1/44. The abdominal compartment syndrome: a report of 3 cases including instance of endocrine induction.Three patients with the abdominal compartment syndrome are presented and discussed. In one of the patients the condition was induced in an endocrine fashion, since trauma was sustained exclusively by the middle third of the left leg. The development of the syndrome as a remote effect of local trauma has never been reported previously. In all three instances only insignificant amounts of intraperitoneal fluid was found and the increase in abdominal pressure was due to severe edema of the mesentery and retroperitoneum. Since the condition is highly lethal, early diagnosis is imperative, and this starts by carrying a high index of suspicion. Measurement of the intraperitoneal pressure easily confirms this diagnosis. It is emphasized that measurements at various sites, like bladder and stomach, in each patient is essential to confirm the diagnosis, since one of the sites may be rendered unreliable due to intraperitoneal processes impinging on the affected site and affecting its distensibility.- - - - - - - - - - ranking = 1keywords = compartment syndrome, compartment (Clic here for more details about this article) |
2/44. Acute compartment syndrome complicating a distal tibial physeal fracture in a neonate.This case report of a neonate who developed an acute compartment syndrome secondary to a minimally displaced distal tibial physeal injury represents the youngest patient to be reported with such a condition. After undergoing emergency four-compartment decompression fasciotomies, the 4-week-old child had a return of normal neuromuscular function and anatomic remodeling of the fracture. It is difficult to diagnose compartment syndrome in a neonate. The patient can neither give a history, nor follow commands to cooperate with the exam. The physician must rely primarily on the physical examination; however, the quantitative measurement of intracompartmental pressure can corroborate the diagnosis of compartment syndrome. We have found using a monometer to measure intracompartmental pressure to be helpful in conjunction with a physical exam when evaluating a neonate suspected of having a compartment syndrome.- - - - - - - - - - ranking = 1.7258080678954keywords = compartment syndrome, compartment (Clic here for more details about this article) |
3/44. Isolated tibial shaft fracture.A nineteen-year-old otherwise healthy woman is seen in the emergency room after being struck by a car. The patient reports left lower extremity pain and has no other injuries. Exam shows a Tscherne grade I soft tissue injury with otherwise normal motor and sensory exam. There are no signs of compartment syndrome. A closed reduction was performed.- - - - - - - - - - ranking = 0.2keywords = compartment syndrome, compartment (Clic here for more details about this article) |
4/44. Ectopic calcification following tibial fracture: property analysis.We present a patient whose ectopic calcification following deep posterior compartment syndrome was studied by electron microscopy, chemical analyses, and x-ray diffraction. The patient complained of a toe flexion deformity following a tibial fracture which he sustained 18 years earlier. Damage to the peroneal artery was demonstrated by magnetic resonance angiography, suggesting that the patient had had deep posterior compartment syndrome in the past. A large radiopaque mass, identified in the flexor hallucis longus muscle by radiographs and computed tomography, was resected, resulting in a dramatic improvement of the toe deformity. The resected material was analyzed in detail. It included no osseous tissue, and was not birefringent under a polarizing microscope, being compatible with ectopic calcification rather than ossification. On electron microscopy the material was found to be an assembly of tiny rods. Chemical and x-ray diffraction analyses suggested a carbonate-containing apatite as the most probable substance.- - - - - - - - - - ranking = 0.4keywords = compartment syndrome, compartment (Clic here for more details about this article) |
5/44. Compartment syndrome of the calf and foot following a displaced Salter-Harris type II fracture of the distal tibia: a review of the literature and a case report.A 14 year-old boy with an epiphyseal fracture of the distal right tibia and fibula developed compartment syndrome of the calf and foot. The diagnosis of compartment syndrome was delayed and a fasciotomy resulted in uncontrolled infection, which ultimately resulted in an above knee amputation. Constant vigilance is necessary in uncooperative or non-complaining patients to detect the signs and symptoms of compartment syndrome, even where the injury is not often associated with this complication. The difficulties in management, following a fasciotomy for delayed diagnosis of compartment syndrome, are discussed.- - - - - - - - - - ranking = 0.8keywords = compartment syndrome, compartment (Clic here for more details about this article) |
