The compartment syndrome was described by von Volkmann in 1872 and numerous reports have since been published. The anterior tibial syndrome is well known, but the peroneal compartment syndrome is very rare and have some differences in it's etiology, diagnosis and treatment. We experienced a case of the peroneal compartment syndrome developed after playing foot-ball, and treated by fasciotomy with some delay, but obtained a satisfactory functional result.
Anterior Compartment Syndrome ; Compartment Syndromes ; Diagnosis

Bosworth fracture-dislocation of ankle is very rare, occurred by eversion and external rotation force. It is known as irreducible fracture by closed method. Also, compartment syndrome after ankle fracture are exceedingly rare. There are only a few reported cases of compartment syndrome after ankle fracture and compartment syndrome are involved commonly deep posterior compartment. We present a case in which a patient had a Bosworth fracturedislocation of the ankle underwent open reduction with internal fixation and subsequently occurred an anterior compartment syndrome of the leg.
Ankle Fractures ; Ankle* ; Anterior Compartment Syndrome* ; Compartment Syndromes ; Humans ; Leg

Acute limb compartment syndrome (ALCS) is defined as compound symptoms resulting from poor oxygenation and decreased nutrition supply to muscles and nerves in a tightly confined compartment. The most common cause of ALCS is tibia fracture, followed by blunt trauma to soft tissue. However, non-traumatic causes are rare. We report an iatrogenic, non-traumatic ALCS case after venoarterial extracorporeal membrane oxygen (VA-ECMO) therapy. A 14-year-old male received VA-ECMO therapy due to cardiorespiratory failure after drowning. Although he had no symptoms during therapy, leg swelling appeared 10 hours after ECMO treatment. Two days after the leg swelling, the patient underwent a fasciotomy. Unfortunately, nerve conduction studies and electromyography showed multiple neuropathies in the lower leg. Despite 2 weeks of rehabilitation with electrical stimulation, an exercise program, and physical therapy, there was no definite change in muscle strength. To our knowledge, this is the first reported case of non-traumatic ALCS after VA-ECMO therapy in Korea.
Adolescent ; Anterior Compartment Syndrome ; Compartment Syndromes* ; Drowning ; Electric Stimulation ; Electromyography ; Extracorporeal Membrane Oxygenation* ; Extremities* ; Humans ; Korea ; Leg ; Male ; Membranes ; Muscle Strength ; Muscles ; Neural Conduction ; Oxygen ; Rehabilitation ; Tibia

Compartment Syndromes ; etiology ; Crush Syndrome ; complications ; Fascia ; Hand Injuries ; complications ; Humans ; Infant, Newborn

Acupuncture Points ; Acupuncture Therapy ; Aged ; Anterior Compartment Syndrome ; therapy ; Humans ; Male ; Tibia ; injuries

As a decompression means, the fasciotomy has been of good evaluation in many diseases such as impending V.I.C., ischemic myositis due to CO poisoning, snake bite, burn, anterior tibial compartment syndrome, carpal tunnel syndrome and gas gangrene, etc. From 1966 to 1973, 7 cases of snake bites and 5 cases of the ischemic myositis due to CO poisoning were treated at the Orthopedic Department of Seoul National University Hospital and the results were as follows; 1. All cases of the snake bites had got good results without any complication after the fasciotomy, while the fasciotomy performed in the ischemic myositis due to CO poisoning were not effective. 2. The time elapsed from the snake bite to the fasciotomy had a close relation to the prognosis. 3. In the 4 of 5 cases of the ischemic myositis due to CO poisoning, infections were superimposed on the fasciotomy sites. 4. The inappropriately continuous use of the tourniquet for hours after the snake bites caused worse prognosis.
Burns ; Carpal Tunnel Syndrome ; Compartment Syndromes ; Decompression ; Extremities ; Gas Gangrene ; Myositis ; Orthopedics ; Poisoning ; Prognosis ; Seoul ; Snake Bites ; Tourniquets

OBJECTIVETo explore the Ilizarov mini-invasive distraction technique for the treatment of severer ankle and foot deformities secondary to ischemic contracture of the leg.

METHODSBased on the tension-stress low of Ilizarov, a serial of adjustable three dimensions external distractive instrument was developed in our department. From April 2002 to March 2004, 8 patients with ankle and foot deformities secondary to ischemic contracture of the leg induced by trauma and fracture were treated with the distractive instrument. Of them, 4 patient were male and 4 female, aged from 13 to 31 years with an average of 23 years. Five affected legs were in the left and 3 in the right. Preoperative abnormal style included talipes equines in 6 feet and equinovarus in 2 feet, with extensive scar contracture in the legs. Five patients suffered from failure of soft tissue release before, two patients with severe bony deformity of the feet were underwent limited foot triple osteotomy in this department before the distractive correction. The distraction was begun from 7 d after operation and distractive time from 29 to 60 d with an average 46 d.

