Compartment Syndrome

Researchers are evaluating whether accelerated flap coverage within 72 hours of injury reduces infection-related complications compared to standard flap coverage timing in patients with severe open fractures and/or dislocations below the knee. This randomized controlled trial addresses an important uncertainty in care for these injuries, aiming to provide clear evidence to guide treatment timing and improve patient outcomes. The study includes adult patients 18 years and older who require acute flap coverage for their injury. Participants will be randomly assigned to receive either flap surgery within 72 hours of injury or flap surgery at the standard timing practiced at their medical center. The choice of flap type and management after surgery will be decided by the treating surgeons and recorded. Both groups will have their fracture or dislocation managed according to usual care. Follow-up visits are scheduled at 6 weeks, 3 months, 6 months, and 12 months after randomization to monitor progress. During the study, researchers will assess a combined primary outcome at 6 months that includes overall survival, limb amputation due to injury, re-operations for infection or flap issues, and days spent in acute hospital care. Secondary outcomes include these individual measures at 6 and 12 months, as well as patient-reported quality of life and satisfaction. Safety events will be reviewed regularly by a monitoring committee to ensure participant well-being throughout the trial.

Researchers are evaluating blood flow restriction therapy for patients with lower limb extensor injuries such as quadriceps tendon rupture, patella tendon rupture, and patella fracture. This therapy aims to promote muscle growth and strength by restricting venous outflow using an inflatable cuff, creating a high-intensity environment that may improve rehabilitation. The study is randomized and double-blind to compare this therapy against a placebo treatment. Participants will receive six weeks of physical therapy exercises similar to standard care, but with a pressure cuff placed around the upper thigh of the injured leg. In the experimental group, the cuff pressure will restrict approximately 80% of arterial blood flow, adjusted by a device that monitors and controls pressure. The placebo group will have a cuff with pressure set at 50% less than the effective level. The cuff includes safety features like automatic deflation timers and alarms for under or over pressurization. During the study, participants will have their leg extensor strength and knee function measured at the start and after six weeks. Researchers will track changes in muscle strength and recovery using these assessments. The trial lasts for six weeks of treatment with ongoing monitoring for safety and effectiveness. Participants must be between 18 and 65 years old and intend to receive physical therapy as part of their standard care.

Researchers are comparing two local anesthetic methods for ultrasound-guided popliteal sciatic nerve block in adults aged 18 to 65 undergoing elective distal lower leg surgery. This study focuses on how quickly sensory and motor blockades begin and evaluates several postoperative outcomes such as pain levels, opioid use, and recovery quality. The trial is conducted at Ataturk University Research Hospital in Turkey with 60 participants divided into two groups. Participants will receive one of two treatments before surgery: one group gets a combination of lidocaine and bupivacaine, while the other group receives bupivacaine alone. Both treatments involve 20 mL total volume administered via ultrasound guidance to the popliteal sciatic nerve. Some patients may also receive an additional adductor canal block. During surgery, sedation and vital signs are carefully monitored, and standardized postoperative pain relief is provided. Throughout the study, researchers will assess block onset time, success rates, duration of sensory and motor block, and pain scores at multiple time points up to 24 hours after surgery. They will also monitor opioid use, quality of recovery, and any rebound pain. Neurological assessments are performed one week after surgery to check for any nerve issues. The study uses a double-blind design, with patients and outcome assessors unaware of the treatment group.

This study aims to collect prospective safety and effectiveness data for the C-Brace System, a microprocessor-controlled knee ankle foot orthosis, following standard care practices. The research focuses on patients with lower extremity pareses who are fitted with the C-Brace device. The goal is to better understand how the C-Brace influences walking speed, balance, risk of falling, and confidence in balance over time. The C-Brace is a custom-made device with thigh, calf, and foot components connected by an ankle joint or spring element. It uses sensors to continuously monitor knee joint movement and walking phases, adjusting hydraulic resistance and knee motion accordingly. Patients enrolled in the registry will undergo baseline evaluation, fitting, training or therapy sessions, and follow-up visits at 6, 12, 24, and 36 months after fitting. Participants will be assessed through various tests including timed walk tests, balance confidence scores, and mobility assessments at different intervals. The study also tracks falls related to device use and changes in activity levels with an activity tracker. Data collected will help characterize the safety and functional impact of the C-Brace over three years of follow-up.

