compartment syndrome Flashcards
how does compartment syndrome happen
when compartmental pressure rises over 30mmHg which leads to compression of the capillaries, veins and ultimately arteries
and also nerves running in that compartment
this can happen following limb trauma > where there is muscle swelling and inflammation > increase in pressure
how do you manage compartment syndrome
taking patient to theatre to be decompressed (fasciotomy)
analgesia
fluids
what are the clinical features of compartment syndrome
severe pain - passive flexion of toes especially
pallor
paralysis of the limb
pulsenessless
paraesthesia
A 27 year old woman is admitted on the ward following external fixation of a tibial fracture. Six hours later, she complains of pain in the leg and she is prescribed oral morphine.
Twelve hours after the operation, she is still in pain despite removing the dressing, elevating the leg and taking 40 mg of oral morphine. She now complains of tingling and numbness in the toes.
what do you do now ?
take patient to theatre immediately for fasciotomy
they need to be decompressed
A 21-year old man on the orthopaedic ward complains of severe pain in his right leg. He sustained a proximal fracture of the tibia and fibula this morning when he was involved in a motorcycle accident. He underwent surgical fixation for the fracture and his right leg is set in a long leg cast.
On examination, he is crying in pain and says that his right leg feels extremely tight. He describes feeling pins and needles in his right toes. There is high clinical suspicion of acute compartment syndrome. What would be the next best step in managing this patient?
split the plaster cast open and get his leg above heart level to ensure intracompartmental pressure does not rise
if this doesn’t settle his symptoms then urgent fasciotomy is indicated
A 21-year old man on the orthopaedic ward complains of severe pain in his right leg. He sustained a proximal fracture of the tibia and fibula this morning when he was involved in a motorcycle accident. He underwent surgical fixation for the fracture and his right leg is set in a long leg cast.
On examination, he is crying in pain and says that his right leg feels extremely tight. He describes feeling pins and needles in his right toes. There is high clinical suspicion of acute compartment syndrome. What would be the next best step in managing this patient?
split the plaster cast open and get his leg above heart level to ensure intracompartmental pressure does not rise
if this doesn’t settle his symptoms then urgent fasciotomy is indicated
what is a fasciotomy
limb-saving procedure used to treat acute compartment syndrome
surgical
incisions are made in the compartments of the leg which have elevated pressure
