Abstract：
BACKGROUND:Chronic exertional compartment syndrome is diagnosed based on symptoms and elevated intramuscular pressure and often is treated with fasciotomy. However, what contributes to the increased intramuscular pressure remains unknown. QUESTIONS/PURPOSES:We investigated whether the stiffness or thickness of the muscle fascia could help explain the raised intramuscular pressure and thus the associated chronic compartment syndrome symptoms. PATIENTS AND METHODS:We performed plain radiography, bone scan, and intramuscular pressure measurement to diagnose chronic compartment syndrome and to exclude other disorders. Anterior tibialis muscle fascial biopsy specimens from six healthy individuals, 11 patients with chronic compartment syndrome, and 10 patients with diabetes mellitus and chronic compartment syndrome were obtained. Weight-normalized fascial stiffness was assessed mechanically in a microtensile machine, and fascial thickness was analyzed microscopically. RESULTS:Mean fascial stiffness did not differ between healthy individuals (0.120 N/mg/mm; SD, 0.77 N/mg/mm), patients with chronic compartment syndrome (0.070 N/mg/mm; SD, 0.052 N/mg/mm), and patients with chronic compartment syndrome and diabetes (0.097 N/mg/mm; SD, 0.073 N/mg/mm). Similarly, no differences in fascial thickness were present. There was a negative correlation between fascial stiffness and intramuscular pressure in the patients with chronic compartment syndrome and diabetes. CONCLUSIONS:The lack of difference in fascial thickness and stiffness in patients with chronic compartment syndrome and patients with chronic compartment syndrome and diabetes compared with healthy individuals suggests structural and mechanical properties are unlikely to explain chronic compartment syndrome. To prevent chronic exertional compartment syndrome, it is necessary to address aspects other than the muscle fascia. LEVEL OF EVIDENCE:Level II, prognostic study. See the guidelines online for a complete description of level of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Dahl M,Hansen P,Stål P,Edmundsson D,Magnusson SPdoi
10.1007/s11999-011-2073-xsubject
Has Abstractpub_date
2011-12-01 00:00:00pages
3495-500issue
12eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：BACKGROUND:Radiation-crosslinked UHMWPE has been used for joint implants since the 1990s. Postirradiation remelting enhances oxidative stability, but with some loss in strength and toughness. Vitamin E-stabilized crosslinked UHMWPE has shown improved strength and stability as compared with irradiated and remelted UHMWP...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3850-0
更新日期：2015-03-01 00:00:00
abstract：:Eleven patients with a previous patellectomy and primary total knee arthroplasty (TKA) had chart reviews, recent clinical examinations, evaluation of roentgenograms, rating of knee arthroplasty on a standard scale, and quantitation of quadriceps and hamstring torque using an isokinetic dynamometer. Good to excellent r...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-10-01 00:00:00
abstract：:Fifty-two patients with subtalar joint involvement secondary to os calcis fractures have been treated with a surgical technique designed by George F. Pennal. There were 23 tongue-type fractures and 33 joint depression fractures in this series. All were treated by open reduction and internal fixation, and occasionally ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-10-01 00:00:00
abstract：:Thirty-six patients (36 shoulders) who underwent the Eden-Hybbinette procedure for recurrent anterior dislocation of the shoulder with an average followup of 15 years were evaluated. Evaluation consisted of radiographic assessment in a true anteroposterior view and an axillary lateral view of both shoulders, physical ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200004000-00016
更新日期：2000-04-01 00:00:00
abstract：:The etiology of the foot deformity in patients with Charcot-Marie-Tooth disease has not previously been discussed in relation to the extrinsic muscle function around the foot and ankle. Eight adult patients with a strong familial history were evaluated, and their foot findings were remarkably similar. All demonstrated...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-09-01 00:00:00
abstract：:We identified changes in proapoptotic and extracellular matrix-related gene expression with prolonged storage of fresh osteochondral allografts using gene array analysis to better understand the process of graft degradation during storage. Six human distal femurs were obtained according to standard organ harvesting pr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000187058.42820.39
更新日期：2006-01-01 00:00:00
abstract：:The commonly used classification systems of hip dislocation are based on the direction of the dislocation and the presence of associated lesions. However, no rating system can reliably predict the patient's outcome and prognosis based on the initial presentation and classification. In general, patients with anterior d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200008000-00004
更新日期：2000-08-01 00:00:00
abstract：:Reduction of the porosity of bone cement by centrifugation significantly improves the fatigue life of the cement when smooth, waisted specimens are tested. However, bone cement in vivo has surface irregularities at the interdigitation of the cement with the trabecular bone. The effect of centrifugation on the fatigue ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：:Stress deprivation alters the morphologic, biochemical, and biomechanical characteristics of various components of synovial joints. Prominent among the protean changes that result are proliferation of fibrofatty connective tissue within the joint space, adhesions between synovial folds, adherence of fibrofatty connect...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：:Degradation of yttria-stabilized zirconia femoral heads in vivo has been linked to increased roughening and even fracture of the femoral head. To determine whether magnesia-stabilized zirconia is better suited to resist degradation, we characterized the monoclinic phase concentration, surface topography, and microhard...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e318158b4d3
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:Metastatic bone disease is a substantial burden to patients and the healthcare system as a whole. Metastatic disease can be painful, is associated with decreased survival, and is emotionally traumatic to patients when they discover their disease has progressed. In the United States, more than 250,000 patient...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-4739-x
更新日期：2016-07-01 00:00:00
abstract：:For reappraisal of total hip arthroplasty (THA) in the treatment of nontraumatic osteonecrosis (ON) of the femoral head, 29 hips in 23 patients with ON were surveyed in a comparison with 63 osteoarthritic (OA) hips treated in the same manner during the same period; the hips were selected according to the same criteria...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-07-01 00:00:00
