Compartment Syndrome

Question 1

When does compartment syndrome occur?

Answer 1

Might happen after fractures or after ischaemic reperfusion injury

Question 2

Two main #s a/w compartment syndrome?

Answer 2

Supracondylar
Tibial shaft

Question 3

Features of compartment syndrome?

Answer 3

Pain esp on movement (EVEN PASSIVE)
Paraesthesiae

Pallor maybe
Pulseless maybe
Paralysis maybe

Question 4

When should you raise suspicion for compartment syndrome?

Answer 4

Excessive use of breakthrough anaesthesia

Question 5

Ix for compartment syndrome?

Answer 5

Intracompartmental pressure measurements
>20mmHg = abnormal
>40mmHg = diagnostic

Question 6

Role of imaging in compartment syndrome Ix?

Answer 6

X-ray does not reveal any pathology

Question 7

Mx of compartment syndrome?

Answer 7

Prompt + extensive fasciotomy
If muscles are necrotic at fasciotomy, consider debriding and amputating

Question 8

Comps of fasciotomy?

Answer 8

Myoglobinuria (which might cause renal failure, so pt need aggressive IV fluids)

Question 9

When may death of muscle groups occur in compartment syndrome?

Answer 9

Within 4-6h