SEARCH · PubMed Health

Results for “Compartment Syndromes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources

PubMedDate not supplied

Acute compartment syndrome of the foot caused by a hemangioma.

Acute compartment syndrome is most commonly caused by trauma. Although it has been well described in adults, few have addressed this condition in the pediatric patient. The most common causes of acute compartment syndrome of the foot in children are crush syndromes with or without fractures. We present the case of an 8-year-old girl who had a congenital hemangioma on the second toe of her right foot, with persistent pain and swelling of her right lower extremity. On exploration, the limb was cold and swollen, and pulses were timidly palpable. She was admitted with a working diagnosis of cavernous hemangioma with a hematoma that affected the blood flow of the foot. After measuring the compartment pressures, acute compartment syndrome of the right foot was diagnosed and fasciotomy was performed. The current medical literature was reviewed for acute compartment syndromes secondary to hemangiomas. It appears that this could be a new complication of hemangiomas located in limbs with severe consequences if not detected in time.

Acute Disease↗

PubMedDate not supplied

Compartment syndrome in the diabetic foot.

The compartment syndrome is a well-described clinical entity that results from increased pressure within a myofascial compartment. The infection in a diabetic foot usually presents in the whole compartment and can spread to a neighboring compartment. The association of infection and increased compartment pressure in the diabetic foot makes its treatment a formidable challenge. Fasciotomies of the feet when indicated may accelerate infection control and wound healing in the diabetic foot. The presence of a compartment syndrome in the diabetic foot is seldom recognized. Awareness of this problem is mandatory for physicians dealing with diabetic feet.

Compartment Syndromes↗

PubMed2005

Abdominal compartment syndrome.

PURPOSE OF REVIEW: This review will set forth the new consensus definitions for intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome from the World Congress on the Abdominal Compartment Syndrome in December 2004. The review will explore the challenges in diagnosis, pathophysiology, and recent concepts in the treatment of abdominal compartment syndrome. RECENT FINDINGS: Intra-abdominal pressure greater than 12 mm Hg may exert adverse physiologic sequelae, progressing to intra-abdominal hypertension and full-blown abdominal compartment syndrome as intra-abdominal pressure increases. The first challenge is to recognize that abdominal compartment syndrome may be a potential problem in critically ill patients. Intra-abdominal pressure monitoring is essential for this. Continuous monitoring of intra-abdominal pressure and abdominal perfusion pressure adds real-time measurements and can be performed by way of the stomach or bladder. Intra-abdominal hypertension occurs in approximately 35% of patients in the intensive care unit, and abdominal compartment syndrome in approximately 5%. SUMMARY: Massive resuscitation is increasingly recognized as a major contributor to abdominal compartment syndrome. Prophylactic decompression and temporary abdominal closure have important roles in preventing tertiary or recurrent abdominal compartment syndrome. Failure to recognize and treat intra-abdominal hypertension will result in increased risk of renal impairment, visceral and intestinal ischemia, respiratory failure and death.

Abdomen↗

PubMed1994

Atraumatic gluteal compartment syndrome.

A case of atraumatic gluteal compartment syndrome complicated by sciatic nerve palsy and acute rhabdomyolysis is presented. A presumed diagnosis of deep venous thrombosis led to a delay in diagnosis. Gluteal compartment syndrome should be considered in the differential diagnosis of the swollen leg.

Adult↗

PubMed2005

Forearm compartment syndrome in the newborn: report of 24 cases.

