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Background. One of the common treatments for prostate cancer is radical prostatectomy, which is performed in different ways. One of the advantages of the nerve bundle preservation method is better exposure, decrease in rectal damage the lower rectum. In addition, the possibility of a positive margin is less. Therefore, this study aimed to examine the results of using the high anterior release (HAR) technique in radical open prostatectomy surgery. Methods. In this cross-sectional study, after examining patients and their entry into the study and obtaining their medical records, questions were asked to assess erectile function and urinary incontinence. The prostate-specific antigen level was checked before and after the operation. In addition, the average surgical time, blood loss, and hospitalization time were evaluated. Finally, the data were analyzed using the SPSS statistical analysis program, version 19. Results. In this study, 102 patients underwent radical prostatectomy, with an average age of 62.33 years. About 56.9% of patients had stage t2b. During the 6-month follow-up after surgery, 70.5% of patients had complete urinary continence. Data analysis demonstrated that there is a direct relationship between urinary incontinence, with a history of radiotherapy (P<0.001), and the stage of the disease (P=0.019). After surgery, 61.8% of patients were satisfied with the erection function . Conclusion. The results of this study revealed that urinary incontinence and erectile dysfunction are relatively common complications of this surgery. However, compared to other similar studies, the incidence of these two complications is lower. Practical Implications. Urinary incontinence and erectile dysfunction are relatively prevalent complications of radical prostatectomy surgery using the HAR technique. Nonetheless, the incidence of these two complications is lower compared to other similar studies. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided procedures for the proper targeting of the interface between the plantar fascia and the flexor digitorum brevis with a solid needle. Methods: A crossover cadaveric study was conducted. Five experienced therapists performed a series of 20 needle insertions each (n = 100 in total, 10 landmark-guided and 10 ultrasound-guided) on 10 anatomical samples. The therapists were instructed to accurately place the needle on the interface between the plantar fascia and the flexor digitorum brevis muscle. The distance of the tip of the needle to the identified target (accuracy), the surrounding sensitive structures targeted (safety), the time needed for the procedure, the number of needle passes, and the needle length outside the skin were assessed. Results: The ultrasound-guided technique was associated with a significantly higher accuracy (p < 0.001) but without differences in safety (p = 0.249) as compared to the palpation-guided procedure. Conclusion: Our results suggest that ultrasound-guided insertion exhibits greater accuracy but not greater safety than palpation-guided insertion when targeting the interface between the plantar fascia and the flexor digitorum brevis. [ABSTRACT FROM AUTHOR]

Background: The integrity of the acetabular labrum is critical in providing normal function and minimizing hip degeneration and is considered key for success in today's hip preservation algorithm. Many advances have been made in labral repair and reconstruction to restore the suction seal. Purpose/Hypothesis: To compare the biomechanical effects of segmental labral reconstruction between the synthetic polyurethane scaffold (PS) and fascia lata autograft (FLA). Our hypothesis was that reconstruction with a macroporous polyurethane implant and autograft reconstruction of fascia lata would normalize hip joint kinetics and restore the suction seal. Study Design: Controlled laboratory study. Methods: Ten cadaveric hips from 5 fresh-frozen pelvises underwent biomechanical testing with a dynamic intra-articular pressure measurement system under 3 conditions: (1) intact labrum, (2) reconstruction with PS after a 3-cm segmental labrectomy, then (3) reconstruction with FLA. Contact area, contact pressure, and peak force were evaluated in 4 positions: 90º of flexion in neutral, 90º of flexion plus internal rotation, 90º of flexion plus external rotation, and 20º of extension. A labral seal test was performed for both reconstruction techniques. The relative change from the intact condition (value = 1) was determined for all conditions and positions. Results: PS restored contact area to at least 96% of intact (≥0.96; range, 0.96-0.98) in all 4 positions, and FLA restored contact area to at least 97% (≥0.97; range, 0.97-1.19). Contact pressure was restored to ≥1.08 (range, 1.08-1.11) with the PS and ≥1.08 (range, 1.08-1.10) with the FLA technique. Peak force returned to ≥1.02 (range, 1.02-1.05) with PS and ≥1.02 (range, 1.02-1.07) with FLA. No significant differences were found between the reconstruction techniques in contact area in any position (P >.06), with the exception that FLA presented greater contact area in flexion plus internal rotation as compared with PS (P =.003). Suction seal was confirmed in 80% of PSs and 70% of FLAs (P =.62). Conclusion: Segmental hip labral reconstruction using PS and FLA reapproximated femoroacetabular contact biomechanics close to the intact state. Clinical Relevance: These findings provide preclinical evidence supporting the use of a synthetic scaffold as an alternative to FLA and therefore avoiding donor site morbidity. [ABSTRACT FROM AUTHOR]

