Acute Compartment Syndrome of the Lower Leg: A Review

Pechar, J; Lyons, M. Melanie

doi:10.1016/j.nurpra.2015.10.013

Cited by 52 publications

(41 citation statements)

References 14 publications

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“…Rhabdomyolysis, a serious condition caused by muscle injury, may occur if the diagnosis of ACS is not made in time for urgent fasciotomy. The presence of high CK levels in the blood may indicate severe muscle damage or ischemia and may cause acute renal failure [ 3 , 5 , 9 ]. In the absence of clinical signs, raised CK levels could indicate an unsuspected ACS [ 6 ]; however, because rhabdomyolysis can lead to acute renal failure, and can be life-threatening [ 9 ], elevated CK levels should not be relied on for an early diagnosis of ACS [ 2 – 4 , 6 , 7 ], and creatinine clearance and plasma creatinine are late-stage markers of kidney damage that has already occurred [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…The symptoms of ACS include swelling, pain on passive stretch, pain out of proportion to the injury, paresthesia, and paresis or paralysis [ 4 ]; however, it is important to note that not all characteristic of ACS may be present [ 5 ]. Clinical signs such as pallor, reduced capillary return, and absent peripheral pulses are late signs of ACS, and therefore the presence of distal pulses should not be relied on to exclude a diagnosis of ACS [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute compartment syndrome of the lower limb following childbirth: a case report

et al. 2020

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Background Acute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Prompt diagnosis is crucial to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors and signs and symptoms of acute compartment syndrome is necessary to prevent long-term complications and amputation. Case presentation This paper presents a case of a 26-year-old primiparous Sri Lankan woman who developed acute compartment syndrome of the lower right limb following childbirth by cesarean section. Conclusion Acute compartment syndrome is an important differential diagnosis in the setting of sudden onset of lower limb pain following childbirth. Predisposing factors for its manifestation within an obstetric environment are augmented labor, the lithotomy position, postpartum hemorrhage, hypotension following epidural analgesia, and the use of vasoconstrictive agents. If left undiagnosed and untreated, acute compartment syndrome may cause permanent neurovascular deficit, leading to a poor functional result, tissue ischemia, limb amputation, and rhabdomyolysis. If severe, and in large compartments, it can lead to renal failure and death. Alertness and a high index of clinical suspicion for the possibility of acute compartment syndrome are required to avoid a delay in diagnosis, and intracompartmental pressure measurement can be used to confirm the diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute compartment syndrome of the lower limb following childbirth: a case report

et al. 2020

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“…Patients most often present with symptoms of aching or burning pain that may be disproportionate to the injury, which can occasionally have associated paresthesia. Cardinal physical exam signs are an associated tense compartment and motor deficits in the affected limb [31,32]. Measurement of ICP in the suspected compartment is used as a supplemental diagnostic tool for cases that are not diagnosed clinically.…”

Section: Discussionmentioning

confidence: 99%

Acute compartment syndrome in patients on long-term anticoagulation therapy

Jabaly¹,

Ebraheim²

2019

J Trauma Crit Care

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Development of acute compartment syndrome (ACS) poses problems for patients on long-term anticoagulation, who are at higher risk for hemorrhagic insult. The populations predisposed to ACS and long-term anticoagulation individually are quite different, making this a particularly unique population that has been rarely studied. Eight patients at our institution were included in this study based on development of ACS while being on long-term anticoagulation. Causes of ACS were almost evenly split between idiopathic, fracture, and blunt trauma without fracture. The most commonly involved compartment was the lower leg. ACS was appropriately diagnosed based on clinical assessment alone in all patients, based on heightened level of suspicion. All patients were treated with single-or double-incision fasciotomy, as is the standard of treatment in the general population. All patients experienced good outcomes post-fasciotomy with prompt bridging to anticoagulant regimen, with minimal complications and no cases of mortality. These patients were not revealed to have any identifiably unique risk factors for developing ACS, and they can be treated similarly to patients not on anticoagulation and adequately bridged to therapeutic anticoagulation levels.

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“…Poikilothermia, also known as “6Ps”, is a fundamental symptom of acute limb ischemia (ALI) ; however, this condition cannot be assessed objectively. Herein, we present a case of a 27‐year‐old man whose right foot was diagnosed with ALI due to insertion of a cannula into the right femoral artery for veno‐arterial extracorporeal membrane oxygenation (ECMO).…”

Section: Case Presentationmentioning

confidence: 99%