Poverty is Bad: Ways forward in livelihood research

In this paper, we take the view that the essence of poverty is the fact that one or several basic conditions for generating a living are not being met. The conditions considered most vital for making a living are to a certain extent context specific and subject to (cultural and social) interpretation and evaluation

Lower Leg Lateral Chronic Exertional Compartment Syndrome:Prospective Surgical Treatment Outcomes for Isolated or Combined Lateral Fasciotomy

BACKGROUND: Chronic exertional compartment syndrome involving the lower leg lateral compartment (lat-CECS) seldom occurs isolated but is usually combined with CECS of the anterior (ant-CECS) or deep posterior compartment (dp-CECS). Patient characteristics in lat-CECS and outcome after surgery are largely unknown. The aim of this prospective case series was to describe patient characteristics and symptoms and to report on outcome following a fasciotomy. METHODS: All patients diagnosed with lat-CECS based on exertional lateral lower leg symptoms and elevated intracompartmental pressure (ICP) measurements according to the Pedowitz criteria (ICP?=?15?mm Hg at rest, and/or =30?mm Hg after 1?minute, and/or =20?mm Hg 5?minutes after exercise) were eligible for this study. A standard intake questionnaire scoring symptom patterns was completed by all patients. Patients who were operated for lat-CECS were asked to complete a 3-month and 12-month postoperative questionnaire scoring symptoms and surgical outcome. Patients with a history of CECS surgery, recent lower leg trauma, or peripheral neurovascular disease were excluded. RESULTS: A total of 881 patients with possible lower leg CECS completed an intake questionnaire and 88 (10%) were diagnosed with lat-CECS according to the Pedowitz criteria (isolated lat-CECS n?=?10; lat/ant CECS n?=?54, lat/ant/dp CECS n?=?19, lat/dp CECS n?=?5). Severe pain during exercise and moderate tightness during rest were frequently reported. A group of 28 patients (49 legs; isolated lat-CECS n?=?2; lat/ant CECS n?=?22, lat/ant/dp CECS n?=?3, lat/dp CECS n?=?1) was analyzed after fasciotomy. Complications were minor (wound infection requiring antibiotics, n?=?3; temporary complex regional pain syndrome with spontaneous recovery, n?=?1). Superficial peroneal nerve damage was not observed. One year after surgery, 64% rated outcome as excellent or good, whereas 71% had resumed sports activities. CONCLUSION: One in 10 patients with anterolateral exertional lower leg pain evaluated in a tertiary referral center met diagnostic criteria for lat-CECS. Pain and tightness were present during exertion and were often reported occurring during rest and at night. In this series, we found fasciotomy-either an isolated (lateral) or a multiple (combined with anterior and/or deep posterior) compartment fasciotomy-is safe and beneficial in most patients. LEVEL OF EVIDENCE: Level IV, case series

Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study

Supplemental material, FAI811632-ICMJE for Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study by Johan A. de Bruijn, Aniek P. M. van Zantvoort, Henricus P. H. Hundscheid, Adwin R. Hoogeveen, Joep A. W. Teijink and Marc R. Scheltinga in Foot & Ankle International</p