compartment syndrome

Question 1

pathophysiology

Answer 1

bleeding and inflammatory exudate from fracture cause pressure to begin to rise within muscle compartment, this causes compression of the venous outflow system so no oxygenated blood can supply the congested muscle resulting in ischaemia

Question 2

buzzword

Answer 2

woodlike feel on palpation

Question 3

presentaion

Answer 3

• increased pain on passive stretching of affected muscle compartment
• excruciating pain which is disproportionate to the primary injury
• limb is swollen and may be pale
• paraesthesia

Question 4

what is the final stage of compartment syndrome

Answer 4

loss of pulse and paralysis which means it is too late and the muscle is already dead an no longer salvageable

Question 5

management of compartment syndrome

Answer 5

emergency fasciotomy

Question 6

what happens if left untreated

Answer 6

the muscle will necroses and result in a fibrotic contracture known as volkmans ischaemic contracture where the only management is amputation

Question 7

what is also key in management of compartment syndrome

Answer 7

IV hydration because the creatinine kinase released from the ischaemic muscle is toxic to the kidneys known as myogloblobuniria

Question 8

most common fractures causing compartment syndrome

Answer 8

• tibial plateau fractures

- supracondylar humeral fractures

Question 9

what should you not ever do in compartment syndrome

Answer 9

• give anticoagulants as they worse compartment syndrome