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Fasciotomy incisions in the forearm, hand and fingers. A: Preferred incision figures which were used in forearm fasciotomy procedures and radial and ulnar pedicule flaps that can be used to close up the wrist B: Incisions used to free the dorsal, volar, and adduc - tor compartment of the thumb in the hand C: Incisions with non-dominant sides in digit fascioto- mies. The thumb was opened up from the radial side while the other fingers were opened up from the ulnar side.
Contexts in source publication
Context 1
... syndrome diagnoses were clinically obtained. All the cases had full derma- tomy and fasciotomy under general anesthesia. 2 types of volar incision were used in forearm fasciotomy pro- cedures ( Figure 1A). The dorsal, volar, and the adductor compartment of the thumb in the hand were freed by two longitudinal incisions passing through the 2nd and 4th metacarpi in the dorsal of the hand ( Figure 1B). ...
Context 2
... the cases had full derma- tomy and fasciotomy under general anesthesia. 2 types of volar incision were used in forearm fasciotomy pro- cedures ( Figure 1A). The dorsal, volar, and the adductor compartment of the thumb in the hand were freed by two longitudinal incisions passing through the 2nd and 4th metacarpi in the dorsal of the hand ( Figure 1B). The non-dominant sides were used in finger fasciotomies (Fig. 1C). ...
Context 3
... anesthesia. 2 types of volar incision were used in forearm fasciotomy pro- cedures ( Figure 1A). The dorsal, volar, and the adductor compartment of the thumb in the hand were freed by two longitudinal incisions passing through the 2nd and 4th metacarpi in the dorsal of the hand ( Figure 1B). The non-dominant sides were used in finger fasciotomies (Fig. 1C). Cutaneous nerves and veins were preserved. Guyon's canal and carpal tunnel were decompressed in patients with symptoms of ulnar and median nerve ...
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In the following case presentation, a young man who incurred orbital compartment syndrome (OCS) from physical trauma significantly improved from timely lateral canthotomy. Lateral canthotomy is recommended to be performed as soon as possible to avoid permanent vision loss, which is the most feared complication associated with orbital compartment sy...
Citations
... Twenty articles provided relevant data about 112 patients who developed ACS (86.8% of all patients) after a soft tissue injury [9,11,[18][19][21][22][23][24][25]27,30,[32][33][35][36][37][38][39][40]42]. Four of these identified burn as the most prevalent cause of soft tissue trauma-related ACS, leading up 71 cases (63.4% burned patients) of soft tissue injured patients [30,32,40,42], followed by seven articles reported animal bites making up to 10 cases (8.9%) of soft tissue injured patients [19,[22][23][24][25]38,39]. ...
... Twenty articles provided relevant data about 112 patients who developed ACS (86.8% of all patients) after a soft tissue injury [9,11,[18][19][21][22][23][24][25]27,30,[32][33][35][36][37][38][39][40]42]. Four of these identified burn as the most prevalent cause of soft tissue trauma-related ACS, leading up 71 cases (63.4% burned patients) of soft tissue injured patients [30,32,40,42], followed by seven articles reported animal bites making up to 10 cases (8.9%) of soft tissue injured patients [19,[22][23][24][25]38,39]. Two articles did not specify the extent of the trauma, reporting generic soft tissue injuries in 21 patients as the cause of ACS ( ...
... Diagnosis of ACS is made based on clinical findings and intercompartmental pressure measuring in 46 cases (35.7%) [11,15,19,25,30,31,38], on the other hand, 45 cases diagnosed based on clinical findings only (34.9% of all cases) [18,[22][23][24]26,[27][28][29][30]32,34,[35][36][37]39,[41][42]. The remaining cases did not specify the method of diagnosis in 38 cases (29.5%) [9,[20][21]34]. ...
Hand compartment syndrome is a limb-threatening emergency. Although it is a relatively uncommon condition, early diagnosis, and urgent fasciotomy can prevent irreversible ischemia, myonecrosis, nerve dysfunction, and subsequently permanent loss of hand functions. The occurrence of hand compartment syndrome is relatively infrequent, resulting in a limited amount of literature on its causes. As a result, we conducted a systematic review to provide the most comprehensive data regarding the etiology of traumatic hand compartment syndrome.
This systematic review was conducted and reported in light of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We searched among Medline, and EBSCO Database, with no restriction on the dates (last date of the systematic search was done on April 28, 2022). We included all studies containing data regarding traumatic hand compartment syndrome.
A total of 29 articles with 129 patients constituted the basis of this review. The etiology of traumatic hand compartment syndrome was classified into three groups: soft tissue injury-related, fracture-related, and vascular injury-related causes. The most common etiology of hand compartment was related to soft tissue injuries which constituted 86.8% of all etiologies, followed by fracture-related (5.4%), then vascular injury-related (1.5%). Further, burns were the most likely injury to lead to hand compartment syndrome which made up 63.4% of soft-tissue injuries, followed by animal bites (8.9%).
Hand compartment syndrome can be caused by multiple etiologies that affect people of different ages. Therefore, identifying the most prevalent causes can help in early detection of compartment syndrome by frequent assessment of patients that present with the most prevalent causes like burn among soft tissue injuries and metacarpal bone fracture among fractures.
