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Archive » 2014 » 3 » | Kirurgija » Archive » Medical field » Fields » Surgery »

Compartment Syndrome

 
Abstract:

This post is also available in: enEnglish slSlovenščina (Slovenian)

Compartment syndrome is a condition in which increased pressure within the confined space of a compartment impairs blood flow and causes organ or tissue dysfunction. Compartment syndrome can be primary or secondary, acute or chronic. If acute, it has an urgent clinical presentation which requires prompt surgical intervention. Common causes of acute compartment syndrome are trauma, vascular, iatrogenic or soft tissue causes, while the chronic compartment syndrome usually occurs in professional athletes due to excessive exercise. Two main pathophysiologic mechanisms are inadequate tissue/organ perfusion and oxygenation inside a confined space. Without proper intervention, the tissue damage caused by increased pressure is irreversible. A high index of suspicion is required to make the diagnosis. The most important clues are disproportionate pain that is unresponsive to analgesics and pain caused by passive movement of an extremity. The diagnosis is confirmed with intracompartmental pressure measurement. Pressure, equal or lower than 30mmHg [DELTA] (diastolic blood pressure – compartment pressure), requires surgical intervention. The goal of the treatment is to decrease tissue pressure, restore blood flow as well as minimize tissue damage and functional loss. If possible, conservative approaches can be used; otherwise, the only treatment is surgical fasciotomy. In high risk patients, fasciotomy can also be preventive. Untreated increased intracompartmental pressure leads to massive muscle damage resulting in metabolic acidosis, myoglobinuria, renal failure, hyperkalemia and contracture formation or loss of limb.

Authors:
Gradišek Barbara, Ahčan Uroš, Sluga Boštjan, Smrke Dragica Maja

Keywords:
acute compartment syndrome, chronic compartment syndrome, muscle compartments, inadequate tissue perfusion, pressure, therapy, fasciotomy

Cite as:
Med Razgl. 2014; 53 (3): 379–97.

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