Acute compartment syndrome following revisionai arthroplasty of the forefoot: The dangers of ankle-block.

Noorpuri, B.S.W.; Shahane, Shantanu; Getty, C.J.G.

doi:10.1177/107110070002100809

Cited by 33 publications

(25 citation statements)

References 4 publications

(5 reference statements)

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“…The authors suggest that the nerve block masked the patient's pain and subsequently led to a delayed diagnosis of compartment syndrome. These findings are similar to those of Noopuri et al ,12 who described a patient who underwent forefoot revision arthroplasty for rheumatoid arthritis and was given an ankle block. The patient was comfortable in the immediate postoperative period but developed severe pain in the subsequent 12 h. Later, the patient underwent emergency fasciotomy and, fortunately, suffered no long-term effects.…”

Section: Discussionsupporting

confidence: 89%

Acute compartment syndrome risk in fracture fixation with regional blocks

Ganeshan¹,

Mamoowala

Ward

et al. 2015

BMJ Case Reports

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Acute compartment syndrome is a surgical emergency that most commonly occurs after trauma or reperfusion after prolonged arterial occlusion. It is caused by a build-up of blood and oedema fluid within a closed muscle compartment, and can be limb and life-threatening. It is therefore imperative that a prompt diagnosis is made. The risk of developing this condition is <1% in patients with distal radius fractures and 4-5% in those with tibial diaphyseal fractures. Pain management is an important aspect of treatment following any fracture. Regional anaesthesia can be used during surgical fixation of the fracture and has the potential to reduce the need for specialist postoperative care and analgesia, as well as to shorten the length of hospitalisation. With this case report, we hope to highlight the potential risk of masking symptoms of compartment syndrome while using regional blocks, as this can cause a delay in diagnosis and treatment, leading to associated complications.

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Section: Discussionsupporting

confidence: 89%

Acute compartment syndrome risk in fracture fixation with regional blocks

Ganeshan¹,

Mamoowala

Ward

et al. 2015

BMJ Case Reports

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“…16 Second, there exists the potential for vascular occlusion and compartment syndrome when large volumes of local anesthetics are used. 17,18 Finally, intravascular injections and subsequent convulsions have been reported during tibial nerve blockade. 19 There are several limitations to our study.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Improves the Success Rate of a Tibial Nerve Block at the Ankle

Redborg

Antonakakis

Beach

et al. 2009

Regional Anesthesia and Pain Medicine

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“…18 Second, there exists the potential for vascular occlusion and compartment syndrome when large volumes of local anesthetics are used. 19,20 Finally, there is a perception among providers that ankle blocks have a significant failure rate, which may discourage their performance. 5 A technique that allows direct visualization of key vascular structures may increase confidence of the provider.…”

Section: Discussionmentioning

confidence: 99%