Background: Previous observational studies showed higher rates of abdominal wall closure with the use of hypertonic saline in trauma patients with abdominal injuries. However, no randomized controlled trials have been performed on this matter. This double-blind randomized clinical trial assessed the effect of 3% hypertonic saline (HS) solution on primary fascial closure and the timing of abdominal wall closure among patients who underwent damage control laparotomy for bleeding control. Methods: Double-blind randomized clinical trial. Patients with abdominal injuries requiring damage control laparotomy (DCL) were randomly allocated to receive a 72-h infusion (rate: 50 mL/h) of 3% HS or 0.9 N isotonic saline (NS) after the index DCL. The primary endpoint was the proportion of patients with abdominal wall closure in the first seven days after the index DCL. Results: The study was suspended in the first interim analysis because of futility. A total of 52 patients were included. Of these, 27 and 25 were randomly allocated to NS and HS, respectively. There were no significant differences in the rates of abdominal wall closure between groups (HS: 19 [79.2%] vs. NS: 17 [70.8%]; p = 0.71). In contrast, significantly higher hypernatremia rates were observed in the HS group (HS: 11 [44%] vs. NS: 1 [3.7%]; p < 0.001). Conclusion: This double-blind randomized clinical trial showed no benefit of HS solution in primary fascial closure rates. Patients randomized to HS had higher sodium concentrations after the first day and were more likely to present hypernatremia. We do not recommend using HS in patients undergoing damage control laparotomy. Trial registration The trial protocol was registered in clinicaltrials.gov (identifier: NCT02542241). [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of superficial temporal artery (STA)- middle cerebral artery (MCA) bypass combined with temporoparietal fascia flap in the treatment of moyamoya disease (MMD). Methods Retrospective analysis was performed on 18 patients with MMD who were treated with STA-MCA bypass combined with temporoparietal fascia flap in Tianjin Huanhu Hospital from January 2018 to January 2020. The improvement of clinical symptoms, incision healing and complications were observed 7 days or 6 months after operation. DSA and PWI were used to evaluate the changes of cerebral hemodynamics, patency of bridge anastomosis and collateral compensation in pre- and post-operation. Results During the postoperative and follow-up period, 13 cases showed significant improvement in clinical symptoms, 4 cases showed no obvious improvement, one case was worse than before operation, 5 cases had cerebral hyperperfusion syndrome (CHS), one case had ischemic stroke, 2 cases had residual limb movement disadvantage, one case had unsteady walking, and one case had memory loss. All the patients had good wound healing during the postoperative and follow-up period. All operative incisions healed well, cerebral blood flow (CBF) and cerebral blood volume (CBV) were improved, mean treasnit time (MTT) and time to peak (TTP) were slightly delayed, and blood flow at the bridge anastomis was unobvious. Conclusions STA-MCA bypass combined temporoparietal fascia flap can effectively improve cerebral hemodynamics, increase blood flow in MCA blood supply area and intracranial cerebral perfusion, reduce the incidence of ischemic stroke, maintain the normal anatomical position and the function of the temporalis muscle, and improve postoperative comfort of patients. [ABSTRACT FROM AUTHOR]

Purpose: Pain management is a challenging issue in elderly patients with hip fracture. Despite the accepted clinical outcomes following hip surgery, pain and prolonged recovery time are the most difficult consequences associated with the rehabilitation process. The purpose of this study was to evaluate pain relief and functional improvement associated with the Fascia Iliaca Compartment Block (FICB) during the perioperative period of elderly patients with hip fracture. Patients and methods: This study included 120 elderly patients with hip fracture, who were admitted to our institution between January 2019 and December 2020. The participants were subsequently randomly divided into the routine analgesia (RA) and fascia iliaca compartment block (FICB) groups. Inter-group differences were compared via VAS scores at rest and during movement, Harris hip scores (HHS), presence of complications, adverse events after surgery, and length of hospital stay. Results: The FICB group VAS scores at rest at 6 hour, 1 and 3 days, and 1 week after surgery were significantly lower than the RA group (P <.05). Moreover, the FICB group VAS scores with movement were markedly lower at 6 hour, 1 and 3 days, as well as 1 and 2 weeks after surgery (P <.05). The HHS of the FICB and RA groups were (53.41±8.63) and (40.02±9.61), respectively, on the seventh day after surgery, and the difference was statistically significant (P <.05). The incidence of postoperative complications and adverse events in the FICB group were not statistically different from the RA group. The average hospital stay of the FICB group was 2.12 days shorter than the RA group, but the difference did not reach statistical significance (P =.13). Conclusion: FICB provides superior analgesic effect both at rest and with movement, along with rapid short-term recovery of hip function following surgery in elderly patients with hip fracture, without increasing postoperative complications or adverse events. [ABSTRACT FROM AUTHOR]

Objective. To explore the role of conjoint fascial sheath (CFS) suspension in the treatment of severe ptosis. Methods. A total of 110 patients with severe ptosis who were admitted to our hospital from May 2018 to December 2020 were included. Fifty-seven patients treated with frontalis suspension were assigned into group A, and the remaining 53 patients treated with CFS suspension were assigned into group B. The curative effect, ocular surface alterations, complications, and satisfaction in the two groups were compared. Results. Patients in group B suffered from severe upper eyelid retraction and lid lag than those in group A, as well as more limited range of motion (ROM) (P < 0.05). The curative effect and patient satisfaction in group B were higher than those in group A (P < 0.05). Postsurgical complications in group B were fewer than those in group A (P < 0.05). Conclusion. CFS suspension is effective in the treatment of severe ptosis. [ABSTRACT FROM AUTHOR]

Introduction: Repetitive and time sensitive demands of clothing workers has been associated with higher salivary cortisol levels that may reflect the stress experienced by the worker. Objective: This trial evaluates if suboccipital fascial release (SFR) is associated with reduced salivary cortisol levels. Methods: Randomized controlled trial with 40 workers, divided into: untreated group (UG, n = 15) and treated group (TG, n = 25). Both were removed from the work environment. The TG received the above technique and the UG remained lying at rest, both for five minutes. Salivary cortisol levels were measured by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Statistical analysis of data distribution, intragroup and intergroups, were performed with α adjusted to 0.05. Results: Pre / post intragroup analyses showed significant differences in cortisol levels in both groups, as well as intergroup analyses with lower values in favor of TG (p = 0.014). Conclusion: The reduction in salivary cortisol levels in TG suggests that SFR may be more effective than rest in reducing stress. Future studies with increased experimental rigor are necessary to confirm this conclusion. Clinical trial registration number: REBEC -- RBR -- 56yk9m. [ABSTRACT FROM AUTHOR]

The main aim of our study was to study morphological state of the autograft from the fascia of the temporal muscle in myringoplasty. Until now, there is no consensus on issue of which fabrics are more suitable for use in the eardrum. We decided to study of use of an autograft from the fascia of the temporal muscle for myringoplasty in rabbits in the experiment, and in patients with chronic dry mesotympanitis. An electron microscopic examination of the fascia taken immediately, after 10, 20 min and 1 h after sampling. It was found that there are no gross destructive changes in the fascia structure. Minor changes are detected in the form of a light disorganization of the collagen complex, granular dystrophy with an increase in cell. Inflammatory diseases of the middle ear are widespread among population of all age groups. In the experiment, a positive result was obtained in 29 (82.8%) rabbits. In our research we performed morphological features of xenograft engraftment in an experimental animal on 3, 7, 14, 21 days and 1-3 months. In period from 3 days to 3 months after operation, the animals were euthanized by an air embolism and subjected to pathological examination. Then recovered xenograft, was examined macro and microscopically. Pieces were fixed in a 10% solution of neutral formalin. After washing with water, dehydration was carried out in alcohol and chloroform, and after, waxed with paraffin. Histological sections were stained with hematoxylin-eosin. Collagen fibers were detected by method of Vann-Gieson. [ABSTRACT FROM AUTHOR]

