Ultrasound-Guided Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg.

Chronic exertional compartment syndrome is characterized by exertional pain and elevated intracompartmental pressures affecting the leg in physically active young people. In patients who have failed conservative measures, fasciotomy is the treatment of choice. This study presents a new method for performing fasciotomy using high-resolution ultrasound (US) guidance and reports on the clinical outcomes in a group of these patients. Over a 3-year period, 7 consecutive patients with a total of 9 involved legs presented clinically with anterior compartment chronic exertional compartment syndrome, which was confirmed by intracompartmental pressure measurements before and after exercise. After a US examination, fasciotomy under US guidance was performed. Preoperative and postoperative pain and activity levels were assessed as well as number of days needed to "return to play." All patients had a decrease in pain, and all except 1 returned to presymptomatic exercise levels with a median return to play of 35 days.

Ultrasound-Guided Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg.

Chronic exertional compartment syndrome is characterized by exertional pain and elevated intracompartmental pressures affecting the leg in physically active young people. In patients who have failed conservative measures, fasciotomy is the treatment of choice. This study presents a new method for performing fasciotomy using high-resolution ultrasound (US) guidance and reports on the clinical outcomes in a group of these patients. Over a 3-year period, 7 consecutive patients with a total of 9 involved legs presented clinically with anterior compartment chronic exertional compartment syndrome, which was confirmed by intracompartmental pressure measurements before and after exercise. After a US examination, fasciotomy under US guidance was performed. Preoperative and postoperative pain and activity levels were assessed as well as number of days needed to "return to play." All patients had a decrease in pain, and all except 1 returned to presymptomatic exercise levels with a median return to play of 35 days.

Adoption of preventive measures after returning to work among workers affected by De Quervain's tenosynovitis.

OBJECTIVES: To determine whether if there was any increase in preventive measures adopted following reincorporation to their jobs among workers affected by De Quervain's tenosynovitis (DQT), who were treated by surgical intervention. METHODS: Study subjects where those workers, members of a mutual health insurance scheme, who were operated on between June 2006 and June 2009 (n=52). For each worker we checked whether preventive measures had been taken in their workplace, both before their episode, and following reincorporation. The difference in proportions (DP) was calculated between the proportion of individuals with preventive measures after reincorporation and the proportion with preventive measures implemented prior to their surgical intervention, both globally and in terms of sociodemographic, occupational, and clinical variables. RESULTS: The proportion of workers with preventive measures adopted following reincorporation to their job was higher than the proportion with preventive measures prior to their surgical intervention (DP = 23.1 %; 95 %CI: 6.4-39.7 %). The risk factors associated with the greatest change in preventive measures were repetitive movements (DP = 25.6 %; 95 %CI: 6.1-45.1 %) and awkward postures (DP = 40 %; 95 %CI: -22.9 to 100 %). CONCLUSIONS: Despite the increased proportion of workers with preventive measures implemented in their workplace following reincorporation to the job, there is a lack of information and of adoption of ergonomic preventive measures specific to this pathology. Implementation of ergonomic programs could reduce incidence of musculoskeletal disorders such as DQT, and would thus increase productivity, efficiency and worker satisfaction, while diminishing sick leave episodes, and the associated costs and relapses.

Treatment of Osteochondral Lesions of the Talus With Bone Marrow Stimulation and Chitosan-Glycerol Phosphate/Blood Implants (BST-CarGel).

Bone marrow stimulation (BMS) techniques represent the first-line treatment for unstable osteochondral lesions of the talus or after conservative treatment failure. These techniques are intended to penetrate the subchondral bone to elicit bleeding and allow precursor cells and cytokines from bone marrow to populate the lesion. However, the fibrocartilaginous repair tissue arising after marrow stimulation confers inferior mechanical and biological properties compared with the original hyaline cartilage. The limitations of BMS can be overcome by the use of the soluble chitosan-based polymer BST-CarGel (Piramal Life Sciences, Laval, Quebec, Canada). When mixed with freshly drawn autologous whole blood and applied to a lesion surgically prepared by BMS, BST-CarGel acts as a natural bioscaffold that increases the quantity and improves the residency of the blood clot formed in the cartilage lesion, enhancing the local healing response. The use of BST-CarGel has been previously described in the knee and hip joints with successful results. We describe the arthroscopic technique for BST-CarGel application in combination with BMS techniques for the treatment of osteochondral lesions of the talus.

Different feed withdrawal times before slaughter influence caecal fermentation and faecal Salmonella shedding in pigs.

The effects of different pre-slaughter feed withdrawal times (FWT) on the gastrointestinal tract (GIT) weight and the gut environment of pigs and Salmonella shedding were investigated. Trial 1 evaluated the effects under experimental conditions (feed withdrawal for 18, 30 and 36 h) and trial 2 under commercial conditions (15 and 30 h). In trial 1, the GIT weight tended to decrease (P=0.07), the caecal pH increased (P<0.0001), short-chain fatty acids (SCFA) decreased (P<0.001) and percentage of branched-chain fatty acids (BCFA) increased as FWT increased. Similar results were observed in trial 2, but Enterobacteriaceae numbers and Salmonella positive pigs tended to increase whereas lactobacilli decreased (P<0.0005) as FWT increased. The increase in FWT involved changes in the gut microbial ecosystem that could be associated with the trend of increased caecal Enterobacteriaceae and Salmonella in faeces, and may represent a higher risk of carcass contamination in cases of laceration of viscera.