MyMedR

Dengue fever with compartment syndrome of the right arm

Khoo C, Chu G, Rosaida MS, Chidambaram SK

J R Coll Physicians Edinb, 2016 Dec;46(4):241-243.

PMID: 28504777 DOI: 10.4997/JRCPE.2016.406

A 44-year-old woman was admitted to our hospital with dengue fever. She developed a haematoma in the right arm at the site of a previous arterial line insertion. Due to coexisting thrombocytopenia, the bleeding was severe enough to cause compartment syndrome. An emergency fasciotomy was performed and her limb salvaged. The case illustrates one important potential complication of this common infectious disease.

Matched MeSH terms: Compartment Syndromes/complications*; Compartment Syndromes/surgery

Fulltext Compartment syndrome of the foot in a child

Sharma AK, Sharaf I, Ajay S

Med J Malaysia, 2001 Jun;56 Suppl C:70-2.

PMID: 11814254

We report a case of a 12-year-old boy with acute compartment syndrome of the foot following a road-traffic accident. Due to the rarity of the injury, there was a delay in diagnosing the injury. An emergency fasciotomy was performed 19 hours after the injury. The foot healed with a mild extension contracture of the second toe.

Matched MeSH terms: Compartment Syndromes/pathology*; Compartment Syndromes/radiography*; Compartment Syndromes/surgery

Fulltext Orbital compartment syndrome in idiopathic orbital inflammatory disease: A case report

Tiong KI, Aziz S, Hazlita I

Med J Malaysia, 2015 Oct;70(5):316-7.

PMID: 26556124 MyJurnal

Orbital compartment syndrome (OCS) is a visual threatening ocular emergency. We report a 50-year-old male with acute presentation of OCS, a rare manifestation of idiopathic orbital inflammatory disease. At presentation, high intraocular pressure was reduced by prompt lateral canthotomy and cantholysis. The disease responded to systemic steroids and treatment resulted in good visual outcome. Detail evaluation and early detection and treatment are mandatory to prevent permanent vision loss.
Keywords: Sarawak General Hospital

Matched MeSH terms: Compartment Syndromes*

Fulltext Neglected acute post exertional anterior compartment syndrome: a case report

Sambandan S

Med J Malaysia, 1985 Dec;40(4):338-40.

PMID: 3842737

A case of Acute Post Exertional Anterior Compartment Syndrome of the leg, seen five days after the onset of symptoms is presented. Decompression with delayed closure was done. There was only sensory recovery. However functional recovery at one year was good. Acute Post Exertional Compartment Syndrome cases are diagnosed late due to the lack of awareness, the paucity of radiological features, and the presence of intact peripheral pulses. A review of the literature revealed no previous documentation from South-East Asia.

Matched MeSH terms: Compartment Syndromes/etiology*

Fulltext Anatomical variations of thenar muscle of hand, among Cadavers In Universiti Putra Malaysia (UPM)

Che Norma Mat Taib, Jegathis Prushothuman, Muhammad Adib Farhan Abdullah, Mohamad Aris, Mohd Moklas

Malaysian Journal of Medicine and Health Sciences, 2019;15(107):86-86.

MyJurnal

Introduction: Detailed information of structural and functional anatomy of thenar muscle is very significant in order to improve diagnostic and various conditions of hand surgeries so that the function of hand movement can be re-stored and to prevent further iatrogenic injuries. Methods: In this study, fifty hands were dissected to determine the variation in each of the thenar muscle. Results: Only the abductor pollicis brevis showed significant findings. Normal formation of one belly in abductor pollicis brevis represented 72.0% (18) and 84.0% (21) for the left and right hands, respectively. Variations according to the number of belly of the abductor pollicis brevis were also observed. One of the variations is the absence of the abductor pollicis brevis, 4.0% (1) in the right hand. Two belly formations of abductor pollicis brevis were observed, 28.0% (7) and 12.0% (3) for left and right sides of hand respectively. Thus, more variations were observed to occur on the left hand (7) compared to the right hand (4). Many studies describe about the variations of each thenar muscle, but few literatures were found discussing on the association of thenar muscle variation with the sides of hand. Using the Fisher Exact Test, it showed that there was no significant associa-tion of variations in the thenar muscle in relation to the sides of hand. Conclusion: This study conclude that there is no consistency between variations of the thenar muscle in relation to the sides of hand. However, clinical awareness of these variations is important in the context of compartment syndrome, use of the aberrant structures as grafting material in reconstructive surgery and proper interpretation of imaging modalities.

Matched MeSH terms: Compartment Syndromes

Fulltext Delayed compartment syndrome of leg and foot due to rupture of popliteal artery pseudoaneurysm following posterior cruciate ligament reconstruction

Shahrulazua A, Rafedon M, Mohd Nizlan MN, Sullivan JA

BMJ Case Rep, 2014;2014.