Researchers are evaluating the use of Near Infrared Spectroscopy (NIRS) and intramuscular glucose monitoring to detect impaired blood flow in the anterior compartment of the leg in patients with tibial fractures complicated by acute compartment syndrome or vascular injury. This study aims to determine if these methods can identify reduced tissue oxygenation and relative hypoglycemia compared to the uninjured leg. Currently, NIRS is not a standard tool for monitoring leg fractures, and this research seeks to provide evidence for its clinical use. Adult patients aged 18 to 75 years with unilateral tibial fractures and acute compartment syndrome or vascular compromise are enrolled. After diagnosis confirmation, NIRS sensors are applied to both legs to measure tissue oxygenation until surgery. During surgery, glucose levels are measured directly from muscle tissue and compared to fingerstick glucose levels. Additional monitoring continues for 72 hours post-surgery if possible. Data collection includes ultrasound measurement of muscle depth, compartment pressure, and demographic and surgical details. Participants will undergo bedside ultrasound and NIRS sensor application, blood glucose testing during surgery, and continuous monitoring before and after surgery. Researchers will collect data on oxygenation changes at multiple time points up to 72 hours post-operation. Safety and privacy are maintained with encrypted data storage and de-identification of patient information. The primary outcomes include detecting perfusion changes with NIRS and documenting intramuscular glucose levels as indicators of tissue ischemia during acute compartment syndrome.

This research aims to compare the effects of nerve gliding exercises and conventional grip strength exercises on handgrip strength, range of motion, and performance in cricket batters. The study focuses on the modernization of cricket batting, where power hitting and higher strike rates are key, and evaluates how these exercise types may impact batting efficiency. Participants aged 18 to 35 years from various cricket academies in Lahore will take part in this randomized clinical trial. Participants will be randomly assigned to one of two groups. Group A will receive nerve gliding exercises consisting of 25-minute sessions five days a week for six weeks, including warm-up, median, ulnar, and radial nerve gliding, and cool down. Group B will receive conventional grip strength exercises with a similar schedule, including tendon gliding sequences, squeezing a rubber ball, dead hang, and cool down. Both exercise regimens aim to improve handgrip strength and wrist mobility. During the 6-week intervention, researchers will assess participants using an adjustable hand dynamometer to measure grip strength, a goniometer to evaluate wrist range of motion, and a batting tee test to measure batting performance. Data will be analyzed using statistical tests to compare the effects of the two exercise types. The study will monitor progress throughout the treatment period to understand the impact on cricket batting skills.

Researchers are studying how aging affects muscle strength and blood vessel function during resistance exercise, comparing responses between young adults (18-30 years) and older adults (over 60 years). The study focuses on how aging reduces nitric oxide availability and microvascular function, which impacts muscle performance and overall physical ability. It aims to understand the effects of different resistance training methods on vascular health in these age groups. Participants will be randomly assigned to one of two exercise groups: low intensity resistance training with blood flow restriction (LIRT-BFR) or high intensity resistance training without blood flow restriction (HIRT). The LIRT-BFR group performs 4 sets of 20 repetitions at 30% of their one-repetition maximum (1-RM) with cuffs restricting blood flow on the upper thighs, while the HIRT group performs 3 sets of 10 repetitions at 75% 1-RM without blood flow restriction. Each participant attends three sessions, including a familiarization visit and two exercise sessions spaced at least one week apart. During each session, participants rest supine for 15 minutes before measurements of blood pressure, heart rate, and microvascular function are taken at rest and after exercise. After completing the assigned exercise, these measurements are repeated at 5 and 30 minutes into recovery. The study tracks changes in macrovascular and microvascular function, arterial stiffness, and blood pressure to understand vascular responses to these exercise types. Researchers ensure participant safety with trained staff and monitor adherence to pre-visit instructions such as avoiding caffeine, alcohol, and vigorous exercise 24 hours before sessions.

