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Compartment Syndrome

Compartments are groupings of tissues in the arms and legs covered by a tough fascia membrane. Compartment syndrome occurs when pressure builds dangerously within these compartments. It can be acute from injury or chronic from repetitive exertion. The classic signs are pain, weakness, swelling, and increased pain with stretching. Treatment is to decompress the compartment with fasciotomy surgery before muscle death from ischemia occurs within 4-6 hours. Complications include muscle death, contractures, and reperfusion issues if not treated promptly.

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126 views10 pages

Compartment Syndrome

Compartments are groupings of tissues in the arms and legs covered by a tough fascia membrane. Compartment syndrome occurs when pressure builds dangerously within these compartments. It can be acute from injury or chronic from repetitive exertion. The classic signs are pain, weakness, swelling, and increased pain with stretching. Treatment is to decompress the compartment with fasciotomy surgery before muscle death from ischemia occurs within 4-6 hours. Complications include muscle death, contractures, and reperfusion issues if not treated promptly.

Uploaded by

robby
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Osseofascial Compartment

Compartments are groupings of muscles, nerves, and blood vessels in arms


and legs. Covering these tissues is a tough membrane called a fascia.
The role of the fascia is to keep the tissues in place, and, therefore, the fascia
does not stretch or expand easily.
2 compartments of arm
3 compartments of thigh

Anterior

Medial Posterior
4 compartments of lower leg
Anterior
Lateral

Posterior Posterior
deep superficial
Compartment syndrome
Compartment syndrome is a painful condition that
occurs when pressure within the muscles builds to
dangerous levels.

Bleeding, oedema or inflammation may increase the


pressure within one of the osseofascial
compartments

Reduced capillary flow Muscle ischaemia,


further oedema, still greater pressure and more
profound ischaemia
Types of compartments syndrome

Chronic compartment syndrome


Acute compartment syndrome
v Known as exertional compartment syndrome
v Caused by a severe injury
v Most often by athletic exertion
v Reestablished blood flow after blocked circulation
v subsides when activity stop
v Constricting bandages
The classic features of
ischaemia

Ø The earliest classic is Pain (bursting sensation)


Ø Weakness in active muscle contraction
Ø Swollen or tense
Ø Tested by stretching toes or fingers, increase pain
The first concept
uses CP values
higher than 30–40
mmHg

Whiteside’ theory
The development of a
compartment syndrome also
depends on

MPP =
Diastolic BP – Intracompartment
pressure
(𝚫P )

Striker slit catether


𝚫P < 30 mmHg immediate open
fasciotomy is performed
Treatment
v Decompressed
v The limb should be nursed flat If the facility is
not available 3 or
more signs are
present the
diagnosis is
almost certain.

Soft sign should be


examined at 30 mins
Interval, if no
improvement
do fasciotomy

Muscle will be dead after 4-


6 hours of total ischaemia
There is no time to lose!
Complication

v Myonecrosis
v Volkman ischaemic contracture
v Reperfusion syndrome

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