abstract：:The anatomic abnormalities and the effects of serial release of soft tissue are described in seven stillborn fetal clubfeet. The essential anatomic abnormality is a dislocation of the talocalcaneonavicular joint, with dysplastic changes in the talus and less severe changes in the adjacent bones. By gradually releasing...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-04-01 00:00:00
abstract：BACKGROUND:There is no consensus as to which surgical approach to the treatment of giant cell tumor of bone is most appropriate or which patients are at a higher risk for recurrence or metastasis. QUESTIONS/PURPOSES:Therefore, we asked: (1) Are there subsets of patients who are associated with a more recalcitrant dise...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2172-8
更新日期：2012-03-01 00:00:00
abstract：:Simultaneous proximal and distal interphalangeal joint dislocations in a single finger are rare. Even though the joints above and below are routinely evaluated, one of the joint dislocations can be missed. When phalangeal dislocations are suspected, special attention should be given to obtaining sufficient roentgenogr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-08-01 00:00:00
abstract：:The erythrocyte sedimentation rate (ESR) was analyzed in 176 patients treated with cemented total hip arthroplasty (THA) for primary osteoarthritis and correlated with the degree of heterotopic bone formation (HBF) one year after the THA. Ninety patients were treated with indomethacin in the first six postoperative we...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1989-11-01 00:00:00
abstract：BACKGROUND:Although several types of culture medium have been used for preservation of osteochondral allografts, the viability of chondrocytes decreases with increasing storage duration. We previously showed the University of Wisconsin solution is more suitable for graft preservation than culture medium. QUESTIONS/PUR...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2182-6
更新日期：2012-10-01 00:00:00
abstract：:In 20 dogs olecranon osteotomies fixed with tension band wires were studied histologically to reveal the pattern of healing. Different degrees of stability existed in different areas of the osteotomy. Under stable conditions cancellous bone healed by direct formation of woven bone. Instability resulted in an internal ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：:The dislocation rate of 3197 Charnley prostheses with 22 mm head in which the surgery was done between 1979 and 1991 in 2 orthopaedic centers was compared with that of 2875 Lubinus prostheses with 32 mm head in which the surgery was done between 1980 to 1991 in 3 other centers. A 1-year followup showed an equal rate o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：
更新日期：1996-12-01 00:00:00
abstract：:Regional osteopenia may persist after certain types of fractures. To investigate the practical importance of this observation, the authors studied 2744 past fractures in 1659 patients with present fractures. Radial fractures rarely occurred ipsilateral to previous radial fractures, whereas fractures of the hand were m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：BACKGROUND:While the primary objective of joint arthroplasty is to improve patient quality of life, pain, and function, younger active patients often demand a return to higher function that includes sporting activity. Knowledge of rates and predictors of return to sports will help inform expectations in patients antici...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2198-y
更新日期：2012-02-01 00:00:00
abstract：:Malposition of the acetabular component during hip arthroplasty increases the occurrence of impingement, reduces range of motion, and increases the risk of dislocation and long-term wear. To prevent malpositioned hip implants, an increasing number of computer-assisted orthopaedic systems have been described, but their...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000141903.08075.83
更新日期：2004-09-01 00:00:00
abstract：:The presence of the ossific nucleus and its role in reducing the risk of ischemic necrosis in developmental dysplasia of the hip remains a matter of controversy. Ischemic necrosis of the pre-osseous capital femoral epiphysis, defined as chondronecrosis, was evaluated in a rabbit model. Histologic evidence of chondrone...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2000-08-01 00:00:00
abstract：BACKGROUND:The most important objective of clinical classifications of slipped capital femoral epiphysis (SCFE) is to identify hips associated with a high risk of avascular necrosis (AVN)--so-called unstable or acute slips; however, closed surgery makes confirmation of physeal stability difficult. Performing the capita...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2339-y
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:Large-head metal-on-metal (MoM) hip arthroplasties have demonstrated poor survival. Damage at the taper-trunnion junction is a contributing factor; however, the influence of junction design is not well understood. QUESTIONS/PURPOSES:(1) Does taper type affect fretting, corrosion, and volumetric wear at the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3115-3
更新日期：2014-02-01 00:00:00
abstract：:The results of two-stage flexor tendon reconstruction in the hand, evaluated in 25 fingers in 20 patients with an average followup of 5 months, were graded on the basis of total range of active flexion and combined extension loss. Two-stage flexor tendon reconstruction can significantly improve the functional status o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：:Metasul metal-on-metal articulations have been used for 15 years in approximately 300,000 total hip replacements. We have used Metasul articulations in three clinical studies and have shown clinical success as measured by Harris hip scores and patient self-assessment; we also have had the usual mechanical complication...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000150343.66755.79
更新日期：2004-12-01 00:00:00
abstract：:Imaging, sensing, and computing technologies that are being introduced to aid in the planning and execution of surgical procedures are providing orthopaedic surgeons with a powerful new set of tools for improving clinical accuracy, reliability, and patient outcomes while reducing costs and operating times. Current com...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199809000-00004
更新日期：1998-09-01 00:00:00
abstract：:Acetabular bone stock loss compromises the outcome in primary and revision total hip arthroplasty. In 1979, a biologic method was introduced with tightly impacted cancellous allografts in combination with a cemented polyethylene cup for acetabular reconstruction. With this technique, it is possible to replace the loss...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200112000-00023
更新日期：2001-12-01 00:00:00
abstract：:Three hundred three patients undergoing total hip replacement were enrolled in a prospective, randomized, double-blind clinical study of heterotopic bone formation. All the procedures were primary arthroplasties done for osteoarthritis using an anterolateral approach. Patients with spondyloarthropathy, previous surger...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1995-05-01 00:00:00
