Compartment Syndrome: Difference between revisions
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== Diagnostic Procedures == | == Diagnostic Procedures == | ||
The only way to diagnose a compartment syndrome is to measure the pressure within the compartments of the affected limb. | |||
- Intracompartmental pressure monitoring (ICP): <ref name="bron 5" /><br>When measuring the ICP using a needle, a plastic tube filled with a saline solution and air, connected to a mercury manometer. <br>This objective method can provide a continuous recording of pressure measurement for up to 16 to 24 hours.<br>The normal ICP ranges from zero to 10 mmHg. When the pressure is near a 30 mmHg below the diabolic pressure a fasciotomy is required.<ref name="bron 4" /> Time is also a very significant parameter but very difficult to measure.<ref name="bron 6" /> Decompression within 6 hours will be resulted in a full recovery. If more than 12 hours pass by without any acting an inevitable disability will be identified. | |||
== Outcome Measures == | == Outcome Measures == | ||
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Clinically Relevant Anatomy
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add text here relating to clinically relevant anatomy of the condition
Mechanism of Injury / Pathological Process
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The connective tissue of a compartment is not able to stretch, so when there appears a bleeding or a swelling of the muscles within the compartment, the pressure rises likely. [1][2]
Normally a non-contracting muscle contains a pressure near zero, nevertheless if the pressure rises up to 30 mmHg, the vessels will be compressed resulting into pain and a reduction of blood flow. Also the lymphatic drainage will activate to prevent the increasing interstitial fluid pressure[3], when this reached to its maximum; the pressure between the compartments will cause physiological defects such as a nerve dysfunction and deformation. A hemorrhage of an edema causes the interstitial pressures within the soft tissues to increase, creating possible ischemia by loss of capillary refill.[4]
Ischemia starts when the local blood flow can’t fulfill the metabolic demands of the tissues. When a body part is not provided with blood for more than eight hours, the damage is irreversible and may lead to the death of the concerning tissues.[5]
Clinical Presentation[edit | edit source]
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Diagnostic Procedures[edit | edit source]
The only way to diagnose a compartment syndrome is to measure the pressure within the compartments of the affected limb.
- Intracompartmental pressure monitoring (ICP): [1]
When measuring the ICP using a needle, a plastic tube filled with a saline solution and air, connected to a mercury manometer.
This objective method can provide a continuous recording of pressure measurement for up to 16 to 24 hours.
The normal ICP ranges from zero to 10 mmHg. When the pressure is near a 30 mmHg below the diabolic pressure a fasciotomy is required.[3] Time is also a very significant parameter but very difficult to measure.[2] Decompression within 6 hours will be resulted in a full recovery. If more than 12 hours pass by without any acting an inevitable disability will be identified.
Outcome Measures[edit | edit source]
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Management / Interventions
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Differential Diagnosis
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Key Evidence[edit | edit source]
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Resources
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Case Studies[edit | edit source]
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References[edit | edit source]
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- ↑ 1.0 1.1 Kirsten G B, Elliot A, J Johnstone. Diagnosing acute compartment syndrome. The journal of bone and joint surgery, Vol. 85, N°5, July 2003 A1 (2)http://web.jbjs.org.uk/cgi/reprint/85-B/5/625.pdf
- ↑ 2.0 2.1 Galanakos S, Sakellariou V I, Kkotoulas H, Sofianos I P. Acute Compartment Syndrome: The significance of immediate diagnosis and the consequences from delayed treatment. E.E.X.O.T, Vol 60: 127-133, 2009
- ↑ 3.0 3.1 Abraham T Rasul Jr. Compartment syndrome. eMedicine. 11 March 2009 A1 (2)http://emedicine.medscape.com/article/307668-overview
- ↑ Tucker Alicia K. Chronic exertional compartment syndrome of the leg. Current Reviews in Musculoskeletal Medicine. 2 September 2010 A1 http://ukpmc.ac.uk/articles/PMC2941579/
- ↑ Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S. Compartment syndrome of the lower leg and foot. The Association of bone and joint surgeons. 27 may 2009 http://emedicine.medscape.com/article/140002-overview
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