compartment syndrome

Question 1

causes of compartment?

Answer 1

trauma, fx (bleeding from bone marrow), DVT, tight dressings, circumferential burns

Question 2

pathophysiology?

Answer 2

elevated pressure within a closed compartment that will exceed venous and capillary perfusion pressure -> muscle and nerve ischemia and necrosis

Question 3

clinical presentation?

Answer 3

most important 2 signs:
-pain out of proportion not relieved by analgesics and increased with passive eextension of muscles within compartment

-firm wooden feeling upon deep palpation

-late findings: pallor, pulselessness, paresthesia, paralysis

-decreased 2 point discrimination

Question 4

diagnosis?

Answer 4

CLINICAL DX

-measure intracompartmental pressure with catheter = >40mmHg is diagnostic
it’s done if pt is unconscious or atypical presentation

Question 5

management?

Answer 5

EMERGENCY

-remove tight dressings
-place limb on level of heart DO NOT ELEVATE to not reduce arterial flow.

if pt not improve within 1 hr, do fasciotomy

Question 6

complication if left untreated?

Answer 6

volkmann contracture