as the first choice of arterial access to reduce vascular complications during percutaneous coronary diagnostic and interventional procedures. Radial artery pseudoaneurysm is an extremely rare complication associated with transradial access. We report such a case in an 85 year-old woman with a diagnosis of coronary artery syndrome who underwent cardiac catheterisation via the transradial approach. An 85 year-old woman with a history of hypertension and recurring chest pain, slightly elevated level of troponin I (0.9 [n: < 0.1] ng/mL), left bundle branch block and atrial fibrillation on ECG tracing (duration unknown) was referred to our department with a diagnosis of acute cardiac syndrome. Before admission, she was treated with acetylosalicic acid, perindopril, bisoprolol and indapamide. Echocardiography showed a slightly enlarged left ventricle with decreased ejection fraction (45%), moderate mitral regurgitation and slightly enlarged left atrium. Coronary angiography performed via the left radial artery using a 6 F catheter sheath and 5 F diagnostic catheters revealed non-significant atherosclerosis in coronary arteries. As per convention, a 5,000 IU heparin bolus was administered though the sheath. The arterial sheath was withdrawn just after the procedure and a compressive dressing was applied for 2 h. The next morning, enoxaparin was administered because of sustained atrial fibrillation (AF) with a CHA2DS2-VASc score of 4. Two days after the radial artery puncture, a painful swelling with a small haematoma was noted at the site of radial access. Colour Doppler ultrasonography (USG) revealed a pseudoaneurysm (Fig. 1A) with a typical to-and-fro flow in its neck (Fig. 1B). Enoxaparin was stopped and prolonged compression was applied for the next 24 h, but only partial thrombosis with continued flow through the neck was seen on follow-up USG (Fig. 2). After obtaining verbal informed consent, the patient underwent ultrasound-guided compression therapy for 25 min at the neck of the pseudoaneurysm, successfully obtaining complete thrombosis (Fig. 3). The sinus rhythm was restored spontaneously, but short episodes of AF were recorded on 24-h ECG monitoring. After confirmation 2 weeks later of complete resolution of the radial artery pseudo aneurysm and normal blood flow in the radial artery, oral anticoagulation was recommended. Although uncommon, radial-related vascular complications are possible and may not be trivial. Early confirmation and treatment of a radial artery pseudoaneurysm using USG is essential to avoid further complications such as hand ischaemia, compartment syndrome, neurologic complications and spontaneous rupture.

The upper hand on compartment syndrome

Metacarpal fractures are common injuries, accounting for approximately 30% to 40% of all hand fractures and with a lifetime incidence of 2.5%. Traditionally regarded as an innocuous injury, metacarpal fractures tend to be associated with successful outcomes after closed reduction and immobilization. Hand compartment syndrome (HCS) is a rare clinical entity with potential devastating consequences in terms of loss of function and quality-of-life outcomes. We discuss the case of a 44-year-old woman presenting with multiple closed metacarpal fractures as a result of low-energy trauma, complicated by acute HCS. We review the presentation, clinical assessment, and optimal surgical management of acute HCS with reference to international literature.

Compartment syndrome of forearm and hand as complication of prone position during neurosurgery operation

We present a case of compartment syndrome (CS) after neurosurgical operation where patient was 6 hours in prone position with forearm and hand beneath his chest. Clinical signs were confirmed with measuring of intra-compartmal pressure (ICP), and fasciotomy of forearm and hand were performed. After 3 months of rehabilitation all movements and strength in hand and fingers were come back. CS is a rare complication, but if unrecognized and untreated it can seriously damage extremities. Measuring of ICP is a simple and reliable diagnostic procedure in unclear cases and prompt fasciotomy is a salvage procedure with good results.

Acute paediatric compartment syndrome of the hand caused by hereditary angiooedema

Compartment syndrome of the leg and forearm are well described in the literature. However, compartment syndrome of the hand is rare and in children it is even rarer. Atraumatic hand compartment syndrome has not to our knowledge been previously reported. We describe a case of an atraumatic compartment syndrome of the hand in a child who underwent an urgent fasciotomy. The child was diagnosed with hereditary angiooedema. We highlight a rare but serious complication of a hereditary disease not commonly seen by the surgical community. We hope that this report raises the awareness of this condition, thereby reducing delays in reaching a prompt diagnosis.

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.