Acute compartment syndrome of the thigh in a rugby player.
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ABSTRACT:
SUBMITTER: Smith RD
PROVIDER: S-EPMC4533690 | biostudies-other | 2015 Aug
REPOSITORIES: biostudies-other
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Project description:We reported a rare case of thigh compartment syndrome (TCS) complicated by sciatic nerve palsy, rhabdomyolysis, and acute renal failure in an alcoholic patient. Intensive care measures and immediate posteromedial decompressive fasciotomy were performed. These timely interventions resulted in improvement of the nerve injury and restoration of the kidney function.
| S-EPMC4736529 | biostudies-other
Project description:Compartment syndrome is a medical emergency and must be considered in patients who present with severe limb pain. Compartment syndrome is a clinical diagnosis, classically described as presenting with the 5 'P's (pain, pulselessness, pallor, paraesthesia, and paralysis). Apart from pain, the other findings signify acute arterial obstruction and would be late findings. We present a case of a 31-year-old male in which point of care ultrasound (POCUS) expedited this diagnosis by demonstrating a large thigh hematoma in the anterior compartment. This prompted emergent orthopedic surgery consultation, and the diagnosis of compartment syndrome was confirmed both at the bedside and in the operating room. Compartment syndrome can be a challenging diagnosis, especially early in the course of illness. While POCUS should not be used in isolation in the assessment of possible compartment syndrome, it can be used as an adjunct in the workup, especially if it identifies an underlying cause.
| S-EPMC9979932 | biostudies-literature
Project description:BackgroundAcute compartment syndrome (ACS) is defined as a clinical entity originated from trauma or other conditions, and remains challenging to diagnose and treat effectively. The review was aim to present the controversy in diagnosing, treating ACS. It was found that there was no criterion about the ACS, and result unnecessary osteotomy. The presence of clinical assessment (5P) always means the necrosis of muscles and was the most serious or irreversible stage of ACS. Besides pressure methods, the threshold of pressure identifying ACS was also controversial.MethodsImmediate surgical fasciotomy was important to prevent severe suquelae of the ACS. However, there was still controversy about the right time that fasciotomy should be done to avoid irreversible ischemic changes. The most important thing to treat ACS was comprehension to the true injury mechanism, but a systemic classification about traumatic mechanism in most literature was not clear.ResultsAfter observations to fracture patients with blister, we recommended that surgeons dealing with such emergencies should be vigilant, and the indication for fasciotomy should be strictly controlled following with injury mechanism especially for patients without severe soft tissue injury.ConclusionFor those crushing and soft tissue injuries, the current evidence based strategies for managing patients was useful, but for those fracture related injury, more examination was necessary to avoid overtreatment especially for those patients with blister observed. In facing patients, medical history, injured mechanism should be paid special attention, and rigorous classification about traumatic etiology was the key for the treatment of these patients.
| S-EPMC6635163 | biostudies-literature
Project description:Acute compartment syndrome (ACS) is a syndrome in which local circulation is affected due to increased pressure within the compartment. We previously found in patients with calf fractures, the pressure of fascial compartment could be sharply reduced upon the appearance of tension blisters. Deep fascia, as the important structure for compartment, might play key role in this process. Therefore, the aim of the present study was to examine the differences in gene profile in deep fascia tissue in fracture patients of the calf with or without tension blisters, and to explore the role of fascia in pressure improvement in ACS. Patients with lower leg fracture were enrolled and divided into control group (CON group, n = 10) without tension blister, and tension blister group (TB group, n = 10). Deep fascia tissues were collected and LC-MS/MS label-free quantitative proteomics were performed. Genes involved in fascia structure and fibroblast function were further validated by Western blot. The differentially expressed proteins were found to be mainly enriched in pathways related to protein synthesis and processing, stress fiber assembly, cell-substrate adhesion, leukocyte mediated cytotoxicity, and cellular response to stress. Compared with the CON group, the expression of Peroxidasin homolog (PXDN), which promotes the function of fibroblasts, and Leukocyte differentiation antigen 74 (CD74), which enhances the proliferation of fibroblasts, were significantly upregulated (p all <0.05), while the expression of Matrix metalloproteinase-9 (MMP9), which is involved in collagen hydrolysis, and Neutrophil elastase (ELANE), which is involved in elastin hydrolysis, were significantly reduced in the TB group (p all <0.05), indicating fascia tissue underwent microenvironment reconstruction during ACS. In summary, the ACS accompanied by blisters is associated with the enhanced function and proliferation of fibroblasts and reduced hydrolysis of collagen and elastin. The adaptive alterations in the stiffness and elasticity of the deep fascia might be crucial for pressure release of ACS.