PMID: 24459225 DOI: 10.1136/bcr-2013-202098

Arthroscopic posterior cruciate ligament (PCL) reconstruction carries some risk of complications, including injury to the neurovascular structures at the popliteal region. We describe a delayed presentation of the right leg and foot compartment syndrome following rupture of popliteal artery pseudoaneurysm, which presented 9 days after an arthroscopic transtibial PCL reconstructive surgery. Fasciotomy, surgical exploration, repair of an injured popliteal vein and revascularisation of the popliteal artery with autogenous great saphenous vein interposition graft were performed. Owing to the close proximity of vessels to the tibial tunnel, special care should be taken in patients who undergo arthroscopic PCL reconstruction, especially if there is extensive scarring of the posterior capsule following previous injury. Emergency fasciotomy should not be delayed and is justified when the diagnosis of compartment syndrome is clinically made.

Matched MeSH terms: Compartment Syndromes/diagnosis; Compartment Syndromes/etiology*; Compartment Syndromes/surgery

Fulltext 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

Yeap JS, Fazir M, Ezlan S, Kareem BA, Harwant S

Med J Malaysia, 2001 Jun;56 Suppl C:66-9.

PMID: 11814253

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.

Matched MeSH terms: Compartment Syndromes/etiology*

The role of a point-of-care ultrasound protocol in facilitating clinical decisions for snakebite envenomation in Taiwan: a pilot study

Ho CH, Ismail AK, Liu SH, Tzeng YS, Li LY, Pai FC, et al.

Clin Toxicol (Phila), 2021 Sep;59(9):794-800.

PMID: 33605805 DOI: 10.1080/15563650.2021.1881535

BACKGROUND: The incidence of acute compartment syndrome (ACS) following snakebite envenomation may be seriously overestimated in Taiwan. Snakebite-induced ACS is difficult to determine solely by clinical examination. Snakebite patients previously underwent surgical intervention based on speculation and general clinical examinations suggesting ACS presentations instead of direct intracompartmental pressure (IP) measurement prior to fasciotomy. Point-of-care ultrasound (POCUS) is a relatively widely available noninvasive tool. This study aimed to evaluate snakebite-envenomated patients for the presence of subcutaneous edema and diastolic retrograde arterial flow (DRAF).

MATERIALS AND METHODS: Snakebite patients were prospectively recruited between 2017 and 2019. All patients were examined with POCUS to locate edema and directly visualize and measure the arterial flow in the compressed artery. The presence of DRAF in the compressed artery is suggestive of ACS development because when compartment space restriction occurs, increased retrograde arterial flow is observed in the artery.

RESULTS: Twenty-seven snakebite patients were analyzed. Seventeen patients (63%) were bitten by Crotalinae snakes, seven (26%) by Colubridae, one (4%) by Elapidae, and two (7%) had unidentified snakebites. All Crotalinae bit patients received antivenom, had subcutaneous edema and lacked DRAF in a POCUS examination series.

DISCUSSION: POCUS facilitates clinical decisions for snakebite envenomation. We also highlighted that the anatomic site of the snakebite is an important factor affecting the prognosis of the wounds. There were limitations of this study, including a small number of patients and no comparison with the generally accepted invasive evaluation for ACS.

CONCLUSIONS: We are unable to state that POCUS is a valid surrogate measurement of ACS from this study but see this as a starting point to develop further research in this area. Further study will be needed to better define the utility of POCUS in patients envenomated by snakes throughout the world.

Matched MeSH terms: Compartment Syndromes/diagnosis*; Compartment Syndromes/physiopathology

Fulltext Stonefish envenomation of hand with impending compartment syndrome

Tay TK, Chan HZ, Ahmad TS, Teh KK, Low TH, Wahab NA

J Occup Med Toxicol, 2016;11:23.

PMID: 27168760 DOI: 10.1186/s12995-016-0112-y

BACKGROUND: Marine stings and envenomation are fairly common in Malaysia. Possible contact to various marine life occurs during diving, fishing and food handling. Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment. Stonefish is one of the most venomous fish in the world with potential fatal local and systemic toxicity effects to human.

CASE PRESENTATION: We reported a case of stonefish sting complicated with impending compartment syndrome.

CONCLUSIONS: Medical staff should be alert about the possibility of this potential emergency in standard management of stonefish stings.

Matched MeSH terms: Compartment Syndromes

Fulltext Jellyfish Envenomation Resulting In Vascular Insufficiency And Neurogenic Injury of Upper Limb

Choong C, Chan HZ, Faruk NA, Bea KC, Zulkiflee O

Malays Orthop J, 2015 Nov;9(3):49-51.

PMID: 28611910 MyJurnal DOI: 10.5704/MOJ.1511.007

Following a week after a jellyfish sting, a young man presented with regional cyanosis and threat of distal gangrene secondary to vascular spasm in the forearm. The patient also suffered from transient paresis and numbness of the affected upper limb. Contrasted imaging revealed unopacified vessels in the distal forearm and worsening swelling warranted emergency surgical fasciotomy for impending compartment syndrome. This case highlights the occurrence of jellyfish envenomation and the need for early treatment.

Matched MeSH terms: Compartment Syndromes

Fulltext Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report

Malhotra R, Chua WL, O'Neill G

Malays Orthop J, 2016 Nov;10(3):49-51.

PMID: 28553450 DOI: 10.5704/MOJ.1611.014

We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

Matched MeSH terms: Compartment Syndromes

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