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Acute compartment syndrome of the thigh following hip replacement by anterior approach in a patient using oral anticoagulants

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World Journal of Orthopedics 2017年第12期8卷 964-967页

作者： Dirk Pieter Hogerzeil Imraan Muradin Eline W Zwitser joris a jansen Department of Orthopedic Surgery Alrijne Hospital

Acute compartment syndrome(ACS) of the thigh following primary total hip arthroplasty(THA) is a highly uncommon complication and has not yet been reported before with regards to the anterior approach through the anterior supine interval. We present a case of a 69-year-old male patient with a history of stroke, who developed ACS of the thigh after elective THA while using therapeutic low molecular weight heparin as bridging for regular oral anticoagulation. ACS pathogenesis, diagnostic tools, treatment and relevant literature are discussed. The patient's ACS was recognized in time and treated by operative decompression with fasciotomy of the anterior compartment. Follow-up did not show any neurological deficit or soft-tissue damage.

关键词： Orthopedics Total hip arthroplasty Anterior supine intermuscular approach Acute compartment syndrome Anticoagulation therapy

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Painless swollen calf muscles of a 75-year-old patient caused by bilateral venous malformations

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World Journal of Orthopedics 2017年第7期8卷 602-605页

作者： Roderick S M Piekaar Eline W Zwitser Paul P A Hedeman Joosten joris a jansen Department of orthopaedic surgery Alrijne Hospital Department of vascular surgery Alrijne Hospital

A 75-year-old man presented with knee pain due to medial osteoarthritis of the knee in the orthopedic outpatient clinic. Conservative treatment was started with steroid infiltration. Besides his knee complaint reported a bilateral painless swollen calf muscle without traumatic cause, and also without any pain at night, fever or medical illness. On physical examination the soleus muscle had a swollen aspect in both calfs. The skin appeared normal without deformities and the arterial pulsations were intact. An X-ray did not show abnormalities in the tibia. Magnetic resonance imaging of the legs revealed bilateral multiple saccular intramuscular venous malformations involving the soleus muscle. Intramuscular venous malformations in skeletal muscles are rare, especially when the occurrence is bilateral. Bilateral venous malformations have the potential to be missed because of the intramuscular localization. Symptoms of intramuscular venous malformation can be often mild and overlap with nonexercise related compartment syndrome, claudication, lymphedema and post thrombotic syndrome or muscle strains.

关键词： Venous malformations Bilateral intramuscular venous malformation Swollen calf muscles

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