PURPOSE: Isolated cases of ischemia, compartment syndrome, or Volkmann's ischemic contracture in the forearm of the newborn infant have been reported in the past. The purpose of this study is to review a large series of patients with neonatal forearm compartment syndrome and to report the important clinical features. METHODS: A search of medical records from 1980 to 2000 identified 24 children with evidence of ischemia of the forearm at the time of birth. Records and images were reviewed for prenatal and birth history, maternal factors, medical conditions, pattern of involvement, treatment, and outcomes. Patients were grouped according to the extent of initial soft-tissue involvement. RESULTS: All patients presented with a sentinel forearm skin lesion. Patterns of involvement ranged from mild skin and subcutaneous lesions to dorsal and volar compartment syndrome with or without distal tissue loss. Early treatment intervention was limited to a single case in which the diagnosis of compartment syndrome was made and an emergency fasciotomy was performed with a good outcome. In other cases tissue loss, compressive neuropathy, muscle loss, and late skeletal changes were responsible for impaired function. Distal bone growth abnormality was common. CONCLUSIONS: Forearm compartment syndrome in the newborn is not as uncommon as previously thought. The skin lesion was the common, salient, initial diagnostic finding. Early diagnosis and appropriate referral led to the salvage of a functional limb in 1 of the patients in this series. The severity of the initial insult correlated with the degree of impairment in growth and function. The delayed diagnosis and treatment of an evolving compartment syndrome may compromise further final function.

Compartment Syndromes↗

PubMed2001

Compartment syndrome of the foot.

The hindfoot compartment syndrome occurs in 10% of cases after calcaneal fracture. We analyzed the pathological anatomical reasons for this syndrome using the 10 feet from cadavers plastinated and cut into 4-mm thick sequential sections. CT scans of patients with calcaneal fractures were then compared with the anatomical findings. The key component of this compartment syndrome is the quadratus plantae muscle. The sustentacular calcaneal fragment causes bleeding from the bone or the medial calcaneal arteries into this compartment. The medial and lateral plantar nerves and vessels are then compressed between the quadratus plantae muscle and the short flexor digitorum muscle. Relieving pressure by surgical decompression of the quadratus plantae compartment via a medial or plantar approach is the recommended treatment.

Anatomy, Cross-Sectional↗

PubMed2005

The diagnostic value of intracompartmental pressure measurement, magnetic resonance imaging, and near-infrared spectroscopy in chronic exertional compartment syndrome: a prospective study in 50 patients.

BACKGROUND: Patients with chronic exertional compartment syndrome have pain during exercise that usually subsides at rest. History and physical examination may raise suspicion of the syndrome; diagnosis is usually confirmed with intracompartmental pressure measurement after exercise. Studies have shown that magnetic resonance imaging and near-infrared spectroscopy have diagnostic ability in this syndrome. HYPOTHESIS: Magnetic resonance imaging and near-infrared spectroscopy can be used to diagnose chronic exertional compartment syndrome. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: Patients were enrolled if there was clinical suspicion of chronic exertional compartment syndrome, and a fasciotomy was performed based on this suspicion. Before fasciotomy, intracompartmental pressure, near-infrared spectroscopy, and magnetic resonance imaging data were collected during and after exercise on a treadmill. Near-infrared spectroscopy and intracompartmental pressure values were recorded in the same manner after fasciotomy. Retrospective proof that diagnosis of the syndrome had been correct was the absence of exertional complaints from the preoperative examination during exercise at postfasciotomy visit. RESULTS: Fifty patients (100 legs) participated in the prefasciotomy visit; 3 refused fasciotomy; 2 were lost to follow-up. Of 45 patients who completed the postfasciotomy visit, the diagnosis of chronic exertional compartment syndrome was retrospectively confirmed in 42 patients and discarded in 3 patients. The sensitivity for intracompartmental pressure (cutoff point, 35 mmHg) found in this study was 77% (67%-86%, exact 95% confidence interval), lower than estimates from the literature (93%). The sensitivity (previously defined cutoff) for near-infrared spectroscopy was 85% (76%-92%, exact 95% confidence interval), validating the estimate found in the literature (85%). Sensitivity of magnetic resonance imaging was comparable to that of intracompartmental pressure and near-infrared spectroscopy; associated specificity at a given sensitivity appeared to be lower with magnetic resonance imaging. CONCLUSION: This study validates the sensitivity of near-infrared spectroscopy and provides estimates for the sensitivity and specificity of magnetic resonance imaging in chronic exertional compartment syndrome in a large group of patients. The sensitivity of noninvasive near-infrared spectroscopy is clinically equivalent to that of invasive intracompartmental pressure measurements.

Adolescent↗

PubMed2006

Survey of intensive care physicians on the recognition and management of intra-abdominal hypertension and abdominal compartment syndrome.

