Compartment Syndrome

Question 1

Compartment Syndrome Definition

Answer 1

• Increased pressure within a closed anatomical space

- Compromised circulation and function of tissues

Question 2

Compartment Syndrome Types

Answer 2

• Acute: most often caused by trauma, can be caused by intense exercise
• Chronic: usually caused by exercise

Question 3

Compartment Syndrome Sites

Answer 3

• Forearm
• Lower limb
• Gluteal
• Abdominal

Question 4

Compartment Syndrome Acute Pathogenesis

Answer 4

• Increasing pressure causes increasing impairment and necrosis
• Venous compromise leads to reduced flow leads to ischaemia leads to increased pressure cycle

Question 5

Compartment Syndrome Acute Aetiology

Answer 5

• Fractures, especially of forearm and leg that have been internally fixed or infected
• Crush injury
• Burns
• Infection
• Prolonged immobilisation

Question 6

Compartment Syndrome Acute Presentation

Answer 6

• Usually presents within hours
• Severe pain disproportionate to the injury
• Not readily improved despite initial measures
• Made worse by passively stretching the muscles
• Distal paraesthesia
• Will not be swollen, but will be tense
• Acute limb ischaemia will develop (5 Ps)

Question 7

Compartment Syndrome Investigations

Answer 7

• Essentially clinical
• Have high degree of suspicion
• Can measure intracompartmental pressure

Question 8

Compartment Syndrome Management

Answer 8

• Early recognition and immediate surgical treatment are most important
• Keep limb at neutral position
• Oxygen
• Augment blood pressure with fluids
• Remove all dressings/ splints/ casts down to skin
• Treat pain