Subject(s)
Arthralgia/diagnostic imaging , Lunate Bone/diagnostic imaging , Osteonecrosis/diagnostic imaging , Arthralgia/etiology , Arthralgia/surgery , Biocompatible Materials/therapeutic use , Carbon/therapeutic use , Humans , Lunate Bone/surgery , Middle Aged , Osteonecrosis/complications , Osteonecrosis/surgery , Prosthesis Implantation , Tomography, X-Ray Computed , Wrist Joint/diagnostic imaging , Wrist Joint/surgeryABSTRACT
Spontaneous bilateral compartment syndrome is a very rare condition but one which requires swift diagnosis and urgent surgical decompression by fasciotomies in order to achieve the best outcome. We present the case of a 31-year-old HIV-positive man. The case highlights the perils of being sidetracked by an atypical clinical history instead of acting on the classical clinical examination findings. We will discuss the presentation and management of this patient, review the literature and highlight the key learning points. The most important learning point being that no matter how atypical the history, if a patient presents with limb pain out of proportion to the injury (with or without pain on passive stretch), sensory changes and a loss of motor power, then a diagnosis of acute compartment syndrome must be considered.
Subject(s)
Compartment Syndromes/diagnosis , Fascia/pathology , HIV Infections/complications , Leg/pathology , Muscle, Skeletal/pathology , Adult , Compartment Syndromes/complications , Compartment Syndromes/surgery , Decompression, Surgical , Fasciotomy , Humans , Leg/surgery , Male , Muscle, Skeletal/surgeryABSTRACT
PURPOSE: The impact factors (IF) of orthopaedic journals is an important component in determining the future of orthopaedic research funding. We aim to characterise the trend in journal IF over the last decade and draw comparisons with other surgical specialties. METHODS: We conducted an analysis of impact factors from Journal Citation Reports between 2000 and 2010. RESULTS: Between 2000 and 2010 the number of orthopaedic journals increased from 24 to 41, more than any other surgical specialty and the mean IF increased from 0.842 to 1.400. Journals printed in the English language had a significantly higher IF in the year 2010 (1.64 vs. 0.33, p = 0.01) than those printed in other languages. English language journals published in the US had significantly higher mean 2010 IF (1.932 vs. 1.243, p = 0.025) than those published in Europe, and this had changed compared with 2000 mean IF (0.978 Vs. 0.704, p = 0.360). Orthopaedics was ranked sixth out of 11 surgical subspecialties in 2000 but dropped to seventh out of 11 in 2010. CONCLUSIONS: The quality of orthopaedic journals has significantly increased over the last decade and this has been accompanied by a rise in mean IF. It is important that orthopaedics continues to improve the quality of research, which may help orthopaedic researchers secure funding in the future.