The percutaneous nephrolithotomy method is the most used treatment option for urinary stone disease. Bleeding is the most feared complication of this method. Transcatheter coil or medical glue embolization is currently the used treatment option for this bleeding complication. The aim of this report to show the novel subcutaneous fat tissue embolization technique for percutaneous nephrolithotomy related bleeding complications. In these two cases, we treated the percutaneous nephrolithotomy related bleeding complication with subcutaneous fat tissue. Subcutaneous fat tissue was taken with subcutaneous fascia from the femoral site by 1 cm incision. This tissue to be used for embolization was passed on the 0.014 guidewire from the back end of this guidewire (like shish kebab). The fat tissue passed on the 0.014 wire was sent to the bleeding site through the guiding catheter and guideliner, over the 0.014 guidewire with the monorail balloon (as a pusher) placed behind this fat tissue. The subcutaneous fat tissue with subcutaneous fascia embolization was completely stopped the bleeding and fistula. We have successfully used a novel embolization technique for fat tissue embolization to the bleeding site (Ari technique). Subcutaneous fat tissue embolization with the novel embolization technique for percutaneous nephrolithotomy related bleeding is a safe and reliable treatment option. [ABSTRACT FROM AUTHOR]

Introduction: We aim to present a modified technique and outcomes of a novel method allowing for direct visualization of the reservoir placement during a penoscrotal inflatable penile prosthesis (IPP). Methods: Out of165 patients who underwent IPP placement from August 2012 to March 2015, 157 underwent a modified technique and comprised the cohort of this study. A Deaver's retractor was placed lateral to the penis and over the pubic bone to allow for direct visualization of the tissues overlying the lower abdomen. After dissecting through the superficial layers, the Deaver's was slowly advanced, allowing for visualization of the fascia, which was incised. Using blunt dissection, a space for the reservoir was created between the bladder and the pubic bone. The reservoir was then placed safely into this space and the Deaver's retractor was removed. Results: The causes of ED in the study cohort included postprostatectomy ED (n = 107), organic impotence (n = 40), Peyronie's disease (n = 3), ED following cystoprostatectomy (n = 2), ED due to spinal cord injury (n = 2), ED resulting from priapism (n = 2), and ED after pelvic injury (n = 1); all of which were refractory to medical management. The median age of study population was 66 years and the mean (standard deviation) operative time was 72.8 (14.7) min. Eighty percent of the procedures were performed on outpatient basis. Complication rates were low (<5%), with four infections, one proximal pump migration, one scrotal hematoma, and one urinary tract infection. Conclusion: The modified technique for placement of the IPP's spherical reservoir under direct visualization through a penoscrotal incision is quick, safe, and effective. [ABSTRACT FROM AUTHOR]

In the present study; experimental defects were created in the rabbits at the urinary bladder and the repair of the defects with autogenous Fascia latae (FL) graft was provided. The aim was to evaluate whether the grafted urinary bladder capacity reached to the normal urinary bladder capacity. A total of 32, healthy male adult New Zealand rabbits were used in this study. The rabbits were randomly divided into four equal groups, i.e. group I, II, III and IV (control) according to the duration of euthanasia. Bladder capacities of the rabbits were measured preoperatively. Experimentally 2x2 cm defects were induced in the urinary bladder of the rabbits and repaired with autogenous FL graft in the first three groups. The rabbits in the control group underwent no surgical application. Postoperative bladder capacities of rabbits in the groups were measured at the end of 4th (group I), 8th (group II) and 12th (group III and IV), weeks before being euthanized. The urinary bladder capacities of control group were compared with those of the rabbits in the other groups. As a result, it was concluded that the autogenous Fascia latae graft might be used successfully in the urinary bladder with decreased capacity. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Ankle limitation to dorsiflexion in an extended knee is observed during the second rocker of gait in patients with positive Silfverskiold test confirming an isolated gastrocnemius contracture (IGC). Tendons and muscles share intrinsic contractility and relaxation properties which can be modified during physiotherapy in comparison to the fascia which lacks it. The present study describes a case series of patients with positive Silfverskiold associated with various foot pathologies who underwent a selective fasciotomy of the postero-medial superficial portion of the crural fascia. The purpose of this study is to describe the surgical technique and clinical outcomes of this procedure. We hypothesize that this procedure can reach satisfactory clinical outcomes with the advantage of being a less invasive procedure. Methods: 26 patients treated with partial postero-medial superficial release (PMSR) of the crural fascia from January to October 2021 for IGC with associated chronic foot pain were included. Inclusion criteria considered patients with diagnosis of foot pain with IGC and positive Silfverskiold test. A transverse incision was made 2 cm distal to the flexion crease starting at the intermuscular line of the gastrocnemius muscle, 4 cm medially (Figure 1). Subcutaneous dissection was performed identifying the neurovascular bundle. A horizontal incision was performed to the superficial posterior fascia of the medial gastrocnemius head. The medial gastrocnemius muscle was not sectioned. Patients completed the FADI score previous to surgery and at final followup. Data was analyzed using SPSS 20. Paired samples T-tests were performed to identify significance of the difference in pain and function preoperatively and postoperatively with statistical significance set at p<0.05. Descriptive statistics were used for demographic variables. Results: 18 patients underwent partial PMSR of the crural fascia while 8 patients had additional procedures. Mean age of the included patients was 40.6 +/-18.5 years. Specifically, this included 4 feet with a diagnosis of metatarsalgia, 3 feet with metatarsalgia and plantar fasciitis, 6 feet with metatarsalgia, plantar fasciitis and cavus foot, 5 feet with plantar fasciitis, 3 feet with plantar fasciitis and insertional achilles tendinopathy, 4 patients with non-insertional achilles tendinopathy and 1 foot with flexor hallucis longus tendinopathy.The average ankle dorsiflexion increased significantly (p<0.0001) from -1.15 +/-2.15 degrees preoperatively to 10.65 +/-2.02 degrees post-operatively. The average FADI score significantly increased (p<0.0001) from 47.54 +/-12.26 preoperatively to 80.46 +/-14.04 post-operatively. The average follow-up was 9.38 +/-3.76 weeks. All patients had a negative Silfverskiold test at final follow-up. Conclusion: Partial postero-medial superficial release (PMSR) of the crural fascia was found to be an effective outpatient procedure when used to relieve foot pain in those patients with an isolated gastrocnemius contracture. Patients who have failed conservative treatment can expect notable improvement with satisfactory FADI scores after the procedure. Future prospective studies should involve a larger number of patients with no additional procedures to be compared with gastrocnemius muscle release procedure for isolated gastrocnemius contracture with associated foot pain. [ABSTRACT FROM AUTHOR]