OBJECTIVE: To assess current understanding and clinical management of intra-abdominal hypertension and abdominal compartment syndrome among critical care physicians. DESIGN: A ten-question, written survey. SETTING: University health sciences center. SUBJECTS: Physician members of the Society of Critical Care Medicine (SCCM). INTERVENTIONS: The survey was sent to 4,538 SCCM members with a response rate of 35.7% (1622). MEASUREMENTS AND MAIN RESULTS: Primary training, intensive care unit type, and methods for management of abdominal compartment syndrome were assessed. Surgically trained intensivists managed the highest number of abdominal compartment syndrome cases (47% managed 4-10 cases, 16% managed >10 cases). No cases were seen by 25% of medically trained and pediatric trained intensivists. Respondents agreed that bladder pressures and clinical variables were needed to diagnose abdominal compartment syndrome (70%) vs. bladder pressure (7%) or clinical variables (20%) alone. Two percent of surgical intensivists were unaware of a bladder pressure measurement procedure compared with 24% (p < .0001) of pediatric and 23% (p < .0001) of medical intensivists. Forty-two percent of respondents believed bladder pressures of 20-27 mm Hg may cause physiologic compromise. However, 25-27% of pediatric, medicine, or anesthesia trained intensivists believed that compromise occurs between 12 and 19 mm Hg compared with 18% of surgeons. No respondent believed that physiologic compromise occurred at <8 mm Hg. Thirty-eight percent of pediatric intensivists believed that physiologic compromise was patient dependent vs. 7-17% from other specialties (p < .0001; all comparisons). In managing intra-abdominal hypertension, 33% of pediatric intensivists and 19.6% of medical intensivists would never use decompression laparotomy to treat abdominal compartment syndrome compared with 3.6% of intensivists with surgical training (p < .0001; both comparisons). CONCLUSIONS: Significant variation across medical training exists in the management of intra-abdominal hypertension and abdominal compartment syndrome. A significant percentage of intensivists may be unaware of current approaches to abdominal compartment syndrome management including monitoring bladder pressures and decompression laparotomy. Future research and education are necessary to establish clear diagnostic criteria and standards for treatment of this relatively common life-threatening disease process.

Abdomen↗

PubMed2002

[Risk of compartment syndrome in open and closed tibial fractures].

BACKGROUND: In orthopaedic traumatology; acute compartment syndrome is a common complication associated with tibial fractures. In our study, we investigate differences, if any, between open and closed tibialfractures in terms oftheir risk of compartment syndrome. METHODS: Fourty-two tibial fractures of 39 patients, 29 (69%) closed and 13 (31%) open, having the risk of acute compartment syndrome according to the clinical examination, were monitored following traumas during which their DP (DP= Diastolic blood pressure -Absolute compartment pressure) and absolute compartment pressures were measured via intracompartmental pressure measuring equipment. RESULTS: Average absolute compartment pressure was found to be 31.25 mmHg in open and 29,32 mmHg in closed fractures (p=O,484) whereas average DP was measured to be 47,46 mmHg in open and 49,66 mmHg in closedfractures (p=O,415). According to student's test, the difference between the two groups was not significant. We found the incidence of acute compartment syndrome as 7, 7% in open fractures, 6.9% in closed and 7, 1 % in overall tibial fractures andfasciotomy was carried out in those cases. CONCLUTION: Statistically not significant difference between the pressure levels,found in open and closed tibialfractures, showed that open type oftibialfractures holds the risk of compartment syndrome as much as the closed one.

Compartment Syndromes↗

PubMed1995

[Chronic compartment syndrome of the foot. A case report].