RESULTSAll of the 8 patients were followed up from 10 months to 29 months, with an average of 13 months. All of deformities in the feet were corrected satisfactorily, full feet contacted with the ground in stand or walking and achieved with good function. No complication, such as pin tract infection, skin necrosis and neurovascular injury was occurred in this group.

CONCLUSIONSMini-invasive distraction technique for treatment of severe ankle and foot deformity secondary to ischemic contracture of the leg is safe and mini-injury, it is also an effective approach for the treatment of various kinds of rigid foot anomaly.

Adolescent ; Adult ; Anterior Compartment Syndrome ; complications ; Equinus Deformity ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Male ; Treatment Outcome

Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyperpermeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.
Acute Kidney Injury ; Capillaries ; Capillary Leak Syndrome ; Compartment Syndromes ; Kidney Failure, Chronic ; Korea ; Myoglobinuria ; Necrosis ; Paraproteinemias ; Pulmonary Edema ; Renal Dialysis ; Renal Insufficiency, Chronic ; Rhabdomyolysis ; Shock ; Thrombosis

BACKGROUNDOn May 12, 2008, a major earthquake hit Wenchuan County in Sichuan Province of China. The number of cases of crush injury following this event was high. Ultrasonic appearance of rhabdomyolysis (RM) caused by crush injury in the Wenchuan earthquake was observed to evaluate the diagnostic value of ultrasound for detection of rhabdomyolysis.

METHODSWe analyzed clinical and ultrasonic manifestations of 50 cases of RM and 18 cases of RM with osteofascial compartment syndrome (OCS). All cases were caused by crush injury in the Wenchuan earthquake. For these RM patients, we also evaluated the correlations between creatine kinase (CK) and the scope of the muscle lesions as observed by ultrasound.

RESULTSThere were differences in clinical symptoms, physical signs and ultrasonic appearance between the two groups of patients. The ultrasonic characteristics of the RM were as follows: the striated muscle in the lesions thickened with good overall continuity, and the muscle texture was vague; the strength of the echo was uneven and the echo was cloudy or ground glass-like. Liquid dark zones appeared between muscles and were spindle-like or irregular in shape. There were no blood flow signals in the liquid dark areas. The volume of the striated muscle increased in patients with OCS; the fascia wrapping the muscle showed arched protrusions and significant displacement. The flow velocity of the distal arteries decreased and the spectrum was abnormal. The muscle lesion scope of RM group and RM and OCS group was (7.8 +/- 2.0) cm and (13.6 +/- 3.1) cm, respectively. The correlation coefficient (r) between the muscle lesion scope and the CK was 0.681 for the RM group (P < 0.05) and 0.516 for the RM and OCS group (P < 0.05).

CONCLUSIONSThe ultrasonogram of RM has characteristic manifestations and can provide important information for clinical diagnosis and treatment of rhabdomyolysis.

Adolescent ; Adult ; China ; Compartment Syndromes ; diagnostic imaging ; Crush Syndrome ; diagnostic imaging ; Earthquakes ; Female ; Humans ; Male ; Rhabdomyolysis ; diagnostic imaging ; Ultrasonography ; Young Adult

Acute pancreatitis is one of the most common diseases of the pancreas. Although the incidence of acute pancreatitis is increasing, the mortality is decreasing. In general, most of fatal cases occur within 2 weeks after admission due to multi-organ failure. Initial medical treatment of acute pancreatitis is important in order to improve the prognosis of the patients with acute pancreatitis. Essential treatment in this early period includes intravenous hydration, paint control, enteral nutrition, and antimicrobial therapy. Although aggressive intravenous hydration with lactated Ringer's solution can improve mortality rates and decrease the development of systemic inflammatory response syndrome in the patients with acute pancreatitis, fluid overload can induce pulmonary edema, increase of the extra-pancreatic fluid collection, intra-abdominal compartment syndrome, sepsis, and increase of the mortality. Therefore, goal-directed therapy, utilizing various parameters to guide fluid administration, reduces the risk of persistent single or multiple organ system failure, infected pancreatic necrosis or mortality from acute pancreatitis. Initiation of early oral feeding is recommended, beginning within 24 hours for mild acute pancreatitis. Enteral nutritional support is favored over parental nutrition in severe acute pancreatitis. Recent guidelines do not support the use of prophylactic antibiotics to prevent infection in necrotizing acute pancreatitis and severe acute pancreatitis.
Anti-Bacterial Agents ; Compartment Syndromes ; Enteral Nutrition ; Humans ; Incidence ; Mortality ; Necrosis ; Nutritional Support ; Paint ; Pancreas ; Pancreatitis ; Parents ; Prognosis ; Pulmonary Edema ; Sepsis ; Systemic Inflammatory Response Syndrome