Perineal hernia (PH) in dogs normally requires surgical reconstruction of the pelvic diaphragm. The use of fascia lata grafts has been reported and described in previous studies for the correction of PH after failure of the conventional herniorrhaphy. The purpose of this report is to describe a modified technique of fascia lata flap (FLP) for PH repair in dogs. Six client-owned male dogs with PH were included in the study. PH was repaired with a FLP obtained from the dog's ipsilateral thigh and sutured directly into the perineal defect. Caudal scrotal orchiectomy was performed in all dogs that were not castrated. Clinical outcome including postoperative complications and recurrence rates were evaluated. PH did not recur in any of the dogs included in this study. The mean follow-up time was 24 months (range: 18--34). Mild postoperative complications were observed. One dog presented partial skin dehiscence at the PH repair site and one had mild lameness. Complications were completely resolved within 20 postoperative days. FLP is a simple surgical technique that can be used for perineal herniorrhaphy in dogs without long-term recurrence. [ABSTRACT FROM AUTHOR]

Background: Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bemese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO). Materials and Methods: Ten hemipelvises of five donor cadavers were used. The transverse Stoppa incision was made 2 cm over the symphysis pubis for quadrilateral surface exposure and pubic and ischial bone osteotomies. The second skin incision, a few centimeters lateral to the original incision, was made along the tensor fascia lata. Iliac bone osteotomy was performed starting just above the rectus femoris insertion. The displacement of the osteotomy was measured clinically and radiographically. Results: The mean anterior coverage calculated with center-edge angle was improved from 22.8° ±2.8 (range 20° min-28° max) preoperatively to 44.1° ± 3.7 (range 36° min-48° max). The displacement of the osteotomy at the iliopectineal line calculated on the iliac inlet view radiographs was 22.1 ± 3.4 mm (range 15 mm min-26 mm max). The clinical amount of the anterior displacement on the cadavers was 17.8 ± 3.35 mm (range 11 mm-21 mm) and lateral displacement was 20.3 ± 3.23 mm (range 15 mm-24 mm). The amount of the posterior intact bone enlargement at the quadrilateral surface was 5.3 ± 0.48 mm. Conclusion: This less traumatic two-incision exposure is an adequate technique for Bernese PAO, allowing the bone to be cut under direct visual observation and reducing the need to use fluoroscopy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the graft success rates and audiological outcomes of bilaterally performed type 1 tympanoplasty using cartilage palisades or temporal fascia in children. MATERIALS and METHODS: We retrospectively analyzed the medical records of patients who underwent type 1 tympanoplasty at Medical Park Hospital between May 2007 and February 2013. 27 patients (54 ears) were enrolled in the study: 15 (30 ears) in the palisade cartilage group and 12 (24 ears) in the fascia group. RESULTS: The graft success rate for the fascia group was 79.2%, and that for the cartilage group was 96.7%. The difference was statistically insignificant (p=0.078). Audiological improvements were seen in both groups, and the difference was statistically insignificant. CONCLUSION: The use of temporalis fascia grafting has similar outcomes to palisade cartilage tympanoplasty for both success rate and audiological values in children who have bilateral disease. [ABSTRACT FROM AUTHOR]

Hemodynamic resuscitation, source control, and delayed abdominal closure are the three fundamental steps for open abdomen (OA) management. When to start delayed abdominal closure and how to determine which delayed closure method should be applied to each OA patient are not clarified in the literature. We evaluated an algorithm that was developed to address these two questions. A retrospective chart review was conducted for OA patients treated for according to the algorithm. When hemodynamic stabilization and source control using negative pressure therapy resulted in regression of sepsis and decreased procalcitonin levels, patients were assigned to either the skin-only or fascial closure groups according to their Björck scores and open abdominal fascial closure (OAFC) scores. The novel OAFC scoring system was created by adding age and malignancy to the sequential organ failure assessment (SOFA) score. For skin-only closure, skin flaps and skin grafts were used; for fascial closure, an abdominal re-approximation anchor system (ABRA) or ABRA plus biologic mesh was applied. From January 2008 through September 2014, 108 OA patients were managed based on the algorithm; 61 were included in this study. Abdominal closure rate was 90.2 % (55/61). Overall hospital mortality rate was 11.4 % (7/61). Small hernias developed in only 12.5 % (4/32) of the fascial closure group. In this retrospective study, the algorithm with the novel OAFC score provided practical and valid guidance to clarify when to start delayed abdominal closure and which delayed closure method to use for each OA patient. [ABSTRACT FROM AUTHOR]