... Furthermore, Zhang et al. [85] study of 130 patients who underwent forearm fasciotomies 66% (86 patients) resulted from soft tissue injuries. Meanwhile, Özkan et al. [61] reported 43 fasciotomies in their study of 35 patients (81%) who had forearm ACS due to soft tissue injuries, indicating that even minimal injuries to soft tissues could lead to compartment syndrome. Thus, it is important not to underestimate any injuries, as forearm ACS was noticed to be caused by snakes, insects and spider bites [6,60,63,64,68,81]. ...
Objectives
Acute compartment syndrome (ACS) can be caused by multiple causes that affect people of different ages. It is considered an orthopedic emergency condition that requires immediate diagnosis and surgical intervention to avoid devastating complications and irreversible damages. This systematic review aimed to present the etiology of trauma-related forearm ACS.
Methods
A systematic review was performed on four different databases: Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of systematic review register databases via Ovid, with no restriction on dates (last date was June 30, 2021). It included all the studies containing data about the etiology of trauma-related forearm ACS.
Results
A total of 4893 articles were retrieved: 122 met the inclusion criteria, 39 were excluded, 25 were out of scope and 14 had insufficient details. Hence, this review constituted 83 articles and 684 patients. The etiology of ACS causing forearm ACS was classified into three groups: fracture-related, soft tissue injury-related and vascular injury-related. The fracture-related group was the most common group (65.4%), followed by soft tissue injury (30.7%), then vascular injuries (3.9%). Furthermore, supracondylar humerus fractures were the most common cause of fractures related to forearm ACS. Blunt traumas were the most common cause of soft tissue injuries-related forearm ACS, and brachial artery injuries were the most common cause of vascular-related forearm ACS.
Conclusion
Frequent assessment of patients with the most prevalent etiologies of forearm ACS is recommended for early detection of forearm ACS and to save limbs.
... They newly learned that the compartment syndrome is a serious surgical emergency complication of extremity circumferential burns, that results from the irregularities in the functioning and circulation of the tissue because of the increased interstitial tissue pressure in a limited fascial area. [22,23] Students realized that, in orthopedic ward, male admissions were more compared to women. Most of them being young men who drove motorcycles. ...
Background
Clinical experiences provide an opportunity for nursing students to integrate theoretical knowledge into practice, and analyze their learning using a theoretical model. Students do not take this opportunity unless it is intentionally included by the facilitators. These observations from the second cohort of medical surgical nursing students with their facilitators, regarding their clinical training period in selected sub-specialties at the University Teaching Hospital of Kigali (CHUK) aimed at developing students’ analytical and observational skills while developing clinical skills.Methods
The study involved nine medical surgical nursing students who were in different subspecialties at CHUK from 7th January up to the 20th February, 2019. Informed observational approach and concomitant reporting were used to validate their learning and gain clinical experience. The students used Kolb’s Experiential Learning Theory to analyze their experience, with the focus on innovative skills.ResultsAll medical surgical nursing students reported that they improved their knowledge and skills during clinical practice, while broadening their outlook.Conclusion
Kolb’s Experiential Learning Theory is useful in validating and bridging theoretical learning to clinical practice.Rwanda J Med Health Sci 2021;4(3):430-436
... 180 A series of 43 patients undergoing upper limb fasciotomy for burns are presented, with little mention of escharotomy. 181 Use of carpal tunnel decompression in patients requiring fasciotomy for hand burns in 6 patients resulted in better outcomes than in 9 controls. 182 The controversies surrounding the use of escharotomy and ineffective incisions have prompted some to move toward the concept of decompression rather than escharotomy. ...
Introduction:
Advances in the evidence base of acute thermal hand burns help to guide the management of these common injuries. The aim of this literature review was to evaluate recent evidence in the field over 10 years.
Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols methodology was used as a guide for this literature review. PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for English language articles related to hand burns published between 2009 and 2018 inclusive, and the Cochrane Library was reviewed. Exclusion criteria were as follows: participants younger than 18 years, scar or contracture management, rehabilitation, outcomes assessment, late reconstruction, and electrical or chemical burns.
Results:
An initial search retrieved 6493 articles, which was narrowed to 403 full-text articles that were reviewed independently by 3 of the authors and categorized. Of 202 included articles, there were 8 randomized controlled trials and 2 systematic reviews. Six evidence-based guidelines were reviewed. Referral of hand burns to specialist centers, use of telemedicine, early excision and grafting, and immediate static splintage have been recommended. Enzymatic debridement results in earlier intervention, more accurate burn assessment, preservation of vital tissue, and fewer skin grafts, and ideally requires regional anesthesia. Guidance on escharotomy emphasizes indication, technique and adequate intervention, and potential for enzymatic debridement. Inclusion of topical negative pressure, dermal regenerative templates, acellular dermal matrices, and noncellular skin substitutes in management has helped improve scar and functional outcomes.
Discussion:
The results of this literature review demonstrate that multiple national and international societies have published burns guidelines during the decade studied, with aspects directly relevant to hand burns, including the International Society for Burn Injuries guidelines. There are opportunities for evidence-based quality improvement across the field of hand burns in many centers.
Conclusions:
More than 200 articles globally in 10 years outline advances in the understanding of acute management of thermal hand burns. Incorporating the evidence base into practice may facilitate optimization of triage referral pathways and acute management for hand burns.
