Compartment Syndrome

Question 0

Pathophysiology of compartment syndrome

Answer 0

Raised pressure within a fibro-osseous compartment ->
Endothelial damage in capillaries with fluid leak ->
Further rise in pressure: >30mm Hg compresses veins ->
Inadequate tissue perfusion ->
Limb warm, not pale, with retained arterial pulses in early stages

Question 1

Causes of compartment syndrome

Answer 1

Arterial surgery: prolonged clamp then reperfusion
Crush injury
Haematoma
Long tourniquet time
Fracture eg tib/fib +/- tight plaster

Question 2

Complications of compartment syndrome

Answer 2

Muscle necrosis: 
Pain out of proportion to injury
Pain on passive movement of muscle
Tense tender muscles on palpation
Rhabdomyolysis and acute renal failure
Later healing by fibrosis: Volkmanns ischaemic contracture

Nerve necrosis:
Painful hyperasthesiae
Followed by loss of sensation
Motor loss eg foot drop