Compartment syndrome

Question 1

What is compartment syndrome?

Answer 1

An orthopaediac emergency in which there is buildup of pressure in the muscle compartment of a limb, typically following trauma

Question 2

What is the aetiology of compartment syndrome?

Answer 2

Trauma to the limb leads to muscle swelling and inflammation - this can disrupt blood flow to the limb, and cause ischaemia

Question 3

What is the presentation of compartement syndrome?

Answer 3

Severe pain, especially on flexion of the toes
Pallor of the affected limb
Paralysis or weakness of the affected limb
Absence of pulse
Paraesthesia

Question 4

What is the definitive management of compartment syndrome?

Answer 4

Urgent fasciotomy (within 6 hours)

Question 5

What is the interim management of compartment syndrome?

Answer 5

Elevate the leg to heart level
Oxygen
Fluid administration
Remove all dressings/casts/splints
Anaglesia (opioids)

Question 6

Why might patients with compartment syndrome need fluids?

Answer 6

Myoglobinuria can occur following a fasciotomy, and result in renal failure

Question 7

What is the most common cause of compartment syndrome?

Answer 7

Tibial fractures

Question 8

What investigations can be performed to help diagnose compartment syndrome?

Answer 8

Intracompartmental pressure monitoring
Serum CK and urine myoglobin - rhadomyolysis
U&Es