Acta Orthop Belg
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We systematically reviewed published evidence regarding foot compartment syndrome with regards to causes, methods of diagnosis, number of incisions used for fasciotomy, wound closure techniques, complications, and functional outcomes. Publications were collected using PubMed and OVID databases, and were reviewed as above. All were retrospective case series (evidence-based medicine level IV). ⋯ Sixty-five percent of cases required split-thickness skin grafts for wound closure after fasciotomy. Neurological deficits were the most common complication (52%). Thirty-nine percent of the patients reported residual pain and stiffness while ten percent could return to work or their pre-injury activity state after fasciotomy.
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Aneurysmal bone cyst (ABC) is an uncommon, benign but locally destructive bone lesion of unknown origin. Differential diagnosis can be challenging as it shares common radiological and pathological features with other benign and malignant bone lesions. The degree of diagnostic difficulty grows even more when an unusual location has to be taken into account. We report a rare and challenging case of a large primary ABC located at the scapula of a young male, who was surgically treated with subtotal removal of the scapula.
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Comparative Study
Intra-operative cerebral microembolisation during primary hybrid total hip arthroplasty compared with primary hip resurfacing.
Fat embolism during total joint arthroplasty or intramedullary procedures is well documented and is infrequently fatal. Considerable morbidity is associated with fat embolism syndrome, and post operative cognitive dysfunction is frequently seen, yet the exact pathophysiology remains unclear. Intraoperative cerebral microemboli can be detected using transcranial Doppler ultrasound and moreover the presence of a patent foramen ovale (PFO) may be examined for using a validated technique employing this modality. ⋯ The incidence of cerebral microembolisation during hip resurfacing appears to be very low. Although our study demonstrated cerebral microemboli in a significant proportion of patients undergoing primary hybrid THR, the numbers of microemboli were low and the presence of a patent foramen ovale did not influence microemboli incidence or load. Finally, patients who demonstrated cerebral microemboli did not have a worse outcome than patients who did not.