| S-EPMC11216580 | biostudies-literature
Project description:Acute compartment syndrome (ACS) is a disease in which local circulation is affected due to increased pressure within the compartment. We previously found in patients with calf fractures, the pressure of fascial compartment could be sharply reduced upon the appearance of tension blisters. Deep fascia, as the important structure for compartment, might play key role in this process. Therefore, the aim of the present study was to examine the differences in gene profile in deep fascia tissue in fracture patients of the calf with or without tension blisters, and to explore the role of fascia in pressure improvement in ACS. Patients with lower leg fracture were enrolled and divided into without tension blister control group (CON group, n=10), and with tension blister group (TB group, n=10). Deep fascia tissues were collected and LC-MS/MS label-free quantitative proteomics were performed. Genes involved in fascia structure and fibroblast function were further validated by Western blot. The differentially expressed proteins were found to be mainly enriched in pathways related to protein synthesis and processing, stress fiber assembly, cell-substrate adhesion, leukocyte mediated cytotoxicity, and cellular response to stress. Compared with the CON group, the expression of Peroxidasin homolog (PXDN), which promotes the function of fibroblasts, and Leukocyte differentiation antigen 74 (CD74), which enhances the proliferation of fibroblasts, were significantly upregulated, while the expression of Matrix metalloproteinase-9 (MMP9), which is involved in collagen hydrolysis, and Neutrophil elastase (ELANE), which is involved in elastin hydrolysis, were significantly reduced in the TB group (p all <0.05), indicating fascia tissue underwent microenvironment reconstruction during ACS.In summary, the ACS accompanied by blisters is associated with the enhanced function and proliferation of fibroblasts and reduced hydrolysis of collagen and elastin. The adaptive alterations in the stiffness and elasticity of the deep fascia might be crucial for pressure release of ACS.
2024-05-30 | PXD044022 | Pride
Project description:Bald thigh syndrome is a common hair loss disorder in sighthounds. The overall goal of our study was to identify the cause of bald thigh syndrome and the pathological changes associated with it. We approached this aim by comparing skin biopsies and hair shafts of affected and control dogs microscopically as well as by applying high-throughput technologies such as genomics, transcriptomics and proteomics. While the histology is rather unspecific in most cases, trichogram analysis and scanning electron microscopy revealed severe structural abnormalities in hair shafts of affected dogs. This finding is supported by the results of the transcriptomic and proteomic profiling of skin biopsies and hair shafts, respectively, where genes and proteins important for differentiation of the inner root sheath and the assembly of a proper hair shaft were downregulated. Transcriptome profiling of skin biopsies revealed a downregulation of genes encoding 23 hair shaft keratins and 51 keratin associated proteins, as well as desmosomal cadherins and several actors of the BMP signaling pathway, which is important for hair shaft differentiation. To identify differentially expressed proteins in structural abnormal hair shafts, we performed nLC-MS/MS- based proteomic analysis of fractured hair shafts of four dogs with bald thigh syndrome (Greyhounds, n=3, Whippet, n=1) and intact telogen hair shafts of four control dogs (Greyhounds, n=3, Whippet= n=1) plucked on the thighs. Decreased expression of keratin 71 and desmocollin 2 on the mRNA level in skin biopsies corresponded with a reduced protein expression in the hair shafts of affected dogs.
