Acute Compartment Syndrome – a Life and Limb Threatening Surgical Emergency

Abstract

Acute compartment syndrome is a life and limb threatening condition. Clinical assessment is the diagnostic cornerstone of compartment syndrome but pressure monitoring also has a role in equivocal cases, in unconscious or uncooperative patients, and in patients with nerve blocks and other forms of regional and epidural anesthesia. A high degree of suspicion and early decompression of all compartments at risk are important for a satisfactory outcome.

So what! if a pneumatic tourniquet is used intraoperatively: A study of neurovascular assessment practices of orthopaedic nurses

“…One of the most likely causes of post-operative compartment syndrome is the 'application of a tight, unyielding bandage or plaster after the release of the tourniquet' (Klenernman, 2003, p. 68). What is more, Malik et al (2009) suggests compartment syndrome is associated with open and closed fractures, most commonly of the tibia and forearm and can also occur in patients who have sustained severe burns and soft tissue swelling. It is traditionally detected by the presence of paralysis, pain on passive movement, paraesthesia and pulselessness (Tucker, 1998).…”

“…Compartment syndrome is also a recognised complication and is described as 'a life and limb threatening condition' (Malik et al, 2009). One of the most likely causes of post-operative compartment syndrome is the 'application of a tight, unyielding bandage or plaster after the release of the tourniquet' (Klenernman, 2003, p. 68).…”

Acute compartment syndrome of the foot after an ankle sprain: a case report

“…The foot is a rare site for compartment syndrome, with a prevalence of 5% 4 . The result may be devastating without surgical management including severe nerve injuries, ischemic contractures, gangrene, and tissue necrosis that may eventually lead to amputation 5 . Therefore, early diagnosis is of paramount importance requiring high level of suspicion during patient evaluation 6 .…”

“…Other symptoms include sensory deficits in the affected compartment, pallor, paresthesia and paralysis. Excruciating and spontaneous pain has been identified as the earliest and most sensitive clinical sign of an acute compartment syndrome of the foot 5 . The observed ecchymosis of the dorsum of the foot, in our case, may be attributed to the expansion of the initial hematoma of the injured anterior talofibular ligament.…”

Application of contrast-enhanced ultrasonography in the diagnosis of skeletal muscle crush injury in rabbits

“…6,7 Impaired microcirculation is the initial pathological change of crushed muscles. 4 A variety of imaging methods have been used to examine reperfusion of the extremities and therefore detect the presence of muscle crush injury, such as CT, MRI and ultrasonography.…”