Surgical release of the anterior and lateral compartments of the lower leg has been shown to relieve the symptoms of chronic exertional compartment syndrome. We utilize a technique that allows the surgeon to perform anterior and lateral compartment fasciotomies through a single incision while safely identifying the superficial peroneal nerve. After positioning the patient supine on the operating table with the operative extremity prepared and draped, anatomic landmarks are identified on the patient's skin. The major steps of the procedure are (1) identifying the distal end of the fibula, anterior fibular diaphysis, tibial crest, fibular head, and lateral aspect of the patella; (2) drawing the skin incision, beginning 6 to 8 cm proximal to the distal end of the fibula centered between the tibial crest and anterior fibular diaphysis and extending it 6 cm proximally; (3) making a skin incision longitudinally and dissecting the subcutaneous tissue to allow identification of the fascia and superficial peroneal nerve; (4) performing gentle neurolysis; (5) identifying the anterior and lateral compartments, making small incisions in the fascia of each compartment, and then performing fasciotomy of the lateral and then anterior compartments while protecting the superficial peroneal nerve; and (6) irrigating the wound, closing it in layers, and applying a soft, compressive dressing. Postoperatively, the patient is allowed to bear as much weight as he or she can tolerate. Current literature indicates that good-toexcellent outcomes can be expected for 90% to 95% of patients treated with fasciotomy. Military personnel and patients with posterior compartment involvement may have less reliable outcomes. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Corrective surgery for flexible flatfoot deformity (FD) remains controversial, and one of the main reasons for this is the lack of standardised radiographic measurements to define an FD. Previously published radiographic parameters to differentiate between a specimen with and without FD do not have a commonly accepted and distinct threshold. Such a parameter would help validate FDs and the required corrective surgery. The purpose of this study was to assess a new conventional radiographic parameter with a distinct threshold that allowed the differentiation between feet with and without an FD and evaluate its application in corrective surgery for FD. Methods: The plantar fascia-talar head correlation (PTC) with its defined threshold was assessed by measuring the distance between the medial border of the plantar fascia [a connecting line between the medial border of the tibial sesamoid and the calcaneal insertion of the plantar fascia (mPCal)] and the centre of the talar head (DPT) on conventional dorsoplantar and lateral weightbearing radiographs; the authors were blinded to the clinical diagnosis of the 189 patients' first visits. Feet were grouped into specimens with and without an FD based on clinical examination. Then, the effect of surgical correction of FD on PTC was retrospectively evaluated on 38 patients. The intra-class correlation (ICC2) of the intra-observer reliability and the ICC2 of the inter-observer reliability of DPT measurement of 50 randomly selected specimens were calculated. The results of PTC were compared to the measurements of the lateral talar-1st metatarsal angle and the talonavicular uncoverage angle. Results: The intra-class correlation (ICC2) of the intra-observer reliability of DPT measurement was 0.95 (95%-confidence interval CI95[0.92, 0.97]), the ICC2 of the inter-observer reliability was 0.93 (CI95 [0.89, 0.95]). PTC, lateral talar first metatarsal angle and talonavicular uncoverage angle showed a statistically significant difference between the specimens with and without a FD (Wilcoxon test p-values <0.001). However, only the discriminatory power of PTC was distinct. The sensitivity and specificity of PTC was 0.88 (95%CI: 0.77-0.95) and specificity 0.96 (95%CI: 0.92-0.98), respectively, to identify an FD, consistent with the clinical examination. The identification of a sagittal plane FD caused by midfoot osteoarthritis on a lateral conventional weightbearing radiograph before measuring DPT increased the sensitivity for the combined method to 0.98 (95%CI: 0.9-1). Thirty-five of 38 surgeries successfully corrected the FD and PTC comparable to that in subjects without an FD. The unsuccessful corrections did not adequately correct the PTC. Conclusion: PTC is a unique and reliable radiographic parameter with an excellent threshold to confirm an FD, can be used intraoperatively to titrate the required amount for correction of FD under simulated weightbearing fluoroscopic imaging and is therefore useful to monitor and validate sufficient correction of its reconstructive surgery.PTC is an objective radiographic measurement to reliably describe the clinical subjective conclusion of any kind of FD with the exception FDs caused by an explicit midfoot pathology. [ABSTRACT FROM AUTHOR]

Plantar fibromatosis, Ledderhose’s disease, or Morbus Ledderhose is an uncommon benign nodular hyperplasia of the plantar aponeurosis. The aim of this paper was to report the case of a 47-year-old male patient who had concomitant Dupuytren’s disease and failed all conservative measures. He was treated surgically with prompt and complete relief of symptoms postoperatively, and he has had no recurrence at the 2-year follow-up. In this richly documented case, we discuss details of the surgical technique and anatomy, which was important for a successful outcome and preventing complications. The technique for subtotal fasciectomy is reviewed and the relevance of the adequate choice of skin incision to prevent painful scarring, skin necrosis, and difficulties with shoe wearing is highlighted. [ABSTRACT FROM AUTHOR]

Background: Considering that complications and outcome of each method of pediatric inguinal hernia repair are one of the M determinants for pediatric surgeons for selection of the appropriate surgical technique, we compared the early and late complications Ph of two inguinal repair techniques, with and without opening the external oblique muscle fascia. Materials and Methods: In this 0 double-blind clinical trial study, boy children aged 1-month to 6 years with diagnosed inguinal hernia were included and randomly allocated into two groups for undergoing two types of hernia repair techniques, with and without opening the external oblique muscle fascia. Surgical complications such as fever, scrotal edema and hematoma, and wound infections classified as early complication and recurrence, testis atrophy and sensory impairment of inguinal area classified as late complications. The rates of mentioned early and late complications were compared in the two interventional groups. Results: In this study, 66 patients were selected and allocated to the two interventional groups. The prevalence of early and late complications in two studied groups were not different significantly in two interventional groups (P > 0.05). Operation time was significantly shorter in inguinal repair techniques without opening the external oblique muscle fascia than the other studied technique (P = 0.001). Conclusion: The findings of our study indicated that though early and late complications of the two repair methods were similar, but the time of procedure was shorter in herniotomy without opening the external oblique muscle, which considered the superiority of this method than inguinal hernia repair with opening the external oblique muscle. [ABSTRACT FROM AUTHOR]

The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal. However, the OA may require multiple returns to the operating room and may be associated with significant complications, including enteroatmospheric fistulas, loss of abdominal wall domain and large hernias. Surgeons should be aware of the pathophysiology of severe intra-abdominal sepsis and always keep in mind the option of using open abdomen to be able to use it in the right patient at the right time. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciopathy presents with pain at the plantar and medial aspect of the heel. If chronic, it can negatively impact on quality of life. Plantar fasciopathy is not always self-limiting, and can be debilitating. Methods: Surgical management involves different procedures. We describe a percutaneous plantar fascia release. A minimally invasive access to the plantar tuberosity of the calcaneus is performed, and a small scalpel blade is used to release the fascia. Conclusion: With this procedure, skin healing problems, nerve injuries, infection and prolonged recovery time are minimised, allowing early return to normal activities. Level of Evidence: V. [ABSTRACT FROM AUTHOR]

