Compartment syndrome following isolated ankle fracture

Joseph, Joji; Giannoudis, Peter V.; Hinsche, A.; Cohen, A.; Matthews, Stephen J.; Smith, R. M.

doi:10.1007/s002640000128

Cited by 20 publications

(10 citation statements)

References 7 publications

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“…Pressures within a myofascial compartment of as little as 30–40 mm Hg will occlude all capillary flow [28,29]. Compartment syndrome is a well‐known complication of fractures, joint trauma, and joint surgery [26,30–32]. CRPS‐I also often follows fractures, joint injuries, and wrist, elbow, and knee surgery [33,34].…”

Section: A Hypothesis For the Pathogenesis Crps‐imentioning

confidence: 99%

A Hypothesis for the Cause of Complex Regional Pain Syndrome-Type I (Reflex Sympathetic Dystrophy): Pain Due to Deep-Tissue Microvascular Pathology

Coderre¹,

Bennett²

2010

Pain Med

123

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Complex regional pain syndrome-type I (CRPS-I; reflex sympathetic dystrophy) is a chronic pain condition that usually follows a deep-tissue injury such as fracture or sprain. The cause of the pain is unknown. We have developed an animal model (chronic post-ischemia pain) that creates CRPS-I-like symptomatology. The model is produced by occluding the blood flow to one hind paw for 3 hours under general anesthesia. Following reperfusion, the treated hind paw exhibits an initial phase of hyperemia and edema. This is followed by mechano-hyperalgesia, mechano-allodynia, and cold-allodynia that lasted for at least 1 month. Light microscopic analyses and electron microscopic analyses of the nerves at the site of the tourniquet show that the majority of these animals have no sign of injury to myelinated or unmyelinated axons. However, electron microscopy shows that the ischemia-reperfusion injury produces a microvascular injury, slow-flow/no-reflow, in the capillaries of the hind paw muscle and digital nerves. We propose that the slow-flow/no-reflow phenomenon initiates and maintains deep-tissue ischemia and inflammation, leading to the activation of muscle nociceptors, and the ectopic activation of sensory afferent axons due to endoneurial ischemia and inflammation. These data, and a large body of clinical evidence, suggest that in at least a subset of CRPS-I patients, the fundamental cause of the abnormal pain sensations is ischemia and inflammation due to microvascular pathology in deep tissues, leading to a combination of inflammatory and neuropathic pain processes. Moreover, we suggest a unifying idea that relates the pathogenesis of CRPS-I to that of CRPS-II. Lastly, our hypothesis suggests that the role of the sympathetic nervous system in CRPS-I is a factor that is not fundamentally causative, but may have an important contributory role in early-stage disease.

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Section: A Hypothesis For the Pathogenesis Crps‐imentioning

confidence: 99%

A Hypothesis for the Cause of Complex Regional Pain Syndrome-Type I (Reflex Sympathetic Dystrophy): Pain Due to Deep-Tissue Microvascular Pathology

Coderre¹,

Bennett²

2010

Pain Med

123

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“…Three months after surgery, neuromuscular examination results were normal. Joseph et al 10 reported 2 cases of compartment syndrome following ankle fracture. All compartments were involved in both patients.…”

Section: Discussionmentioning

confidence: 99%

Isolated Anterior Compartment Syndrome After a Bimalleolar-Equivalent Ankle Fracture in a Collegiate Football Player

Starr

Swan

2011

Sports Health

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Compartment syndrome after an ankle fracture is an extremely rare and potentially devastating event. The authors report a case of an isolated anterior compartment syndrome in a college student athlete who suffered a bimalle olar ankle fracture dislocation. A review of the literature highlights the importance of vigilance when the sports medicine physician and the community orthopaedist are treating these seemingly basic orthopaedic injuries.

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“…In der Literatur finden sich nur vereinzelte Fallberichte [7]. Besteht jedoch der klinische Verdacht,muss eine umgehende chirurgische Intervention erfolgen.…”

Section: Kompartmentsyndromunclassified

Spezielle Probleme und Sp�tfolgen nach OSG-Fraktur

Beck

Mittlmeier

2004

Trauma Berufskrankh

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Compartment syndrome following isolated ankle fracture

Cited by 20 publications

References 7 publications

A Hypothesis for the Cause of Complex Regional Pain Syndrome-Type I (Reflex Sympathetic Dystrophy): Pain Due to Deep-Tissue Microvascular Pathology

A Hypothesis for the Cause of Complex Regional Pain Syndrome-Type I (Reflex Sympathetic Dystrophy): Pain Due to Deep-Tissue Microvascular Pathology

Isolated Anterior Compartment Syndrome After a Bimalleolar-Equivalent Ankle Fracture in a Collegiate Football Player

Spezielle Probleme und Sp�tfolgen nach OSG-Fraktur

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