Compartment syndrome

Question 1

What is compartment syndrome

Answer 1

• increased pressure within a closed fibro-osseus space
• causing reduced blood flow
• reduced tissue perfusion
• leading to ischmic pain
• and possible permanent damage to tissues of compartment

Question 2

what does Ischmic mean

Answer 2

cell death, no blood supply

Question 3

How does patient present?

Answer 3

• fine at rest

- when exercising blood flow increases and leg will feel like it will explode

Question 4

What are the symptoms of compartment syndrome?

Answer 4

• absence of pain at rest
• increased achy pain with exertion
• sensation of tightness on exertion
• symptoms decrease after several minutes of rest
• ache may remain for up to 30 minutes

Question 5

what are the signs of compartment syndrome

Answer 5

• physicial examination is unremarkable at rest
• with exertion, palpable tenseness within compartment
• muscle buldges

Question 6

what are the three types of compartment syndrome

Answer 6

• deep posterior compartment
• anterior compartment syndrome
• lateral compartment syndrome

Question 7

how would you distinguish between the location of the compartment syndrome

Answer 7

palpation and active and resisted muscle contraction of the compartment

Question 8

How would you screen for compartment syndrome?

Answer 8

• previous history
• limb and foot alignment
• muscle flexibility
• biomechanical demands of sport - footweare/surface

Question 9

what investigations would take place?

Answer 9

• x-ray
• intra-compartmental pressure measurement
• MRI

Question 10

what would you be measuring on an intra-compartmental pressure measurement

Answer 10

• test pressure within each compartment

- resting value within each compartment

Question 11

when would you take an MRI

Answer 11

• at rest
• get patient to perform exercise then take again
• pre and post exertion mat show swelling in compartmet

Question 12

How and when would to pressure test?

Answer 12

• needle or catheter is inserted from medial aspect through 2 layers of fascia, aiming posterior to tibia
• take pre and post exertion

Question 13

what measurements would be considered normal

Answer 13

normal - 0-10 millimetres of mercury

Question 14

What measurements would be compartment syndrome?

Answer 14

max pressure during exercise greater than 35 millimetres of mercury
at rest post exercise pressure greater than 25 millimetres of mercury

Question 15

what treatment would you give to someone with compartment syndrome

Answer 15

conservative

• decrease exercise
• soft tissue therapy
• stretches
• Ax and correction of biomechanical abnormalities

Question 16

what surgery would be given to someone with compartment syndrome

Answer 16

• Fasciectomy

- fascioctomy

Question 17

what is fasciectomy surgery

Answer 17

removal of fascial tissue

Question 18

what is fascioctomy surgery

Answer 18

simple insision to release the pressure in the compartment

Question 19

what rehab would be given post op

Answer 19

• antibiotice and ICE to decrease complications, infections and heamatoma
• ROM exercises for knee and ankle
• 3-5 weeks of limited weight bearing on crutches
• strengthening exercises after the wound has healed
• light jogging at 4-6 weeks

Question 20

how long till athlete can return to sport

Answer 20

• only 1 compartment released, 6-8 weeks
  -both legs and multiple compartments 8-12 weeks
  should be pain free and at 90% strengh