Compartment syndrome of the hand: A case report and review of literature

Mehta, Varun; Chowdhary, Varun; Lin, Chin-Chu; Jbara, Marlena; Hanna, Shirley

doi:10.1016/j.radcr.2017.11.002

Cited by 12 publications

(7 citation statements)

References 9 publications

(58 reference statements)

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“…ACS commonly occurs in the lower leg and upper limb and represents tissue ischemia that is related to an increase in pressure within a closed compartment [ 10 – 12 ]. It often leads to some tough complications, such as infection, amputation, or muscle necrosis.…”

Section: Discussionmentioning

confidence: 99%

Predictors of muscle necrosis in patients with acute compartment syndrome

Wang

Yang

Guo

et al. 2023

International Orthopaedics (SICOT)

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Purpose The predictors of muscle necrosis after acute compartment syndrome (ACS) remain debated. This study aimed to investigate the predictors for muscle necrosis in ACS patients. Methods We collected data on ACS patients following fractures from January 2010 to November 2022. Patients were divided into the muscle necrosis group (MG) and the non-muscle necrosis group (NG). The demographics, comorbidities, and admission laboratory indicators were computed by univariate analysis, logistic regression analysis, and receiver-operating characteristic (ROC) curve analysis. Results In our study, the rate of MN was 37.6% (83 of 221). Univariate analysis showed that numerous factors were associated with muscle necrosis following ACS. Logistic regression analysis indicated that crush injury ( p = 0.007), neutrophil (NEU, p = 0.001), creatine kinase myocardial band (CKMB, p = 0.047), and prothrombin time (PT, p = 0.031) were risk factors. Additionally, ROC curve analysis identified 11.415 10 9 /L, 116.825 U/L, and 12.51 s as the cut-off values for NEU, CKMB, and PT to predict muscle necrosis, respectively. Furthermore, the combination of NEU, CKMB, and PT had the highest diagnostic accuracy. Conclusions Our findings showed that crush injury and the level of NEU, CKMB, and PT were risk factors for muscle necrosis after ACS. Additionally, we also identified the cut-off values of NEU, CKMB, and PT and found the combination of crush injury, PT, and NEU with the highest diagnostic accuracy, helping us individualize the assessment risk of muscle necrosis to manage early targeted interventions.

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Section: Discussionmentioning

confidence: 99%

Predictors of muscle necrosis in patients with acute compartment syndrome

Wang

Yang

Guo

et al. 2023

International Orthopaedics (SICOT)

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“…Провідним принципом первинного хірургічного лікування тактичного потоку потерпілих із глибокими опіковими ураженнями було застосування щадної прецизійної некректомії з використанням хірургічного операційного мікроскопа та мікрохірургічного інструментарію (18 (35,3%) випадків). Суть прецизійної некректомії полягала у виконанні поетапного, починаючи з тильної поверхні кисті, з поступовим переходом на долоню та пальці шляхом пошарового видалення візуально нежиттєздатних тканин у межах здорових до появи феномену «рясної кров'яної роси» [6]. Проведення оперативного втручання в умовах оптичного збільшення (×7) дозволяло чіткіше візуалізувати демаркаційні лінії та адекватніше оцінити межі парабіотичних чи некротичних вогнищ і за допомогою делікатних хірургічних прийомів провести прецизійне механічне видалення некротичних тканин і очистити рани від дрібних сторонніх тіл.…”

Section: результати дослідження та їх обговоренняunclassified

“…Дискусійними залишаються питання радикальності ранніх хірургічних втручань, обсягу й термінів їх виконання, засобів пластичного закриття ран. Відповідно, ситуація, що склалася в сучасній ком-бустіології з ОТК, потребує подальшого вивчення і вдосконалення діагностичних підходів, а також розроблення ефективної, якісно нової програми диференційованого лікування [6,7].…”

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Approaches to surgical treatment of deep burns of the hand burdened with subfascial hypertension syndrome

Chemerys¹,

Хіміч²,

Savchyn³

2022

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The problem of treatment of subfascial hypertension syndrome in burn injury of the hand remains relevant due to lack of vigilance about its possible development. Purpose - to improve the results of treatment of deep burns of the hand by using the tactics of early surgery. Materials and methods. The clinical material consisted of 195 patients with burn lesions of the hand. The main group consisted of 83 victims, who used the tactics of active early surgery, followed by recovery and reconstruction. The comparison group consisted of 112 patients - in the treatment of which the tactics of gradual necrectomies were used after the formation of demarcation lines with the subsequent healing of wounds with the use of ointment dressings. Results. The data obtained showed that timely diagnosis, which consisted of the right treatment tactics, reduced the number of amputations and prevented the disability of victims with burns. This was achieved through timely and technically correct method of performing open decompression fasciotomies, which managed to reduce the subfascial pressure in each affected case, which prevented critical ischemia of muscle fibers and the development of Folkman’s contracture. It is extremely important to perform open fasciotomies in the syndrome of subfascial hypertension, because only in this way a complete decompression of tissues was achieved, and a timely verified diagnosis ensured a good treatment result. Early active surgical tactics for deep burns became a priority, compared to industry standards, which was expressed in an increase in the number of early surgical interventions (54.2% vs 23.2%; p<0.02), which reduced the proportion of wound infectious complications (4.8% vs 18.2; p<0.01), reduce the number of cicatricial contractures (14.5% vs 50.9%; р<0.02). Conclusions. Timely diagnosis of subfascial hypertension of the hand, active early surgical tactics, the proposed technique of decompression fasciotomies significantly improved the results of treatment, which manifested itself in the restoration of motor function of the hand. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: burns, hand’s burns, subfascial hypertension syndrome, open decompression fasciotomies, wounds.

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“…As was already mentioned, failure of the transmembrane pump systems leads to muscle cell swelling. Then, intracompartmental pressure rises and may provoke additional damage and necrosis which due to anatomical particularities (non-communicating, closed systems) may require a fasciotomy [147][148][149].…”

Section: Compartment Syndromementioning

confidence: 99%

Non-traumatic and non-drug-induced rhabdomyolysis

Kolovou

Cokkinos

Bilianou

et al. 2019

Arch Med Sci Atheroscler Dis

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Rhabdomyolysis (RM), a fortunately rare disease of the striated muscle cells, is a complication of non-traumatic (congenital (glycogen storage disease, discrete mitochondrial myopathies and various muscular dystrophies) or acquired (alcoholic myopathy, systemic diseases, arterial occlusion, viral illness or bacterial sepsis)) and traumatic conditions. Additionally, RM can occur in some individuals under specific circumstances such as toxic substance use and illicit drug abuse. Lipid-lowering drugs in particular are capable of causing RM. This comprehensive review will focus on non-traumatic and nondrug-induced RM. Moreover, the pathology of RM, its clinical manifestation and biochemical effects, and finally its management will be discussed.

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Compartment syndrome of the hand: A case report and review of literature

Cited by 12 publications

References 9 publications

Predictors of muscle necrosis in patients with acute compartment syndrome

Predictors of muscle necrosis in patients with acute compartment syndrome

Approaches to surgical treatment of deep burns of the hand burdened with subfascial hypertension syndrome

Non-traumatic and non-drug-induced rhabdomyolysis

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