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 325 records · Page 18Linked to original sources

PubMed2006

Noninvasive measurements of intramuscular pressure using pulsed phase-locked loop ultrasound for detecting compartment syndromes: a preliminary report.

OBJECTIVES: To develop a human model for compartment tamponade and test the efficacy of ultrasonic pulsed phase-locked loop (PPLL) fascial displacement waveform analysis for noninvasive measurement of intramuscular pressure (IMP). DESIGN: Human subject experiment. SETTING: University Level 1 trauma center. PARTICIPANTS: Nine male and 1 female volunteers (age 20 to 59),3 male acute compartment syndrome (ACS) patients (age 31 to 38). INTERVENTION: Thigh tourniquet was inflated in a stepwise fashion from 40 to 100 mm Hg to increase IMP transiently in volunteers. MAIN OUTCOME MEASUREMENTS: Invasive IMP by slit catheter and PPLL fascial displacement waveform in volunteers with model ACS and patients with ACS. RESULTS: In the model compartment tamponade group, thigh cuff occlusion increased IMP in the anterior compartment from a mean of 12.1 mm Hg (SE = 1.5) to a mean of 27.4 mm Hg (SE = 2.4, N = 8, P < 0.0001). By fast Fourier transform, the ratio of the amplitude of the fundamental frequency to the amplitude of the second harmonic frequency of the fascial displacement waveform as measured by PPLL increased from a resting mean of 1.12 (SE = 0.07) to a mean of 1.85 (SE = 0.18) under the same protocol (N = 6, P = 0.001). Combined data with compartment syndrome patients revealed linear correlation between IMP and PPLL with an R value of 0.8887. CONCLUSIONS: Subarterial thigh cuff pressure causes a significant and transient increase in IMP, serving as a model for anterior compartment tamponade. PPLL is able to detect fascial displacement waveforms corresponding to arterial pulsation and furthermore distinguishes between normal and elevated IMP. There is a linear correlation between PPLL measurements and invasive IMP. The PPLL shows potential utility as a device for noninvasive measurement of IMP for detecting compartment syndromes.

Adult↗

PubMed2000

Compartment syndrome in ipsilateral humerus and forearm fractures in children.

Ipsilateral fractures of the humerus and forearm are uncommon injuries in children. The incidence of compartment syndrome in association with these fractures is controversial. The authors reviewed 978 consecutive children admitted to the hospital with upper extremity long bone fractures during a 13-year period. Forty-three children with ipsilateral fractures of the humerus and forearm were identified. Of 33 children with a supracondylar humerus fracture and ipsilateral forearm fracture, three children (7%) had compartment syndrome develop and required forearm fasciotomies. All three cases of compartment syndrome occurred among nine children with ipsilateral displaced extension supracondylar humerus and displaced forearm fractures; the incidence of compartment syndrome was 33% in this group. These findings suggest that children who sustain a displaced extension supracondylar humerus fracture and displaced forearm fracture are at significant risk for compartment syndrome. These children should be monitored closely during the perioperative period for signs and symptoms of increasing intracompartmental pressures in the forearm.

Adolescent↗

PubMed1996

Compartment syndrome associated with an osteocartilaginous exostosis.

The authors describe a compartment syndrome of the deep posterior flexor compartment due to perforation of the popliteal artery by an osteocartilaginous exostosis, in a healthy 13-year-old boy. The difficulties in making the diagnosis are discussed. In a review of the literature regarding this condition, the combination of compartment syndrome and exostoses could not be found.

Adolescent↗

PubMedDate not supplied

Acute exertional compartment syndrome of the medial foot.

A review of compartment syndrome, both acute and chronic, is presented. The pathophysiology, anatomy, diagnosis, and treatment are presented in relation to a unique case report. The case is one of acute exertional compartment syndrome of the medial foot treated by fasciotomy. This condition is uncommon in both its nature and location.

Adult↗

PubMed1992

Anterior compartment syndrome of the thigh in athletes--indications for conservative treatment.

