Journal of surgical orthopaedic advances
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The objective of this study was to review the use of liposomal bupivacaine as a multimodal pain management adjunct following hallux valgus surgery. The study was a prospective review of a consecutive series of patients who underwent hallux valgus surgery and received liposomal bupivacaine. From postoperative day (POD) 1 to 4, pain scores, number of narcotic rescue pills used, and adverse events were recorded. ⋯ One adverse event and one wound complication occurred. Liposomal bupivacaine may be a safe and useful adjunct in a multimodal pain regimen for patients undergoing hallux valgus surgery. More rigorous studies are needed to determine its efficacy, safety profile, and cost-effectiveness compared to placebo.
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Liposomal bupivacaine, a slow-releasing form of bupivacaine, is proving to be effective and safe for postsurgical pain management. It can provide great benefit and patient satisfaction because of its long-duration local analgesia by a single infiltration for up to 72 hours. A technical tip and application considerations of liposomal bupivacaine in total ankle arthroplasties are described.
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Case Reports
Acute lumbosacral plexopathy from gluteal compartment syndrome after drug abuse: a case report.
Acute lumbosacral plexus injury from gluteal compartment syndrome is extremely rare. Physicians should be aware of this diagnosis when examining patients with altered mental status, prolonged immobilization, and gluteal muscle compression. This case report presents a patient with acute complete left lumbosacral plexus paralysis and acute renal failure after gluteal compartment syndrome secondary to prolonged immobilization from drug abuse. ⋯ Electrodiagnostic studies showed complete limb paralysis. Medical treatment and rehabilitation was administered. Renal function recovered within the 1st week; function at the proximal muscles of the left lower limb improved within 6 months, with mild discomfort on sitting at the buttock, foot drop, and sensory deficits at the leg and dorsum of foot.
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Scapular winging resulting from long thoracic nerve palsy is a painful, disabling condition often associated with periscapular weakness and decreased active shoulder range of motion. Observation, therapy, and symptomatic treatment have customarily been the recommended treatment, often with disappointing results. Recently, encouraging results have been reported following decompression of the long thoracic nerve. ⋯ All patients had decreased pain, disability, and scapular winging, and improved shoulder range of motion. One patient had recurrence following a second injury. This procedure has resulted in good outcomes without the morbidity associated with tendon or nerve transfer.