Compartment syndrome Flashcards
What is compartment syndrome?
Raised pressure within a closed anatomical space will eventually compromise tissue perfusion resulting in necrosis
What is compartment syndrome characterised by?
Increased pressure within an anatomical space
Which fractures is compartment syndrome a complication of?
Supracondylar fractures and tibial shaft
How does compartment syndrome present?
- Pain (on movement)
- Paraesthesia
- Pulselessness- (a pulse doesn’t rule out compartment syndrome)
- Pallor
- Paralysis (of the muscle group)
What doesn’t rule out compartment syndrome?
A pulse
How is compartment syndrome diagnosed?
Diagnosis is made by measurement of intercompartmental pressure measurements.
What intercompartmental pressure is classified as diagnostic for compartment syndrome?
> 40mmHg
What is the management of compartment syndrome?
Fasciotomy
What history would make you think of compartment syndrome?
History of rapidly progressive pain not controlled with high dose analgesics
What type of medication causes compartment syndrome to worsen?
Anticoagulants (rivaroxaban, apixaban, warfarin)
What should be removed immediately if someone is suspected to have compartment syndrome?
Casts
What are possible complications of compartment syndrome?
- Volkmann’s contracture
- Rhabdomyolysis
What is rhabdomyolysis?
Skeletal muscle breakdown
What does rhabdomyolysis cause?
It causes creatine kinase and myoglobin to be released into the blood
What else should be measured in someone presenting with possible compartment syndrome?
- Measure creatinine kinase
- Urinalysis
What might you see in a urinalysis of someone presenting with compartment syndrome?
Tea coloured due to increased myoglobin
How long does the death of a muscle group take?
4-6 hours
What would you do if the muscle groups are necrotic at fasciotomy?
Debridement and amputation may have to be considered
What can Myoglobinuria result in?
Renal failure
Patients require aggressive IV fluids
What can compartment syndrome result in?
Compromised tissue perfusion and tissue necrosis
What causes an increase in pressure in the compartment?
Bleeding or tissue swelling (oedema) associated with the injury increases the pressure within the compartment.