2019-11-13 | PXD012371 | Pride
Project description:Introduction and importanceThe abdominal compartment syndrome (ACS) is defined as new-onset organ failure induced by sustained elevated intra-abdominal pressure (IAP). Surgical decompression to decrease IAP may be performed in addition to supportive therapy.Case presentationA 42-year-old woman with a history of type 2 diabetes, dyslipidemia, alcohol disorder (130 g of daily alcohol intake), and schizophrenia presented to the emergency department with worsening abdominal pain and anorexia for 2 days. On arrival, her Glasgow Coma Scale score was 14 (E3V5M6). Physical examination revealed tachypnea with a respiratory rate of 26 breaths/min; other vital signs were stable. She was diagnosed with severe acute pancreatitis and required massive transfusions to stabilize her hemodynamic status from the time of admission to the intensive care unit (ICU). Acute blood purification was initiated. Bilateral pleural effusions increased from the second day, and despite the evacuation of the intraluminal contents, muscle relaxation was initiated because her IAP had increased to 52 mmHg and remained the same. Therefore, midline fasciotomy was performed instead of a midline incision through the linea alba on day 4, and the patient was managed with negative pressure wound therapy thereafter. Blood purification was completed on day 15, extubation was performed on day 17, and the patient was discharged from the ICU on day 29.Clinical discussion and conclusionMidline fasciotomy can have a decompressive effect in patients with primary ACS. This technique may be an alternative to decompressive laparotomy because of its less invasive nature.
| S-EPMC9289434 | biostudies-literature
Project description:Exertional compartment syndrome of the leg is a condition that can cause chronic debilitating pain in active persons during a variety of aerobic activities. Nonoperative treatments using stretching protocols and activity modifications are often unsuccessful, and thus several operative strategies have been used to treat this condition. A novel technique for endoscopically assisted fasciotomy for chronic exertional compartment syndrome is described. By use of a small laterally based incision and an arthroscope, polydioxanone sutures are passed percutaneously along the anterior and lateral compartments with the Spectrum suture-shuttling device (ConMed Linvatec, Largo, FL). These sutures are used to retract the skin and subcutaneous tissues over the respective compartments. This method allows excellent visualization of the intercompartmental septum, the superficial peroneal nerve, and all perforating vessels. The anterior and lateral compartments can be safely and completely released with this minimally invasive approach. The patient is allowed to return to full activity at 6 weeks postoperatively, because of the decreased soft-tissue disruption.
| S-EPMC3716236 | biostudies-literature
Project description:The emergence of viral respiratory pathogens with pandemic potential, such as severe acute respiratory syndrome coronavirus (SARS-CoV), the pathogenic agent of Covid-19, represent a serious health problem worldwide. Respiratory viral infections are, in general, associated with cytokine production, inflammation, cell death, and other pathophysiological processes, which could be link with a redox imbalance or oxidative stress. These phenomena are substantially increased during aging. Actually, severity and mortality risk of SARS-CoV-2 infection or Covid-19 disease have been associated with the age. The aim of the present work was to contribute with the understanding of the possible link between oxidative stress and the pathogenesis, severity and mortality risk in patients affected by SARS-CoV infection.
| S-EPMC7190501 | biostudies-literature
Project description:Compartment syndrome is a serious condition characterized by compartmental pressures within 20 mmHg of diastolic blood pressure, or clinical signs of pain, paresthesia, pallor, and lack of pulses. Often a surgical intervention is necessary. Increased surveillance for compartment syndrome is important when a patient with a bleeding disorder sustains a traumatic injury.We present a case of forearm compartment syndrome in a patient with mild hemophilia B who sustained an olecranon fracture. The patient received factor replacement and he underwent emergent forearm fasciotomies to avoid muscle necrosis. Over the subsequent week, the patient returned to the operating room 3 times for repeat irrigation and debridements, partial wound closure, open reduction internal fixation of his olecranon fracture and eventual skin grafting of the volar forearm wound.Failure to recognize compartment syndrome in even mild forms of hemophilia may result in loss of function, neurologic deficits, and limb amputations. The management of acute compartment syndrome in patients with hemophilia requires timely recognition, replacement of clotting factors, and emergent fasciotomies.
| S-EPMC5553849 | biostudies-other