Postanaesthetic brachial compartmental syndrome in a horse

A 9-year-old Irish sports horse gelding was anaesthetised out-of-hours for management of digital flexor tendon sheath sepsis after a left hind foot penetration. In the postanaesthetic period, the patient manifested a right forelimb non-weight bearing lameness. Diagnostic imaging and serum biochemistry were unremarkable. The animal progressively deteriorated and became recumbent. After consultation with the owner, euthanasia was performed on welfare grounds. A postmortem examination was performed to establish the cause of the right forelimb lameness. After excluding all other probable causes of postanaesthetic lameness, it was concluded that the patient manifested a postanaesthetic compartmental syndrome due to haemorrhage associated with the ulnar nerve developed intraoperatively. This case report discusses factors associated with increased anaesthetic-related mortality in elective surgical procedures performed out-of-hours, other causes of postanaesthetic forelimb lameness and diagnosis of, and treatment options for, brachial compartment syndrome.

Features of Chronic Exertional Compartmental Syndrome of the Leg in Elite Nordic Skiers

This study aimed to assess prevalence and incidence of chronic exertional compartmental syndrome as well as functional outcomes after surgery in elite Nordic skiers. An exhaustive list of 294 elite Nordic skiers from the French national teams between 1994 and 2014 was analyzed through their individual medical files in order to identify cases of chronic exertional compartmental syndrome. Eighteen athletes had confirmed diagnosis and performed a structured interview to identify factors associated with chronic exertional compartmental syndrome and surgery outcomes. The prevalence was 6.1% and the incidence 13 per 1000 skier-years. Biathletes had a higher prevalence than cross-country skiers (OR=0.40, p=0.08). Free-technique skiing and roller-skiing were the main conditions inducing symptoms. All injured athletes had bilateral surgery and 94% of them reported no more or sporadic leg pain after. Almost 90% resumed competition at the same or higher level than prior surgery. Compare to previous studies, the incidence rate of chronic exertional compartmental syndrome is higher in French elite Nordic skiers. The higher prevalence in biathletes and the trigger during free-technique skiing suggest a contribution of this technique to this disease. This study also confirmed that surgery was an efficient therapeutic solution without compromising athletes’ career.

Using Ultrasonography and Doppler Application for Evaluating Vascular Axes and Prevention of Compartmental Syndrome

Ultrasonography is with adequate training, a fast and effective evaluation method in emergency departments. Peripheral vascular injury is frequent in trauma and should have a rapid diagnosis andtreatment,asrisksinclude:opensores,bleeding;closedinjuriesandcompartmentalsyndrome. Prompt evaluation of the integrity in the vascular tree becomes important in preventing events that require surgical intervention (repair and / or fasciotomy). The aim of this work is to demonstrate the usefulness of knowledge of peripheral vascular tree, ultrasound evaluation and Doppler for peripheral vascular trauma management, using checklists for the systematic evaluation of the vasculature. Systematic evaluations were realized in 10 general surgery residents. Initially, using inanimate and animate models which were then evaluated in trauma situations. Divided into periods (February / April 2016 – May/August 2016). The findings with previous criteria made the verification list and subsequent connection with the development of compartment syndrome that were established by correlation. Evaluation animated models: 1st assessment: Recognition of structures> 60 % =6 residents. > 80 % =4 residents. The 2nd assessment: Recognition of structures > 60 % = 3 residents. > 80 % = 7 residents. In the care of multiple trauma: recognition structures > 60% =3 residents. >80 % =7 residents. Patients at risk for compartmental syndrome (n=77)=11 (14.78 %). Resolution: Vascular Lesion 1 (1.3 %) compartmental syndrome: 1 (1.3 %) with surgical resolution. The use of ultrasonography and Doppler for peripheral vascular evaluation is useful for early recognition of risk from developing a single vascular lesion, to compartmental syndrome. The use of the checklists during simulation for the generation of criteria is useful in the training of surgical residents.