Anterior compartment syndrome of the thigh resulting from blunt contusion without an accompanying fracture is rare. The treatment advocated for it by most authors has been surgical. However, because wound infection rates are high and loss of knee range of motion is frequent, we considered conservative treatment in selected patients. Six athletes who developed an anterior thigh compartment syndrome shortly after sustaining a blunt contusion to the quadriceps with an accompanying massive hematoma were studied prospectively. Tissue pressure, renal function, and creatinine phosphokinase (CPK) levels were closely monitored. Fasciotomy was not performed, despite sustained pressure elevations above 50 mm Hg. Neurologic function was not affected. At follow-up examination 1 year later, no limitation of joint motion nor weakness of the quadriceps were observed. Thus in selected young patients in whom an isolated anterior compartment syndrome of the thigh occurs, conservative treatment yielded results superior to fasciotomy.

Adult↗

PubMed2006

Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions.

OBJECTIVE: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. The variety of definitions proposed has led to confusion and difficulty in comparing one study to another. DESIGN: An international consensus group of critical care specialists convened at the second World Congress on Abdominal Compartment Syndrome to standardize definitions for IAH and ACS based upon the current understanding of the pathophysiology surrounding these two syndromes. METHODS: Prior to the conference the authors developed a blueprint for the various definitions, which was further refined both during and after the conference. The present article serves as the final report of the 2004 International ACS Consensus Definitions Conference and is endorsed by the World Society of Abdominal Compartment Syndrome (WSACS). RESULTS: IAH is redefined as an intra-abdominal pressure (IAP) at or above 12 mmHg. ACS is redefined as an IAP above 20 mmHg with evidence of organ dysfunction/failure. ACS is further classified as either primary, secondary, or recurrent based upon the duration and cause of the IAH-induced organ failure. Standards for IAP monitoring are set forth to facilitate accuracy of IAP measurements from patient to patient. CONCLUSIONS: State-of-the-art definitions for IAH and ACS are proposed based upon current medical evidence as well as expert opinion. The WSACS recommends that these definitions be used for future clinical and basic science research. Specific guidelines and recommendations for clinical management of patients with IAH/ACS are published in a separate review.

Abdomen↗

PubMedDate not supplied

Exercise-induced compartment syndrome in the flexor-pronator muscle group. A case report and pressure measurements in volunteers.

Compartment syndrome is caused by an increase in intracompartmental pressure above the capillary level, preventing capillary flow. The acute onset of symptoms occurs after events such as fracture, soft tissue trauma, and revascularization and usually necessitates prompt fasciotomy to avoid loss of function or even necrosis of the enclosed muscle. Compartment syndromes in athletes are of a recurrent nature and are usually referred to as chronic. Nonoperative treatment is often successful. Although compartment syndromes can occur in several anatomic regions, the most commonly seen in athletes involve the leg. Chronic compartment syndromes of the upper extremity are rare, and only a few cases have been reported in the literature. The intracompartmental pressures causing chronic symptoms in these cases ranged between 22 mm Hg at rest and 40 mm Hg after 30 minutes of exercise. Under maximal contraction, a pressure of 58 mm Hg has been recorded. The object of this paper is to report a case of a tennis player where much higher flexor-pronator muscle intracompartmental pressures than those noted above were recorded. We compared the intracompartmental pressure data of this patient with intracompartmental pressures measured in six symptom-free volunteers.

Adult↗

PubMed1975

Compartment syndromes.

A patient is presented who developed the Compartment Syndrome, following blunt trauma to the lower limb. A "fibulectomy-fasciotomy" was performed. This allowed restoration of normal peripheral circulation of the limb but failed to prevent ischaemic necrosis developing in the anterior tibial, peroneal and posterior tibial compartments. Compartment Syndromes in the lower limb are discussed, with a view to their early recognition and management.

Anterior Compartment Syndrome↗

PubMed1995

[Postoperative bilateral compartment syndrome resulting from prolonged urological surgery in lithotomy position. Serum creatine kinase activity (CK) as a warning signal in sedated, artificially respirated patients].

