Compartment syndrome

Question 1

What is CS?

Answer 1

increased pressure within a closed anatomical space

Question 2

Why is it important that its diagnosed?

Answer 2

eventually tissue can become compromised -> necrosis -> occludes blood supply

Question 3

When does CS usually occur?

Answer 3

following fractures
or
ischaemia reperfusion injury in vascular patients

Question 4

What are the main fractures associated with CS?

Answer 4

supracondylar - humerus at narrowest point, just above the elbow
tibial shaft

Question 5

What are the featureS?

Answer 5

1. Pain - especially on movement, disproportionate to injury
2. Paraesthesia
3. Pulselessness - presence doesn’t rule out
4. Pallor
5. Paralysis

Question 6

How is it diagnosed?

Answer 6

Intracompartmental pressure measurements - >20 = abnormal, >40 = diagnostic
Usually clinical diagnosis

Question 7

Give the management of compartment syndrome

Answer 7

Prompt fasciotomy
Aggressive IV fluids
Debride necrotic tissue
Watch for reduced UO and raised plasma K+

Question 8

What are the potential complications of CS?

Answer 8

Renal failure - risk of myoglobinuria

Rhabdomyolysis

Question 9

What is rhabdomyolysis?

Answer 9

condition in which damaged skeletal muscle breaks down rapidly

Question 10

What are the features of rhabdomyolysis

Answer 10

muscle pains, weakness, vomiting, and confusion.