compartment syndrome

Question 1

what is compartment syndrome

Answer 1

trauma to a fascial compartment that may lead to haemorrhage and/oedema and cause rise in intra-compartmental pressure.

Question 2

what are the clinical signs of of compartment syndrome

Answer 2

severe pain in the limb which is excessive got the degree of injury increasing and not relieved by analgesia.
pain is worse by passive stretch of muscles.

Question 3

what is done to treat compartment syndrome

Answer 3

surgical decompression- fasciotomy.

Question 4

short term consequences of compartment syndrome

Answer 4

increase in intracompartmental pressure leads to decreased perfusion of muscle.
Ischaemic muscle releases mediators which further increase capillary permeability and increase the pressure even more.
in severe untreated cases rhabdomyolysis and acute kidney injury can occur.
if the compartment pressure exceeds the systolic arterial pressure there will be loss of peripheral pulses and increased capillary refill time.
nerve fibres are also susceptible to ischaemia but cutaneous nerve fibres are affected more quickly than motor ones so distal paraesthesia precedes loss of motor function.

Question 5

long term consequences of compartment syndrome

Answer 5

rhabdomyolysis can lead to acute kidney injury that can become chronic.
necrotic muscle may undergo fibrosis leading to volkmann’s ischaemia contracture ( a permanent painful and disabling contracture of the affected muscle groups).