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Compartment Syndrome of the Extremities

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Penetrating Trauma
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Abstract

Compartment syndrome (CS) is a limb-threatening and potentially life-threatening condition. Long bone fractures and vascular injuries are the most frequent antecedent events. Burns, crush injury, bleeding in enclosed spaces, external compression of the limb, small thrombotic or embolic events, envenomation, allergy, intravenous infiltration, muscle overuse, nephritic syndrome, and intramuscular injection have all been implicated. Current knowledge unequivocally reflects that if you fail to identify and treat compartment syndrome properly, you will have a patient with tissue necrosis, permanent functional impairment, and potentially renal failure and death. CS has been found wherever a compartment is present: hand, forearm, upper arm, abdomen, buttock, and the entire lower extremity. The leg (calf) is the area that is most commonly affected, followed by the forearm, and the thigh. As a well-trained surgeon who wants to do the best for each patient, you must become intimately familiar with this topic and the techniques to treat it.

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Recommended Reading

  1. Bowyer MW (2015) Lower extremity fasciotomy: indications and technique. Curr Trauma Rep 1:35–44

    Article  Google Scholar 

  2. Dente CJ, Feliciano DV, Rozycki GS et al (2004) A review of upper extremity fasciotomies in a level 1 trauma center. Am Surg 70:1088–1093

    PubMed  Google Scholar 

  3. Donaldson J, Haddad B, Khan WS (2014) The pathophysiology, diagnosis and current management of acute compartment syndrome. Open Orthop J 8:185–193

    Article  PubMed  PubMed Central  Google Scholar 

  4. Feliciano DV, Cruse PA, Spjut-Patrinely V (1988) Fasciotomy after trauma to the extremities. Am J Surg 156:533–536

    Article  CAS  PubMed  Google Scholar 

  5. Harris IA, Kadir A, Donald G (2006) Continuous compartment pressure monitoring for tibia fractures: does it influence outcome? J Trauma 60:1330–1335

    Article  PubMed  Google Scholar 

  6. Kakar S, Firoozabadi R, McKean J, Tornetta P III (2007) Diastolic blood pressure in patients with tibia fractures under anaesthesia: implications for the diagnosis of compartment syndrome. J Orthop Trauma 21:99–103

    Article  PubMed  Google Scholar 

  7. Mathis JE, Schwartz BE, Lester JD, Kim WJ, Watson JN, Hutchinson MR (2015) Effect of lower extremity fasciotomy length on intracompartmental pressure in an animal model of compartment syndrome: the importance of achieving a minimum of 90% fascial release. Am J Sports Med 43:75–78

    Article  PubMed  Google Scholar 

  8. Ojike NI, Roberts CS, Giannoudis PV (2009) Compartment syndrome of the thigh: a systematic review. Injury 41:133–136

    Article  PubMed  Google Scholar 

  9. Raza H, Mahapatra A (2015) Acute compartment syndrome in orthopedics: causes, diagnosis, and management. Adv Orthop 2015:543412

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ritenour AE, Dorlac WC, Fang R et al (2008) Complications after fasciotomy revision and delayed compartment release in combat patients. J Trauma 64(2S):S153–S162

    Article  PubMed  Google Scholar 

  11. Shadgan B, Menon M, O’Brien PJ, Reid WD (2008) Diagnostic techniques in acute compartment syndrome of the leg. J Orthop Trauma 22:581–587

    Article  Google Scholar 

  12. Via AG, Oliva F, Spoliti M, Maffulli N (2015) Acute compartment syndrome. Muscles Ligaments Tendons J 5:18–22

    PubMed  PubMed Central  Google Scholar 

  13. Weaver MJ, Owen TM, Morgan JH, Harris MB (2015) Delayed primary closure of fasciotomy incisions in the lower leg: do we need to change our strategy? J Orthop Trauma 29:308–311

    Article  PubMed  Google Scholar 

  14. Zannis J, Angobaldo J, Marks M et al (2009) Comparison of fasciotomy wound closures using traditional dressing changes and vacuum-assisted closure device. Ann Plast Surg 62:407–409

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The author is indebted to Ms. Elizabeth Weissbrod, MA, CMI, for the expert medical illustrations found in this chapter.

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Correspondence to Mark W. Bowyer .

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Bowyer, M.W. (2017). Compartment Syndrome of the Extremities. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49859-0_61

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  • DOI: https://doi.org/10.1007/978-3-662-49859-0_61

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  • Publisher Name: Springer, Berlin, Heidelberg

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