37: Compartment Syndrome

Question 1

What is compartment syndrome?

Answer 1

a condition in which the circulation to, and function of tissues in, a closed space are compromised by an increased pressure within that space

Question 2

which sites are at risk of compartment syndrome?

Answer 2

• lower leg
• forearm
• hand
• foot
• thigh

Question 3

how does compartment syndrome happen?

Answer 3

• increased volume (internal): haemorrhage, fractures, swelling from traumatised tissue, increased fluid secondary to burns, post-ischaemic swelling
• decreased volume (external): tight casts, dressings
• most common causes of haemorrhage into a compartment: fractures of tibia, elbow, forearm or femur

Question 4

compartment syndrome diagnosis

Answer 4

Clinical:
- pain - out of proportion to injury
- pain - on passive stretch
- altered sensation
- weakness
- swelling
- Measure compartment pressure
- do NOT wait for absent pulse and altered sensation

Question 5

compartment syndrome treatment

Answer 5

• open constrictive dressings to skin
• treat with emergency fasciotomy of all affected compartment
• for tibia use 2 incisions 1-2cm posterior to subcutaneous border of tibia