Compartment Syndrome

Question 1

Compartment syndrome

Answer 1

Pressure within fascial compartment is abnormally elevated, cutting off blood flow to contents of department.

Question 2

Components of fascial compartment

Answer 2

• muscles
• nerves
• blood vessels
• fascia (non-stretchy or expandable)

Question 3

Presenting features in acute compartment syndrome

Answer 3

5 P’s
1. Pain (‘disproportionate’)
2. Paresthesia
3. Pale
4. Pressure (high)
5. Paralysis (late sign)

Usually presents following acute injury e.g. **bone fractures, crush injuries **

Question 4

Differentiating acute limb ischaemia and compartment syndrome

Answer 4

Pulseless not a feature of compartment syndrome - pulses may remain in tact

Question 4

Diagnosing compartment syndrome

Answer 4

• clinical based on signs and symptoms
• needle manometry (measure compartment pressure)

Question 5

Initial management of compartment syndrome

Answer 5

• escalate to ortho reg/consultant
• remove external dressings/bandages
• elevate leg to heart level
• maintain good blood pressure (avoid hypotension)

Question 6

Definitive management of compartment syndrome

Answer 6

Emergency fasciotomy within 6 hours

Question 7

Chronic compartment syndrome

Answer 7

Usually associated with exertion
During exertion, pressure in compartment rises and blood flow reduced, symptoms start.
During rest, symptoms resolve.
Not an emergency.
Pain, numbness, paraesthesia.