We report two cases of compartment syndrome of the lower leg that occurred in male patients aged 62 and 57 years, respectively, after 10 and 12-h urological surgery in the lithotomy position. During sedation and mechanical ventilation creatine kinase (CK) activity of more than 8,000 U/l was found in both patients. After extubation, clinical symptoms of the compartment syndrome were found. On the 1st day after surgery patient 2 underwent fasciotomy of both lower legs (Fig. 2). No lasting neurologic defects were observed. Patient 1 was treated by fasciotomy on the 4th postoperative day after paresis of the peroneal nerve had developed in the left lower leg. This paresis had shown no tendency to regression when the patient left hospital. On phlebography, both patients showed blockage of the deep lower leg veins up to the knee. DISCUSSION. The compartment syndrome is a rare but serious complication resulting from prolonged surgery in the lithotomy position. Symptoms are neuromuscular lesions of the affected limb. Severe complications of the compartment syndrome are acute renal failure resulting from myoglobin residues in the tubules, electrolyte disturbances, and disorders of acid-base balance. A decrease in perfusion due to the elevated position of the legs, on the one hand, and the impeded venous back-flow due to the positioning on the other are discussed. While positioning the legs, it is important to ensure that the lower legs are lifted only slightly above left atrial level. When rehabdomyolysis occurs, serum CK activity increases. CK values of over 2,000 U/l after surgery may be considered a warning sign in ventilated and sedated patients, in whom early clinical symptoms of the compartment syndrome such as pain and paresthesias cannot be ascertained. Frequent and regular checks of these parameters starting shortly after surgery are recommended. A thorough examination of the lower legs and, if necessary, measurement of the tissue pressure in the compartment should follow. The deep veins of the legs should be checked by phlebography. In cases of verified compartment syndrome, early fasciotomy is the best choice of therapy, because neuromuscular defects are known to be irreversible after 12 to 24 h. Enforced diuresis is recommended in order to avoid renal complications.

Biomarkers↗

PubMed1981

Wick catheter in evaluating and treating compartment syndromes.

We prospectively analyzed 45 patients with suspected compartment syndromes involving 55 extremities to determine the role of the wick catheter in their management. The wick catheter technic allows the continuous monitoring of interstitial pressure and provides an objective assessment of compartment pressure. Indications for catheter use, technics for catheter preparation and insertion, and guidelines for the timing of fasciotomy are presented. Clinical evaluation of every extremity injury must be tempered by suspicion and vigilance to detect compartment syndromes early enough to prevent ischemic contracture. Providing reliable and accurate pressure determinations without significant morbidity, the wick allows continuous monitoring of interstitial compartmental pressure and objective indications for fasciotomy.

Adolescent↗

PubMed1992

Chronic compartment syndrome: diagnosis and management.

Young people active in sports, especially cyclists, runners and soccer players, may develop a chronic compartment syndrome, typically after a few years of athletic involvement. Complaints frequently appear when the intensity or frequency of training is increased. It is remarkable that runners develop mainly an anterior compartment syndrome, whereas soccer players and cyclists suffer mostly from a deep posterior compartment syndrome. The chief complaint is a cramp-like pain and weakness in the lower leg during effort. A compartmental tissue-pressure measurement must be performed to evaluate the severity of the compartment syndrome and to determine which compartments are involved. A clear clinical history and abnormal values of tissue-pressure measurements are indicative for a fascial release of the involved compartments and help assure a satisfactory result after surgery.

Adult↗

PubMed2002

Compartment syndrome in multiple uninjured extremities: a case report.

Compartment syndrome is a common problem in trauma patients. It can occur within any space bound by a dense fascial layer, such as the extremities or abdomen. It exists when increased tissue pressure within the limited anatomic space compromises perfusion. Failure to decompress the compartment leads to a self-perpetuating ischemia-edema process and resultant irreversible tissue damage. In the extremities, it typically arises from a vascular injury in that same extremity. Herein is reported a case of the unexpected development of compartment syndrome in multiple uninjured extremities in a trauma patient with hypotension requiring systemic vasopressors.

Abdominal Injuries↗

PubMed2003

Management strategy for compartment syndrome of the upper extremity arising during anticoagulation or thrombolytic therapy: an increasingly common surgical dilemma.

Compartment syndrome is a documented and potentially lethal complication of thrombolytic therapy. With the increasing use of catheter-directed thrombolytic therapy, a high index of suspicion for the potential occurrence of this surgical emergency must be maintained. Errors of omission in the diagnosis of compartment syndrome, even for a few hours, may lead rapidly to limb loss, renal failure, and possibly death. The authors present a case of compartment syndrome arising in the forearm of a patient being treated with continuous catheter-directed thrombolytic therapy for an occluded arterial bypass graft associated with an ischemic lower extremity. Specific to this presentation is their management of compartment syndrome during thrombolytic therapy as well as previously unreported use of a homograft (cadaveric skin) to control ongoing blood loss from a fasciotomy site in this fully anticoagulated patient. The authors think their management in this case may help to provide direction to others faced with a similar, increasingly common, surgical dilemma.

