Compartment Syndrome Flashcards
Features of Compartment Syndrome
Limb Threatening
Ischaemia
Foot still warm, pink and pulse
Aetiology of Compartment Syndrome
Occur after Trauma 70% after Fracture
Soft Tissue Trauma alone sometimes
Also seen in vascular repercussion of acute ischaemic limb
burns (circumferential eschar)
crush
haemorrhage
drug injection
post lithotomy
definition of acute compartmental syndrome
A compartment syndrome develops when intramuscular pressure is elevated sufficiently to reduce nutritional blood flow significantly to tissues within the involved compartment.
An ischaemic injury FROM vascular flow impediment BY high interstitial pressures
at risk sites of acute compartment syndrome
anywhere but especially lower leg
any muscle compartment bounded by inelastic walls
mechanisms of acute compartment syndrome
tissue damage
canine anterior compartment: 30mmhg for 8 hours
At risk patients with no trauma
older
medically unfit
female
at risk patients with trauma
young fit
male
25% of adolescent tibial fractures
which type of fracture particularly at risk of compartment syndrome
adolescent tibial fracture
types of fracture in upper arm particularly at risk of compartment syndrome
tibial
distal radius
forearm
supracondylar
at risk generally of compartment syndrome
reperfusion injury after vascular surgery coagulopathy crush syndrome overdose post lithotomy burns
Acute compartment syndrome is more common in
low energy tibial fractures
can acute compartment syndrome occur in open fractures
yes
5 p’s of acute compartment syndrome
pain on passive move paresthesiae paresis or paralysis pallor pulselessness very late
Presentation of Acute compartment syndrome
Disproportionate Severe pain
Deep Ache
Crushing/Tight made worse by passive movement of limbs
Direct pressure on nerve and ischaemia causing parenthesis
how to measure pressure in compartment syndrome
stryker slit catheter
