Acta orthopaedica Scandinavica
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The concentration of myoglobin in plasma was assessed before and up to 68 hours after tourniquet release in 27 patients who underwent elective operations with no incision into skeletal muscle. The duration of ischemia was 1-3 hours. ⋯ There was a minimal elevation in myoglobin values after 65 and 90 minutes of ischemia, and a marked elevation after more than 150 minutes of ischemia. Maximum values were reached 8 to 10 hours after tourniquet release, and preoperative values after 50 to 60 hours.
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A 56-year-old woman with arthrosis of the knee sustained a fixed superior dislocation of the patella from a minor trauma. Closed reduction was performed. Only 3 other cases have been found reported in the literature.
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A high intramuscular pressure due to contusion with hematoma developed in the thigh of 2 athletes after moderate blunt muscle trauma. The pain became severe a few hours after the trauma. ⋯ The postoperative course was uneventful. A compartment syndrome associated with a major hematoma should be considered as a cause of progressive pain at rest after blunt muscle trauma.
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We report our experience with knee arthroscopy in local anesthesia in 64 patients with subsequent arthrotomy in 14 of these. The effectiveness of the anesthetic method was evaluated by both the patient and the anesthetic personnel. There was no difference in pain assessment between arthroscopy alone and arthroscopy followed by arthrotomy. ⋯ Supplementary analgesia with 0.05 mg fentanyl was given to half of the patients not undergoing arthrotomy and to two thirds of those who had arthrotomy. It was not necessary to abandon any arthroscopic or surgical procedure because of pain. We conclude that local anesthesia is a safe and practical method for diagnostic arthroscopy, arthroscopic surgery, and minor arthrotomy.