6/44. Compartment syndrome without pain!We report the case of a young male patient who underwent intra-medullary nailing for a closed, displaced mid-shaft fracture of tibia and fibula. He was commenced on patient controlled analgesia post-operatively. A diagnosis of compartment syndrome in the patient's leg was delayed because he did not exhibit a pain response. This ultimately resulted in a below-knee amputation of the patient's leg. We caution against the use of patient controlled analgesia in any traumatised limb distal to the hip or the shoulder.- - - - - - - - - - ranking = 0.2keywords = compartment syndrome, compartment (Clic here for more details about this article) |
7/44. Cavus deformity of the foot after fracture of the tibial shaft.Twenty-three cases of claw foot with limited talocrural and subtalar mobility were the result of muscle contracture of the leg after tibial-shaft fracture. A roentgenographic study including arteriography was performed. It was concluded that the typical short cavus foot is due to fibrous contracture of the muscles in the deep posterior compartment caused by vascular damage, swelling in the deep posterior compartment, or severe muscle laceration. On physical examination the distance between the lateral malleolus and the achilles tendon was shortened in comparison with the sound side in all cases. This was found to be caused by dorsiflexion in the talocrural joint coincident with adduction in the mid-tarsal joint. The angulation of the foot forced the patients to rotate the leg outward in order to get the feet in parallel position for walking. This deformity could be misinterpreted as an inward malrotation of the tibial fracture. In severe cases a derotating three-dimensional wedge osteotomy of the distal part of the tibia was performed with promising results.- - - - - - - - - - ranking = 0.083872045263623keywords = compartment (Clic here for more details about this article) |
8/44. Occult bilateral acetabular fractures associated with high-energy trauma and osteoporosis.Acetabular fractures that are radiographically occult are associated with osteoporosis, low-energy trauma, and advanced age. We present a case of bilateral occult acetabular fractures in a 65-year-old woman who presented with an open tibia-fibula fracture and compartment syndrome and thoracolumbar spine fractures sustained in a motor vehicle accident. Initial radiographs of the pelvis and a pelvic CT scan did not show any bony injuries when the films were reviewed prospectively. At 6 weeks after injury, a CT scan and plain radiographs showed bilateral healing transverse acetabular fractures with acetabular protrusio on the left. At most recent follow-up, the patient had posttraumatic hip arthritis with moderate protrusio on the left and was ambulating with a cane. Total hip arthroplasty is anticipated in the future.- - - - - - - - - - ranking = 0.2keywords = compartment syndrome, compartment (Clic here for more details about this article) |
9/44. Unimuscular neuromuscular insult of the leg in partial anterior compartment syndrome in a patient with combined fractures.A complicated case of ipsilateral fractures of the left femur and tibia after a road traffic accident is reported. The patient presented with numbness of the first web of his left foot and contracture of the extensor hallucis longus muscle, with fixed length deformity after intramedullary nailing of the femur and tibia. The extensor digitorum longus and tibialis anterior muscles were spared. Tinel's sign could be elicited at the mid-portion of the anterior compartment of the injured leg. This indicated that the distal half of the anterior tibial nerve (deep peroneal nerve), together with the extensor hallucis muscle of the anterior compartment of the leg, had been damaged. The subsequent management of this patient is described.- - - - - - - - - - ranking = 16.412600076412keywords = anterior compartment, compartment syndrome, compartment (Clic here for more details about this article) |
10/44. False aneurysm of the anterior tibial artery in lower leg fractures treated with the Ilizarov external fixator. Case report.A case of open segmental fracture of the right lower leg treated with an Ilizarov external fixator in emergency surgery is presented. Approximately two months after operation, swelling in the anterior compartment of the tibia and repeated episodes of bleeding from one of the Kirschner wire holes led the authors to perform an angiography, which revealed the presence of a false aneurysm of the anterior tibial artery. The intraoperative finding of a double lesion in the anterior tibial artery confirmed the iatrogenous nature of the injury.- - - - - - - - - - ranking = 2.6300573611565keywords = anterior compartment, compartment (Clic here for more details about this article) |
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