To evaluate the success rate, in terms of anatomical and functional results, in our technique of cartilage support for fascia graft in type I tympanoplasty. Retrospective study of tragal cartilage support for fascia graft in tympanoplasty for large central perforation in 748 patients was carried at an academic institution during January 2004 to March 2012. Patients' age ranged from 11 to 65 years. 325 (43.4 %) male and 423 (56.6 %) female patients were operated and mean post-operative follow up was of 24 months (range 6-48 months). The inclusion criteria were large central or subtotal perforation, anterior quadrant perforation, anterior tympanosclerotic patch with perforation and revision myringoplasty. Small central perforation, posterior perforations, traumatic perforations and Ossiculplasty were excluded from this study. In this technique, a piece of tragal cartilage carved in semi lunar shape is inserted medial to anterior remnant of tympanic membrane. Temporalis fascia graft is sandwiched between cartilage and anterior remnant of tympanic membrane. Post-operative closure of perforation was noted. Pure-tone average pre and post-operative air-bone gap in dB at 250, 500, 1000, 2000, and 4,000 Hz were compared. The overall success rate of our technique was 98.3 % in terms of graft uptake and within 13.35 ± 5.22 dB of air bone gap closure in terms of hearing improvement. This study reveals that cartilage support for fascia graft in type I tympanoplasty is a highly reliable technique and gives significant improvement in graft take-up and hearing status. [ABSTRACT FROM AUTHOR]

Background Necrotizing fasciitis (NF) is a rapid progressive infection of the subcutaneous tissue or fascia and may result in large open wounds. The surgical options to cover these wounds are often limited by the patient condition and result in suboptimal functional and cosmetic wound coverage. Dermatotraction can restore the function and appearance of the fasciotomy wound and is less invasive in patients with comorbidities. However, dermatotraction for scarred, stiff NF fasciotomy wounds is often ineffective, resulting in skin necrosis. The authors use extended negative pressure wound therapy (NPWT) as an assist in dermatotraction to close open NF fasciotomy wounds. The authors present the clinical results, followed by a discussion of the clinical basis of extended NPWT-assisted dermatotraction. Methods A retrospective case series of eight patients with NF who underwent open fasciotomy was approved for the study. After serial wound preparation, dermatotraction was applied in a shoelace manner using elastic vessel loops. Next, the extended NPWT was applied over the wound. The sponge was three times wider than the wound width, and the transparent covering drape almost encircled the anatomical wound area. The negative pressure of the NPWT was set at a continuous 100 mmHg by suction barometer. The clinical outcome was assessed based on wound area reduction after treatment and by the achievement of direct wound closure. Results After the first set of extended NPWT-assisted dermatotraction procedures, the mean wound area was significantly decreased (658.12 cm² to 29.37 cm²; p = 0.002), as five out of eight patients achieved direct wound closure. One patient with a chest wall defect underwent latissimus dorsi musculocutaneous flap coverage, with primary closure of the donor site. Two Fournier's gangrene patients underwent multiple sets of treatment and finally achieved secondary wound closure with skin grafts. The patients were followed up for 18.3 months on average and showed satisfactory results without wound recurrence. Conclusions Extended NPWT-assisted dermatotraction advances scarred, stiff fasciotomy wound margins synergistically in NF and allows direct closure of the wound without complications. This method can be another good treatment option for the NF patient with large open wounds whose general condition is unsuitable for extensive reconstructive surgery. [ABSTRACT FROM AUTHOR]

The article discusses the management and treatment of acute compartment syndrome (ACS), a condition typically associated with traumatic injury in which elevated pressures within a closed fascial compartment lead to vascular compromise. Research has shown that ACS must be treated within six hours to prevent life-long deformity and disability. The author suggests that the most widely accepted surgical approach is the double-incision radical dissection of all fascia within the affected limb.

OBJECTIVES Following extensive chest wall resection, the reconstruction technique should fulfill two opposing functional requirements: adequate rigidity and flexibility of the chest wall during the breathing phases. Reconstruction with fascia lata enables a balance between these two parameters, thus favouring the patients' respiratory dynamics and producing low morbidity and good functional results. METHODS Sixty patients underwent chest wall reconstruction using fascia lata alone or in combination with titanium plates between 2006 and 2011, due to primary tumours in 28 patients, metastases in 23 and local recurrences in 9. The mean area of resected tissue was 107.7 cm2, distributed among the anterior, anterolateral, lateral and posterior zones. One-to-eight ribs were resected, and additional sternum resection was performed in 75% of patients. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were evaluated in 33 patients. RESULTS 46.6% of patients underwent reconstruction with fascia lata alone, 1.6% with fascia lata, DualMesh® and titanium plates and 51.6% with fascia lata and titanium plates. There was no 30-day mortality. All patients were extubated after the operation with no need for reintubation. Five patients had postoperative complications: 2 wound dehiscences, 2 haematomas and 1 seroma. There were no significant differences between preoperative and postoperative FEV1 and FVC measurements in patients with or without lobectomy and wedge resections. CONCLUSIONS Chest wall reconstruction with fascia lata, alone or in combination with titanium plates, allows the surgeon to perform a dynamic reconstruction without flail chest in extensive exeresis. Risks of infection associated with the use of prosthetic materials are also minimized. In addition, the characteristic flexibility of this tissue makes it a precious tool in paediatric chest wall reconstruction, since fascia lata naturally adapts to the physiological growth of younger bodies, thus reducing the risk of scoliosis and local deformities. [ABSTRACT FROM PUBLISHER]

Abstract: This study was designed to compare the analgesic efficacy of levobupivacaine patient controlled analgesia epidural versus patient controlled analgesia with fascia lliaca compartment block. In patients undergoing fixation of fracture neck femur. Methods: Sixty patients ASA II&III undergoing fixation of fracture neck femur were randomly allocated into two groups (n =30). Group E: Epidural group given levobupivacaine 0.25% 15ml before induction of general anesthesia, followed by postoperative PCEA with levobupivacaine (0.125%). Group F: Fascia iliaca block group given levobupivacaine 0.25% 30ml through the catheter before induction of general anesthesia, followed by postoperative patient controlled fascia illiaca analgesia with levobupivacaine (0.125%). Severity of postoperative pain at rest in 24h using VAS, number of patients required additional analgesia (tramadol) in 24h, doses of postoperative 24h tramadol consumed, postoperative mean arterial blood pressure and heart rate were recorded. Results: The severity of postoperative pain was statistically significantly less in E group, number of patients required tramadol in 24h were statistically significantly less in E group than F group, postoperative tramadol consumed was statistically significantly less in E group than F group. Conclusion: PCEA with levobupivacaine (0.125%) was associated with satisfactory analgesia than patient controlled analgesia with fascia iliaca block in patients undergoing fixation of fracture neck femur. [Copyright &y& Elsevier]

