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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-two open fractures of the tibial shaft were treated with external fixation between 1973 and 1981. Early amputation was necessary in one patient. In the remainder, including 14 with extensive soft-tissue lesions, wound healing was obtained within 18 weeks, and the median time until full weight bearing without pain was 32 weeks (range 8-60 weeks). Two deep infections healed during the observation period. Among 26 patients examined 1-9 years after the injury, the result was excellent in six, good in 11, fair in four, and poor in five patients (including the amputation). One fracture had not united during the observation period. Four poor results were due to the stiffness of the ankle and foot after compartment syndrome. In conclusion, alertness for early fasciotomy is necessary even in severe open tibial fractures. The external fixation should not be continued longer than the soft tissue and bone reconstruction make it necessary.
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PMID:Open tibial fractures treated with Hoffmann external fixation. 340 22

Eighteen patients (28 compartments) with chronic exertional compartment syndrome and 14 normal asymptomatic volunteers (18 compartments) were studied. Evaluation included clinical assessment followed by quantitative determination of intracompartmental pressures as monitored by wick or slit catheters before and after exercise. Intramuscular pressures measuring greater than or equal to 10 mmHg at rest and/or greater than or equal to 25 mmHg five minutes after exercise were defined as abnormally elevated. The patients with chronic compartment syndrome described reproducible exertional anterolateral leg pain, and 39% of these patients had a fascial hernia. Such a defect was present in less than five percent of the normal volunteers. Nonsurgical treatment was selected by five patients and all five reported persistent inability to participate in athletics because of their exertional pain. Of the remaining 13 patients, 12 were treated by decompressive fasciotomy and 11 of the 12 (92%) had pain relief and increased exercise tolerance. A single patient had had fascial closure instead of fasciotomy, and this procedure produced an acute compartment syndrome. Effective treatment of the chronic compartment syndrome consists of reduction of exertional activities or surgical decompression by fasciotomy.
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PMID:Management of chronic exertional anterior compartment syndrome of the lower extremity. 359 93

Intramuscular pressure was recorded in 80 patients suspected of suffering from chronic anterior compartment syndrome in the lower leg; the diagnosis was verified in 22 of these patients. The history and clinical findings of the chronic compartment syndrome patients were compared with those of the 58 patients without the syndrome. Pain induced only by athletic activity and only in the anterior lower leg forcing the patient to interrupt running indicated chronic compartment syndrome. The history and clinical findings alone were found to be insufficient to establish the diagnosis. In relation to generally accepted pressure parameters at rest, the muscle relaxation pressure during exercise was found to be a reliable parameter for diagnosing chronic compartment syndrome, whereas mean muscle pressure and muscle contraction pressure were found to be unreliable.
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PMID:Diagnosis of chronic anterior compartment syndrome in the lower leg. 360 30

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. In both patients a fasciotomy and evacuation of the hematoma was performed. In 1 of the patients, a computed tomogram verified the hematoma preoperatively. 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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PMID:Quadriceps contusion with compartment syndrome. Evacuation of hematoma in 2 cases. 360 31

An exceptional complication of a slight sports injury of the knee with rupture of the semimembranosus bursa in a 29-year-old male football player is reported. The diagnosis was verified by immediate arthrography, consequently the possibility of thrombophlebitis could be ruled out. Anticoagulation is dangerous and contraindicated in rupture of the semimembranosus bursa due to the risk of developing compartment syndrome. Simple bed-rest for a week gave complete relief of pain.
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PMID:Ruptured semimembranosus bursa--an unusual complication following sports injury of the knee. 369 97

In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.
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PMID:Medial tibial pain. A prospective study of its cause among military recruits. 378 87

After having had a standard decompression for anterior compartment syndrome, five patients presented with persistent symptoms and pressure values above normal. A repeat procedure combined with fasciectomy relieved their pain; postoperative pressure values were normal.
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PMID:Repeat compartment decompression with partial fasciectomy. 378 53

The aetiology of pain in the lower leg during exercise has been studied in 110 athletes by monitoring intracompartmental pressure during exercise and by technetium bone scans. Patients were assigned to three diagnostic groups: chronic compartment syndrome, medial tibial syndrome and those with non-specific findings. Our results indicate that subcutaneous fasciotomy of the affected compartment(s) is the treatment of choice for chronic compartment syndrome. The treatment of patients with medial tibial syndrome, either by operation or conservatively, has been unsuccessful; non-specific symptoms have been treated conservatively with success.
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PMID:Exercise pain in the lower leg. Chronic compartment syndrome and medial tibial syndrome. 378 54

In nine patients with chronic compartment syndrome, the intramuscular pressure and muscle blood flow during constant dynamic exercise was studied by the microcapillary infusion method and by the 133-xenon clearance technique. Although muscle blood flow was normal at the start of exercise, pain and impaired muscle function eventually developed; muscle blood flow decreased while muscle relaxation pressure increased. The changes of muscle blood flow could not be correlated with any change of mean muscle pressure during exercise. Eight months after fasciotomy the exercise test was repeated. Patients experienced no symptoms and the muscle relaxation pressure and blood flow during exercise were normal. It is suggested that chronic compartment syndrome is due to increased muscle relaxation pressure during exercise which causes decreased muscle blood flow, leading to ischaemic pain and impaired muscle function.
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PMID:Intramuscular pressure and muscle blood flow during exercise in chronic compartment syndrome. 381 65

A 21-year-old welder experienced chronic pain in the region of the first dorsal interosseous muscle after strenuous activity involving his hand. Direct measurement of the tissue pressures within the first dorsal interosseous muscle revealed an elevation of compartment pressure after lateral key pinch activity. After surgical release of the compartment, the pressures returned to normal, and the patient's symptoms improved. Exercise-induced chronic compartment syndrome of the small muscles of the hand should be considered in patients who describe aching pain in the hand after strenuous activity.
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PMID:Exercise-induced chronic compartment syndrome of the first dorsal interosseous muscle of the hand: a case report. 394 26


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