Researchers are studying infants 12 months or younger undergoing surgeries such as laparoscopic pyeloplasty, minimal PSARP, or lateral thoracotomy for esophageal atresia correction to better understand intestinal regional oxygen saturation compared to bladder pressure. The study aims to determine if near-infrared spectroscopy measurements of intestinal oxygen saturation remain stable during muscle-relaxed, intubated states and in awake, non-sedated patients. This investigation focuses on infants without risk of intraabdominal hypertension or abdominal compartment syndrome. The study involves measuring bladder pressure and regional intestinal oxygen saturation with near-infrared spectroscopy twice for each participant: once during surgery within the first 10 minutes after anesthesia induction when the patient is muscle-relaxed and intubated, and once postoperatively during the first three days when the infant is awake and non-sedated. An indwelling urinary catheter is used during and shortly after surgery for bladder pressure measurement. This is a single-arm interventional diagnostic study conducted by the University Children's Hospital, Zurich. Participants will undergo surgery as planned and have these measurements taken intraoperatively and postoperatively. The study team will assess intestinal oxygen saturation stability and bladder pressure values at these times. Measurements are taken during anesthesia and in the recovery period to compare the two methods. Participation lasts through the immediate operative and postoperative periods, with no long-term follow-up mentioned.

Acute compartment syndrome (ACS) is a serious surgical emergency that can occur in patients receiving extracorporeal membrane oxygenation (ECMO), especially veno-arterial (VA) ECMO. ACS happens when increased pressure in a muscle compartment reduces blood flow, leading to limb damage. Diagnosing ACS in ECMO patients is difficult because they are usually sedated and cannot report symptoms like pain. This study evaluates and compares three methods to diagnose ACS: the current standard of care, the new MY01 Continuous Compartment Pressure Monitor device alongside standard care, and a 14-gauge slit catheter device with standard care, aiming to improve accuracy and early detection. Participants will be randomly assigned to one of three groups. The standard care group involves physical exams every 4 hours and single pressure needle measurements if ACS is suspected. The MY01 group will have the device inserted into the leg near the ECMO tubing to continuously monitor pressures for 24 hours, with data accessible via a mobile app. The 14-gauge slit catheter group will use tubing inserted into the leg, connected to a monitor with pressure readings recorded every 4 hours for 24 hours. If ACS is diagnosed, surgery decisions will be made by the medical team. The device is removed after monitoring or upon diagnosis. During the study, participants will undergo regular physical exams and pressure monitoring according to their assigned group. Researchers will track the number of patients diagnosed with ACS, those needing amputation, deaths during hospitalization, and amputation-free survival, with follow-up lasting up to one year. Monitoring will include continuous or intermittent pressure measurements and clinical assessments. The study will help assess the effectiveness of continuous pressure monitoring devices compared to standard care in detecting ACS and potentially improving treatment timing and limb outcomes.

Researchers are evaluating how VKTRY carbon fiber insoles affect vertical jump and sprint performance in moderately active young men aged 18 to 30. The study focuses on explosive athletic tasks, aiming to see if these insoles improve mechanical efficiency and energy return during movement. This observational, cross-sectional study compares performance with and without the insoles to understand their impact on sports activities. Participants will perform countermovement jump (CMJ) and sprint tests twice: once wearing the VKTRY insoles and once without them. The study uses a randomized design to assign test order. The insoles are designed to provide rigidity and energy return, potentially enhancing jump height, flight time, sprint speed, and maximum running speed. Participants will also share their subjective experience using a Likert-type scale. During the study visit, participants will be assessed using the My Jump Lab app for objective measurements like jump height and sprint time. Researchers will monitor flight time, sprint time, and top speed, alongside athlete feedback on the insoles. The main outcome is the difference in jump height on the test day. Overall, the study aims to inform on the immediate effects of these insoles on athletic performance and perception in healthy men.