Compartment Syndromes

Question 1

How many compartments does the foot have?

Answer 1

9 compartments
“The hands and feet have many compartments within them, all too numerous and small to easily measure”

Question 2

What type of injuries is compartment syndrome associated with?

Answer 2

• Foot and ankle fractures
• • especially calcaneal and lis franc
• burns
• contusions
• bleeding d/o
• post ischemic swelling
• arterial injury or thrombosis
• venous obstruction
• snakebites
• exercise
  Prolonged pressure on an area (i.e. cast or weird sitting)

Question 3

Risk factors for compartment syndrome

Answer 3

Youth - age >35 is less likely to happen
- strongest predictor of developing acute compartment syndrome

Atraumatic compartment syndrome
- hemophilia, rhabdomyolysis

Trauma

Question 4

Since splint/casting can cause compartment syndrome what is the management of suspected compartment syndrome?

Answer 4

1st step is to remove the cast/dressing
- this alone can markedly reduce tissue pressures

Question 5

What is the earliest sign of compartment syndrome?

Answer 5

Pain: the awake patient may initially complain of severe pain in the affected compartment
- often refractory to opioids
- pain is worse with active/passive stretching