Acute compartment syndrome in forearm fractures

Broström, Lars‐Åke; Stark, André; Svartengren, G.

doi:10.3109/17453679008993066

Cited by 25 publications

(8 citation statements)

References 6 publications

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“…A number of methods are now available for monitoring the compartment pressure. 9 Stryker hand held monitor, Slit catheter, Wick catheter, fibreoptic transducer and ultrasound scanning to measure exercise ischemia.…”

Section: Discussionmentioning

confidence: 99%

Compartment pressure changes after closed fractures of tibia

Pillai

2016

Int J Res Orthop

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Background: Compartment syndrome is a potentially devastating situation. Raised intracompartmental pressure has been implicated as the primary pathogenic factor in compartment syndrome. The purpose of the study was early detection of compartment syndrome and corroborating the findings with other physical signs and symptoms, to prevent the onset of ischaemia and subsequent tissue changes that lead to crippling deformities.Methods: The present study was conducted in the Department of Orthopaedics, Pushpagiri medical college hospital, Thiruvalla over a period of 12 months. Closed fractures of tibia admitted to the casualty unit within 36 hours of injury were selected for the study. A total of 24 patients were included with the majority in the age group of 31– 45 years. Whitesides technique was used to measure the compartment pressure. A differential pressure of less than 30 mm Hg was taken as the criterion for diagnosis of compartment syndrome. Results: The present study included 24 patients with affected 25 limbs.15 out of 25 limbs were with lower third fractures (60%) followed by upper third 6 (24%) and middle third 4 (16%). Out of 25 limbs 20 cases (80%) had associated fracture of fibula and 5 (20%) were not associated. In this study, out of 32% cases with increased compartment pressure, one case with upper third fracture (above 45 mm Hg) and one of the case with middle third fracture (20-30 mm Hg) with associated fibula had underwent immediate fasciotomy.Conclusion: Compartment pressure measurement is a very good index for predicting and preventing compartment syndrome. Fasciotomy to fully decompress all involved compartments is the definitive treatment for compartment syndrome in the great majority of cases. Delays in performing fasciotomy increase morbidity.

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Section: Discussionmentioning

confidence: 99%

Compartment pressure changes after closed fractures of tibia

Pillai

2016

Int J Res Orthop

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“…But measurement of compartment pressure has been recommended to be the basis of decision for fasciotomy. Assessment of differential pressure (Diastolic blood pressureintra compartment pressure) is preferred over absolute pressure for deciding the need of fasciotomy [12,13] . Compartment pressure can be assessed by several techniques.…”

Section: Introductionmentioning

confidence: 99%

Measurement of compartment pressure in closed tibia fracture using white side’s technique

Sunil¹,

Sanil²

2020

Int. J. Orthop. Sci.

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Introduction: Tibia fractures account for 40% of acute compartment syndrome. Measurement of compartment pressure in high energy trauma, complex fractures, unconscious patient, poly trauma, severe soft tissue injury avoids morbidity and permanent disability by timely fasciotomy. Whiteside's method of needle manometer technique is a accepted method of invasive technique of compartment syndrome measurement. Materials and Methods: Patients admitted in vydehi institute of medical science hospital with closed tibia fractures during Jan 2019 to Dec 2019 were included after consent. Anterior compartment of leg was chosen and site of measurement was 5 cm from fracture. Differential pressure was also recorded and cut off for fasciotomy was 30 mm Hg. Results: 60 patients with closed tibia fractures were included in the study. 5 patients underwent fasciotomy and all patients had delta pressure less than 30 mm Hg before fasciotomy. Conclusion: Whiteside's technique is a safe, easily assembled, inexpensive method of intra compartment pressure measurement and differential pressure is a reliable guide for decision of fasciotomy compared absolute pressure.

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“…Median nerve function recovered in 15 patients. 8 patients had good outcome, and could resume their occupation within one year 9.…”

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confidence: 95%

Bilateral post-traumatic forearm and hand compartment syndrome: a case report and review of literature

et al. 2016

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Acute compartment syndrome is a condition in which interstitial tissue pressure within a closed osteo-fascial compartment is elevated to a nonphysiologic level causing decrease in tissue perfusion, which if left elevated for sufficient time, can lead to tissue necrosis and devastating loss of function. It poses a diagnostic and therapeutic challenge for treating surgeons. We present a case of acute post-traumatic bilateral forearm and hand compartment syndrome in a 12 year old boy associated with fracture of distal ulna and metacarpals. Patient regained excellent function with emergent fasciotomy of volar forearm and hand followed by wound management with vacuum-assisted wound closure system (VAC), delayed primary closure and split-thickness skin graft (SSG). Early diagnosis and emergent fasciotomy are crucial to avoid debilitating complications.

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Acute compartment syndrome in forearm fractures

Cited by 25 publications

References 6 publications

Compartment pressure changes after closed fractures of tibia

Compartment pressure changes after closed fractures of tibia

Measurement of compartment pressure in closed tibia fracture using white side’s technique

Bilateral post-traumatic forearm and hand compartment syndrome: a case report and review of literature

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