Compartment syndrome

• What is compartment syndrome?

  Where the pressure within a fascial compartment is abnormally elevated, cutting off blood flow to the contents of that compartment.
• What do fascial compartments contain?

  Muscles

  Blood vessels

  Nerves
• What is fascia?

  Sheet of strong fibrous connective tissue
• What is a property of fascia which causes compartment syndrome

  Cannot stretch or expand
• Which team would you need to get involved in a case of acute compartment syndrome?

  Trauma and Orthopaedics
• What is the name of the surgery needed in acute compartment syndrome?

  Fasciotomy
• Without prompt treatment of acute compartment syndrome, what can happen?

  Tissue necrosis
• What are the 2 types of compartment syndrome?

  Acute

  Chronic
• Name 5 body parts affected by compartment syndrome

  Legs

  Forearm

  Feet

  Thigh

  Buttocks
• Name 2 acute injuries which could precede compartment syndrome

  Bone fractures

  Crush injuries
• What are the 5 P's for the presentation of acute compartment syndrome?

  Pain

  Pale

  Parasthesia

  Paralysis

  Pressure (high)
• Which P is seen in acute limb ischaemia but not compartment syndrome?

  Pulselessness.

  There is a pulse in compartment syndrome.
• What can be done to measure compartment pressure?

  Needle manometry
• What is the initial management of acute compartment syndrome?

  Escalate to orphopaedics

  Remove any external dressings or bandages

  Elevating the leg to heart level

  Maintaining good blood pressure, avoiding hypotension
• When should an emergency fasciotomy be done in acute compartment syndrome?

  within 6 hours of injury
• How long does it take for the wound to be closed after fasciotomy?

  Several weeks
• Is acute compartment syndrome cured from just one surgery?

  No, multiple surgeries need to happen to explore for necrotic tissue and debride as necessary, also need to wait for the wound the close once swelling has gone down.
• What is chronic compartment syndrome?

  Also know as chronic exertional compartment syndrome

  Associated with exertion

  Pressure within the compartment rises and blood flow becomes restricted, causing onset of symptoms. When at rest pressure falls and symptoms begin to resolve. This is not an emergency.
• Is chronic compartment syndrome made worse or better with exertion?

  Worse

  Better with rest.
• What are the three symptoms of chronic compartment syndrome?

  Pain

  Numbness

  Parasthesia
• What is parasthesia?

  Pins and needles
• How do you treat chronic compartment syndrome?

  They may need a fasciotomy