– Disscussion: – compartment syndrome is uncommon in thigh because of large-volume that the thigh requires to cause a pathological increase in interstitial pressure; – fascial compartments of thigh blend anatomically w/ muscles of hip,potentially allowing extravasation of blood outside compartment; – compartment syndrome may be caused by a decrease … Read more
– See: Fasciotomy of the Leg – Discussion: – general discussion of compartment syndrome – compartment syndrome following tibia fractures are most common in closed frx (upto 20% of frx) but may also occur following open frx; – references: – Outcome at 12 to 22 years of 1502 tibial shaft fractures – Compartment syndrome in … Read more
– Discussion: – comminuted frx of fibula tend to result from high energy injures resulting from direct lateral trauma or vertical loading; – associated injuries include: – impaction frx of lateral tibial plafond; – metaphysis of tibia (Pilon frx); … Read more
– Discussion: – pathophysiology: – compartment syndrome is elevation of interstitial pressure in closed fascial compartment that results in microvascular compromise; – as duration & magnitude of interstitial pressure increase, myoneural function is impaired & necrosis of soft tissues eventually develops; – intracompartmental pressure: … Read more
– Discussion: – many surgeon use 30 mm Hg as the cut off for performing fasciotomy; – diastolic pressure: (Whiteside’ Theory): – development of a compartment syndrome depends not only on intra-compartment pressure but also depends on systemic blood pressure; – DBP – CP should be greater than 30 – references: – Diastolic … Read more
– Discussion: – compartment syndromes can occur in the foot as in other parts of body; – mechanism of injury is severe local trauma, & assoc skeletal injury may be minimal; – classic symptoms & signs are progressive pain, numbness in toes, and decreased motion, however, these are the same symptoms … Read more
– Discussion: – see: Winquist Classification – sign of high energy trauma: more blood loss, systemic complications, and fat embolism syndrome; – all cortical contact is lost; – simple cloverleaf nails are contraindicated w/ type III and IV comminuted frxs because of risk of shortening of frx about nail; – small diameter nails fail to … Read more
– See Clostridium Dificile – Tetanus Prone Wounds – (see tetanus prophylaxis) – greater than 8-24 hrs from injury to treatment – barnyard contamination (bite wounds are considered moderate risk); – devitalized tissue; – Clostridium perfringes: – is a non-motile gram positive, anaerobic bacillus without … Read more
– Discussion: – performed as soon a possible ( < 8-12 hrs) – either in OR under GEA (optimal) or in ER w/ sedation if delays are expected; – reduction may be performed w/ flouro, but orthopaedist may find that flouro interferes w/ hip flexion, which frequently is essential to … Read more
– See: Infections of the Hand / Human Bite Wounds – Discussion: – MP joint and the adjacent tissues and spaces are most commonly involved because teeth of the opponent are struck with knuckle of the clenched fist; – when the hand is unclenched, the skin wound retracts proximally … Read more