PURPOSE OF THE STUDY: The aim of this paper is to present an unusual localization of a chronic compartment syndrome concerning the medial compartment of the foot. It emphasizes surgical treatment, using a fasciotomy procedure. MATERIAL AND METHODS: A thirty year old man was examined for a painful right foot. Pain was situated on the medial plantar aspect of the foot. It appeared following 15 minutes of physical effort, especially after walking and running. It usually disappeared after a few minutes of rest and then, foot and lower leg examination were normal. The patient had comparative tissue pressure measurements at rest and after running, using a digital hand-held monitor (Stryker). A rest, the pressure was about 4 mmhg on both sides and it increased to 55 mmhg against 45 mmhg at the opposite side after exercise. It required more than 7 minutes vs. 30 seconds to return to their preexercise resting values. Thus a fasciotomy of the medial compartment was performed, using a medial approach. RESULTS: The patient had a good result at three months follow-up, recovering normal physical activity without any pain. DISCUSSION: The foot localization of an acute compartment syndrome has been recently described and it concerned only post-traumatic cases. The compartmental structure of the foot has been previously report. The chronic compartment syndrome of the lower leg was the reason for a pressure measurement study, at rest and following physical exercise; thus surgical fasciotomy was indicate when intracompartmental pressure rose above 30 mmHg in the presence of normal diastolic blood pressure, and particularly if delayed normalization of the pressure was greater than 5 minutes. The publications of foot pressure measurement are uncommon and they concerned only pressure at rest. In our observation, the profile of pressure of the patient and the result of fasciotomy, are in favour of chronic compartment syndrome. CONCLUSION: Chronic compartment syndromes require dynamic pressure measurements for an accurate diagnosis. Surgical fasciotomy may be sufficient to restore muscle function. We think this syndrome could happen in all anatomical compartmental structure when there is intensive use of muscles.

Adult↗

PubMed1997

Acute compartment syndrome following non-contact football injury.

Acute compartment syndrome in athletes, although rare, is a limb threatening condition which warrants emergency treatment. The case of a footballer with acute compartment syndrome of the left lower leg, without any preceding direct trauma to the calf, is reported. To our knowledge this is the only description of acute atraumatic compartment syndrome secondary to rupture of one of the heads of gastrocnemius.

Acute Disease↗

PubMedDate not supplied

Acute compartment syndrome of the triceps and deltoid.

Compartment syndrome is a condition in which the circulation and function of tissues within a closed space are compromised by increased pressure within that space. We report on the rare occurrence of compartment syndrome of the upper arm and deltoid in a professional power-lifter. This case stresses the importance of heightened awareness and expedient measures to prevent ischemic muscle necrosis and nerve injury.

Accidental Falls↗

PubMed1988

Compartment syndrome following oral and maxillofacial surgery.

Compartment syndrome must be included in the differential diagnosis in any patient who complains of pain or neuromuscular deficit in an extremity. The etiology, differential diagnosis, clinical features, and treatment of compartment syndrome are reviewed to assist in proper diagnosis and management. Although the exact etiology in this case will never be ascertained, delay in diagnosis and treatment resulted in a neuromuscular deficit. It is therefore imperative that proper patient positioning during the perioperative period be closely monitored to avoid this complication.

Adult↗

PubMed1992

The pelvic compartment syndrome.

In the pelvic region three major compartments (gluteus medius-minimus compartment, gluteus maximus compartment, and iliopsoas compartment) can be distinguished from the smaller compartment of the tensor fasciae latae muscle. Pelvic compartment syndromes are rare. A clear history of trauma is often lacking. Association with drug and alcohol abuse is common, as is the association with the widespread use of anticoagulant therapy. From 1982 to 1990 six patients with acute buttock compartment syndrome were treated in the Department of Trauma Surgery of Hannover Medical School. In five patients fasciotomy of the gluteal compartment was performed. Two patients with a compartment syndrome secondary to necrotizing fasciitis died of septic multiple organ failure. The mean follow-up of the four other patients was 29 months (7-48 months). Three of these four patients revealed a decrease of gluteal muscle volume. Ergometric tests showed a decrease in gluteal muscle force in all patients.

Adolescent↗

PubMed2006

Acute compartment syndrome complicating an intramuscular haemangiosarcoma in a dog.

Acute compartment syndrome in dogs is a rare complication of muscle trauma, but it has not been previously reported as a consequence of neoplasia in dogs. This case report describes the occurrence of a compartment syndrome of the femoral compartment in an 11-year-old, male, mixed-breed dog caused by acute bleeding of an intramuscular haemangiosarcoma. The compartment syndrome was relieved by immediate fasciotomy. The dog was euthanased following acute recurrence of clinical signs seven weeks after surgery.