Aged↗

PubMed2005

Documentation of acute compartment syndrome at an academic health-care center.

BACKGROUND: Documentation of the clinical course of a compartment syndrome is critical to effective treatment; however, such documentation often is found to be inadequate. METHODS: Notes and consent forms for thirty consecutive patients with adequate follow-up who had undergone fasciotomy for the treatment of compartment syndrome were reviewed for legibility, notation of the time and date, and documentation of the presence of core physical examination and history findings, including pain, paresthesias, tenseness, pain on passive stretch, sensory deficit, motor deficit, pulses, compartment pressures, and diastolic blood pressure. RESULTS: Documentation was inadequate for twenty-one patients (70%): the notes and consent forms were not timed or not dated (or both) for nine patients (30%), and the notes were at least partially illegible for sixteen patients (53%). The documentation was incomplete with regard to the presence of paresthesias in eleven patients, pain on passive stretch in ten, sensory deficit in nine, motor deficit in eight, pulses in seven, pain in five, and tenseness in three. The documentation was incomplete with regard to the blood and compartment pressures for sixteen and six patients, respectively. CONCLUSIONS: The documentation of the core history and physical examination findings was inadequate in this series of patients with compartment syndrome. On the basis of the results of this study, and through an organizational systems approach, we have instituted for our residents, nursing staff, and faculty an educational program on the documentation of compartment syndrome in patients who are at risk for this condition.

Academic Medical Centers↗

PubMed2003

Lumbar paraspinal rhabdomyolysis and compartment syndrome after abdominal aortic aneurysm repair.

Lumbar paraspinal compartment syndrome is an extremely uncommon condition that is known to occur after strainful exercise or trauma. We report on the original case of a 55-year-old man in whom lumbar paraspinal rhabdomyolysis and compartment syndrome developed after open abdominal aortic aneurysm repair, documented with technetium Tc(99m) bone scan and computed tomographic imaging, and in whom successful complete recovery was achieved with conservative management. Clinical features, pathophysiology, and diagnostic and therapeutic strategies of this unusual adverse event are discussed.

Aortic Aneurysm, Abdominal↗

PubMed1981

Open tibia fracture with compartment syndrome.

In a series of 104 open tibia fractures, six patients developed compartment syndromes involving all four compartments of the lower leg, four of which developed after initial debridement and reduction. The presence of an open tibia fracture with a displaced, comminuted, fibula fracture should suggest the possibility of a developing compartment syndrome. Clinical symptoms include: increasing muscle pain which can be exaggerated by stretching; loss of sensation; decrease in muscle strength; and palpably swollen compartments. Double fasciotomy incisions may lead to adequate decompression, but result in marked loss of soft tissue support for the fracture. To sustain stability, a single posterolateral incision is recommended for compartmental decompression.

Accidents, Traffic↗

PubMed2003

Acute compartment syndrome of the leg following diagnostic electromyography.

Acute compartment syndrome of the lower extremity is typically associated with some form of trauma, either fracture or blunt injury. Accurate diagnosis and urgent treatment of this condition is required for preservation of the viability of the limb. We report the case of a 73-year-old man who developed an acute compartment syndrome of the leg after diagnostic electromyography. Potential causes and treatment are discussed.

Acute Disease↗

PubMed2002

[Hemilithotomy position for intramedullary nailing of the femur and compartment syndrome of the healthy leg].

The well leg compartment Syndrome following long procedures in the dorsal lithotomy or hemi-lithotomy position is a rare complication. Its diagnosis is usually late and the neurological deficit are often permanent. We report two cases of femoral nailing complicated by Compartment Syndrome of the contralateral leg. We review the published literature on 40 cases which suggests a clear relationship between these positions, the duration of the intervention and the degree of leg elevation. Given the potentially severe sequel, prevention is a must and a high degree of suspicion is the key to an early diagnosis. A modified hemi-lithotomy position is proposed. That avoids extreme elevation of the leg and diminishes the hip and knee flexion required while allowing adequate fluoroscopy.

Adult↗