Abstract: Efficacy of dexmedetomidine addition to bupivacaine on the quality of blind fascia iliaca compartment block in children undergoing femur fracture surgery. Objectives: The objectives of this study were designed to detect the effects of addition of dexmedetomidine to bupivacaine on the quality of blind fascia iliaca compartment block and its possible side effects in children undergoing fracture femur surgery. Methods: This study was conducted on 28 children (2–6years of age), scheduled for fracture femur surgery. Children were randomly allocated to receive either 0.25% bupivacaine 1mlkg−1 (B group), or 0.25% bupivacaine 1mlkg−1 with dexmedetomidine 2μgkg−1 (BD group). Anesthesia was maintained with sevoflurane 1–1.5 minimum alveolar concentration. Intraoperative sevoflurane concentration, hemodynamic, postoperative emergence delirium, sedation scores and pain scores were recorded. Duration of surgery and emergence time were recorded. Postoperative complications such as (nausea and vomiting, respiratory depression, purities, hypotension and bradycardia) were reported. Results: Compared to the group B, patients received bupivacaine–dexmedetomidine for fascia iliaca compartment block had lower intraoperative sevoflurane concentration, higher sedation score, longer duration of postoperative analgesia, less use of rectal paracetamol for the first 24h postoperatively and less number with postoperative agitation. No patients developed postoperative respiratory depression, purities, hypotension or bradycardia. Conclusion: The present study concluded that the combined use of bupivacaine–dexmedetomidine for fascia iliaca compartment block in children provided significant reduction of end-tidal sevoflurane concentration, remarkable hemodynamic stability, significant postoperative analgesia with lower postoperative analgesics requirements without any undesirable complications. [Copyright &y& Elsevier]

Introduction: The use of Negative Pressure Wound Therapy (NPWT) for temporary abdominal closure of open abdomen (OA) wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma. Methods: A prospective study on trauma patients requiring temporary abdominal closure (TAC) with grade 1or 2 OA was carried out. All patients were treated with NPWT (RENASYS AB Smith & Nephew) to achieve TAC. The primary outcome measure was time taken to achieve fascial closure and secondary outcomes were complications and mortality. Results: A total of 20 patients were included. Thirteen patients (65%) achieved fascial closure following a median treatment period of 3 days. Four patients (20%) died of causes unrelated to NPWT. Complications included fistula formation in one patient (5%) with spontaneous resolution during NPWT), bowel necrosis in a single patient (5%) and three cases of infection (15%). No fistulae were present at the end of NPWT. Conclusion: This new NPWT kit is safe and effective and results in a high rate of fascial closure and low complication rates in the severely injured trauma patient. [ABSTRACT FROM AUTHOR]

Purpose: Involutional entropion is a common condition in Asian countries, including Japan. One cause of involutional entropion is weakening of the capsulopalpebral fascia (CPF). The aged, thin, membranous nature of the CPF limits the results of correction by the original Jones procedure (CPF tightening) alone, so we added the modified Hotz procedure to the entropion repair. We then compared the recurrence rates and operation times in corrections performed with and without this additional procedure. Cases: From April 2010 to December 2011, one surgeon performed lower-lid surgery using the Jones procedure with the addition of the modified Hotz procedure. Fifteen patients (a total of 21 eyes) underwent this combined procedure. Previously, the same surgeon performed the Jones procedure alone for eight patients (a total of nine eyes). Results: The average age of the two groups was 76.4 years, with an age range of 66-85 years. All cases reported acceptable ciliary orientation at the end of the surgery. However, patients who underwent the Jones procedure alone (nine eyes total) reported three cases of recurrence after at least 6 months of follow-up. Patients who underwent the combined procedure reported two complications: one recurrence and one ectropion. The recurrence rate was 5%. The Jones procedure using eyelid pinch required an average of 22.6 minutes to complete; the combined method required 33.4 minutes to complete. Conclusion: The combined method resulted in a significantly higher success rate than the Jones procedure alone (P < 0.05). The 5% failure rate of the combined method was found to be superior to the 30% recurrence rate of the Jones procedure. As a result, the Hotz procedure enhanced the results of the entropion correction and required only 10 additional minutes of surgery. We now perform this combined procedure for all cases. [ABSTRACT FROM AUTHOR]

The article offers information on a research related to the classification and treatment of a disease, Omphaloceles which causes herniation in the peritoneal cavity of the umbilical cord. As mentioned, this disease can be classified as major and minor according to the diameter of the protrusions in the affected region but the research shows the third category called intermediate which can help in the isolation of groups and management of disease by primary fascial closure after resuscitation.

Acute compartment syndrome is a limb-threatening condition in which early diagnosis and surgical consultation for fasciotomy are required to preserve functional outcome. The diagnosis is typically considered in patients with traumatic mechanisms of injury such as a direct blow and crush to the compartment, particularly when there is a fracture in the same compartment. We report the case of a patient with acute compartment syndrome of the dorsal forearm that occurred as a result of an atypical noncontact traumatic mechanism. Establishing the diagnosis of compartment syndrome was complicated in this patient, as some of the signs and symptoms of acute compartment syndrome could have been attributed to the presence of a coexisting rupture of the extensor digitorum muscle. This report serves to remind emergency physicians that, although rare, acute compartment syndrome can result from exertional and noncontact traumatic mechanisms. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics related to surgery that were delivered during the 2009 Annual Meeting of the Canadian Society for Vascular Surgery at The Fairmont Château Laurier in Ottawa, Ontario on September 25-26, 2009 including the mental constraints of patients with abdominal aortic aneurysms, use of less invasive lower limb fasciotomy technique, and the importance of consulting vascular surgeons.

