Compartment syndrome Flashcards
what lesions are you likely to get in the ventral compartment of forearm?
dorsal?
- median and ulnar nerves, radial and ulnar arteries
- posterior interosseous nerve
in the lower limb what compartments do you have?
and what complications would you get?
- anterior tibial: (deep perineal nerve, anterior tibial artery)
- superficial posterior: no n/v
- deep posterior: posterior tib nerves + vessels, perineal artery
- peroneal compartment: deep and superficial perineal nerves
gluteal compartment syndrome: what lesion?
how do you measure pressure in abdo compartment?
- uncommon and often diagnosed late, sciatic nerve palsy
- NG tube or Foley’s catheter in bladder
name some causes for abdo compartment syndrome?
what can happen as the compartment pressure drops eventually?
- fractures
- crush injury
- burns
- infection
- vascular
- limb compression
- ischaemic reperfusion injury
how might a patient present with compartment syndrome?
what are late features?
- increasing pain despite immobilisation
- sensory deficit in the distribution of nerves passing through it
- muscle tenderness and swelling
- excessive pain on passive movement
- 6Ps, loss of capillary return
how can you measure intracompartmental pressure?
- wick catheter
- needle manometry
- pressure transducers
what do you do for them?
- orthopaedic referral
- remove cast and splints
- open fasciotomy
- extensive IV fluids to prevent renal failure
what complications do you get?
- tissue necrosis
- ischaemic contracture
- myoglobinuria (may throw off U+Es)
how long does it take for muscle necrosis to occur in compartment syndrome?
what should be done with necrotic tissue?
is it reassuring if you can still feel pulse in compartment syndrome?
- within 6 hours
- debridement
- no as it is microvascular changes at first that cause compromise
