Clinical orthopaedics and related research
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Increased lower-leg intracompartmental pressure compromising neuromuscular function within that compartment is termed compartment syndrome. This condition may be acute (often trauma induced) or chronic (usually exercise related). In a conscious, alert patient, acute compartment syndromes usually are easy to diagnose clinically; however, in the unconscious patient, a diagnostic aid such as the intracompartmental pressure monitor is useful. ⋯ Chronic compartment syndromes require dynamic pressure measurements for an accurate diagnosis. The most important parameters are elevated postexercise pressures and delayed restoration of normal compartmental pressures. Subcutaneous fasciotomy may be sufficient in accurately diagnosed cases of chronic compartment syndrome.
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Clin. Orthop. Relat. Res. · Mar 1989
Comparative StudyTreatment of open ankle fractures. Immediate internal fixation versus closed immobilization and delayed fixation.
Thirty-one open ankle fractures were treated over a period of 11 years and retrospectively reviewed with an average follow-up period of 61 months. Fifteen were managed by closed immobilization and delayed internal fixation. Sixteen were treated with immediate open reduction and internal fixation. ⋯ The fractures treated with immediate open reduction and internal fixation showed less impairment of range of motion but had a greater incidence of chronic ankle swelling. The hospitalization time was significantly shorter for the patients treated by open reduction and internal fixation. Immediate open reduction and internal fixation of open ankle fractures speed recovery with no greater incidence of infection than encountered with conservative treatment.