Objective--To evaluate the effects of fascial abrasion, fasciotomy, and fascial excision on cutaneous wound healing in cats. Animals--Eight 1- to 3-year-old domestic shorthair cats. Procedures--8 evenly spaced 4-cm² skin wounds were created on each cat's dorsum, and the underlying subcutaneous tissue was removed to expose the epaxial muscle fascia. Wounds were randomized to receive 1 of 4 treatments (2 wounds/treatment/cat): fascial abrasion, fasciotomy, fascial excision, or control treatment (muscle fascia not disturbed). Bandages were changed and digital photographs and acetate tracings of the wounds were obtained for planimetry daily for 1 week, every other day for 2 weeks, and then every third day for 3 weeks (ie, 40-day observation period). Digitized images were evaluated for granulation tissue formation, wound contraction (surface area measurements), and area of epithelialization. Results--The epithelialized area and open and total wound areas did not differ among treatments at any time point. Time to the first appearance of granulation tissue was significantly shorter for all treatment groups, compared with that of the control group. Time to achieve granulation tissue coverage of wound base was significantly shorter following fasciotomy (9.6 days) and fascial excision (9.0 days), compared with that of control treatment (18.5 days) or abrasion (16.7 days). Numbers of wounds that developed exuberant granulation tissue following fascial excision (9/16) and control treatment (3/16) differed significantly. Conclusions and Clinical Relevance--Fasciotomy and fascial excision facilitated early granulation tissue development in cutaneous wounds in cats. In clinical use, these fascial treatments may expedite secondary wound closure or skin grafting. [ABSTRACT FROM AUTHOR]

Background Anterior knee pain and young age of the patient have been considered justification for removal of a tibial intramedullary nail. There have been few reports on the outcome after nail removal, however. Patients and methods We studied 71 patients in whom 72 tibial nails had been removed. We used self-assess-ment questionnaires to evaluate the location, intensity, and frequency of pain before and after removal. The degree of satisfaction was scored on a visual analog scale. Results 39 of 71 patients had less pain after removal of the nail, but were not asymptomatic. 14 patients had unaltered pain, and 18 patients had increased pain. 4 of 6 patients who had been treated with fasciotomy were not satisfied with the outcome of nail removal. Interpretation The results of nail removal to alleviate pain are poor. Removal of a nail should not be undertaken unless there is a convincing indication. [ABSTRACT FROM AUTHOR]

We present a silicon sheet for temporary wound covering and gradual wound closure after open fasciotomy. Fasciotomy was performed in a total of 70 limbs with compartment syndrome (CS). The main etiology of CS was predominantly vascular. All patients were treated with a silicon sheet to cover the soft tissue defect and gradually reapproximate the skin margins. In 53% of the patients, a delayed final wound closure was achieved after a mean of 11.9 days. This method allows final closure of fasciotomy wounds without scar contractures, marginal necrosis, infection, or significant pain. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the early surgical intervention for patients with necrotizing fasciitis, advantages of early intervention the medical outcomes of patients, and validation of early surgical intervention.

Background: Damage control surgery has revolutionized trauma surgery. Use of damage control surgery allows for resuscitation and reversal of coagulopathy at the risk of loss of abdominal domain and intra-abdominal complications. Temporary abdominal closure is possible with multiple techniques, the choice of which may affect ability to achieve primary fascial closure and further complication. Methods: A retrospective analysis of all trauma patients requiring damage control laparotomy upon admission to an ACS-verified level one trauma center from 2011 to 2016 was performed. Demographic and clinical data including ability and time to attain primary fascial closure, as well as complication rates, were recorded. The primary outcome measure was ability to achieve primary fascial closure during initial hospitalization. Results: Two hundred and thirty-nine patients met criteria for inclusion. Primary skin closure (57.7%), ABThera™ VAC system (ABT) (15.1%), Bogota bag (BB) (25.1%), or a modified Barker’s vacuum-packing (BVP) (2.1%) were used in the initial laparotomy. Patients receiving skin-only closure had significantly higher rates of primary fascial closure and lower hospital mortality, but also significantly lower mean lactate, base deficit, and requirement for massive transfusion. Between ABT or BB, use of ABT was associated with increased rates of fascial closure. Multivariate regression revealed primary skin closure to be significantly associated with primary fascial closure while BB was associated with failure to achieve fascial closure. Conclusions: Primary skin closure is a viable option in the initial management of the open abdomen, although these patients demonstrated less injury burden in our study. Use of vacuum-assisted dressings continues to be the preferred method for temporary abdominal closure in damage control surgery for trauma. [ABSTRACT FROM AUTHOR]

Morel-Lavallée lesions are cystic lesions occurring between the subcutaneous tissue and the underlying layer of a fascia. The most frequent mechanism of occurrence is posttraumatic, usually after degloving injuries. The chain of events leading to the occurrence of this lesion is the formation of a potential space between the subcutaneous tissue and the firmly attached deep fascia, which in turn fills with blood and/or lymph and/or necrotic fat, secondary to disruption of the capillaries. We present a case of a 74-year-old male patient with a cystic lesion of the lateral surface of his left thigh increasing in size over a period of six months. Despite the meticulous history acquisition, we were unable to reveal any alleged mechanism of injury of the area. The patient underwent an MRI which revealed an ovoid cyst. The patient underwent surgical excision of the cyst. The pathology examination revealed a simple cyst, lined by a fibrous capsule and filled with serosanguineous fluid, thus confirming the diagnosis. The patient made a full recovery and since has been asymptomatic. [ABSTRACT FROM AUTHOR]

Popliteal artery entrapment syndrome (PAES) is an uncommon cause of exercise-induced pain in the lower extremity of young athletes. However, it might explain the symptoms of those athletes who do not respond to treatment for the more common overuse syndromes. We present a case of a young professional male athlete who was diagnosed with bilateral chronic exertional compartment syndrome (CECS), for which he was operated on twice. His symptoms persisted for 5 years before PAES was diagnosed with dynamic ultrasound, and after bilateral surgical release a few months apart, he was completely symptom-free except for some discomfort in the fasciotomy scars. [ABSTRACT FROM AUTHOR]