Acute Disease↗

PubMed1996

Compartment syndrome of the buttock following a total hip arthroplasty.

An elevation of the interstitial pressure in a closed osseofascial compartment results in compartment syndrome. This may be caused by a decrease in compartment volume or an increase in compartment contents. The gluteal compartment syndrome is rare. Because the gluteal region has a large volume, this compartment requires a massive increase in content to cause a compartment syndrome. Also, this compartment blends anatomically with the muscles of the thigh, allowing extravasation of blood outside the compartmental envelope. This case report is of a patient whose medial circumflex femoral artery was severed during a total hip arthroplasty through a posterior approach leading to compartment syndrome of the buttock. Although this clinical presentation has not been described as compartment syndrome, one similar presentation was described in the literature.

Aged↗

PubMed2001

The abdominal compartment syndrome: a complication with many faces.

BACKGROUND: Lately renewed attention has been given to the abdominal compartment syndrome. Despite of this there still remain a lot of controversies with regard to the pathophysiological mechanisms underlying this syndrome and the therapeutic options. METHODS: Two cases of patients with this syndrome are described and the data from animal and human trials concerning the abdominal compartment syndrome are presented and discussed. RESULTS: A variety of clinical disorders may lead to the abdominal compartment syndrome. It mainly affects the cardiovascular, pulmonary and renal organ systems. Although some clinical effects are clearly described, the exact mechanisms underlying these changes in humans are incompletely understood. It is still unclear why some patients develop abdominal compartment syndrome and others do not. The intra-abdominal pressure can easily be assessed by measuring the urine bladder pressure, which correlates well with the actual intra-abdominal pressure. All authors agree that a decompression of the abdomen by means of a laparotomy is the treatment of choice for the abdominal compartment syndrome. Which parameters should determine the indication however, remains controversial, since the correlation between clinical signs and pressure is not straightforward. CONCLUSIONS: The abdominal compartment syndrome is a well-recognised disease entity related to acutely increased abdominal pressure. Urgent laparotomy can be lifesaving in some cases. However no single threshold of abdominal pressure can be applied universally. Pending further clinical trials the best therapeutic option seems to be to decompress the abdomen surgically if the intravesical pressure is 25 mmHg or higher in patients with refractory hypotension, acute renal failure or respiratory failure due to abdominal distension.

Abdomen↗

PubMed1996

Compartment syndromes of the hand.

We retrospectively reviewed the records of nineteen patients who had been managed with fasciotomy because of compartment syndrome of the hand. The patients were five months to sixty-seven years old and included ten adults and nine children. Seventeen patients were followed for an average of twenty-one months (range, one to fifty-eight months), one patient was lost to follow-up after discharge, and one patient died four days postoperatively. All of the patients had a tense, swollen hand and elevated pressure in at least one interosseous compartment. Eight patients also had a compartment syndrome of the forearm. The compartment syndromes developed after intravenous injections (eleven patients); after a gunshot wound, a crush injury, or a complication related to the use of an arterial line (two patients each); and after a complication related to an arthrodesis of the wrist or a crush injury due to prolonged pressure on the upper extremity secondary to a drug overdose (one patient each). Fifteen patients had an obtunded sensorium-either because of a serious illness or injury or secondary to prolonged anesthesia-when the compartment syndrome was recognized. In thirteen of these patients, including eight children and five adults, the compartment syndrome developed because of a complication related to the intravenous or intra-arterial administration of drugs. Carpal tunnel release and decompression of the involved compartments led to a satisfactory result for thirteen of the seventeen patients who were followed. The remaining four patients (including two children who had an amputation, one child who had impaired function of the hand secondary to brain damage, and one adult who had extensive involvement of the forearm and complete loss of function of the hand) had a poor result. All four of these patients had been obtunded when the compartment syndrome developed. The treating physician should maintain a high index of suspicion for a compartment syndrome of the hand when managing seriously ill, obtunded patients-particularly children-who are receiving multiple intravenous or intra-arterial injections.

Adolescent↗