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Results for “Compartment Syndromes”

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At least 487 records · Page 27Linked to original sources

PubMed1991

Compartment syndrome after low-velocity gunshot wounds to the forearm.

Between 1980 and 1988, 127 patients with 131 low-velocity gunshot wounds to the forearm were treated. In 71 extremities there was no bony injury; 60 extremities sustained fractures. The diagnosis of a compartment syndrome was based on tissue pressure measurements and/or clinical examination. A univariate analysis followed by a multivariate stepwise logistic regression was used to evaluate potential risk factors including fracture location, displacement, comminution, and the quantity of radiographically determined metallic foreign bodies in the wound. A compartment syndrome was diagnosed in 13 of the extremities (10%). Fracture location was the only significant risk factor for the development of a compartment syndrome. Low-velocity gunshot injuries to the forearm are at definite risk for the occurrence of a compartment syndrome. A high index of suspicion is necessary to prevent untoward sequelae. Patients with this injury, especially those with a proximal one-third fracture who constitute an extremely high-risk group, should be monitored closely.

Adolescent↗

PubMed1991

Acute compartment syndrome. Effect of dermotomy on fascial decompression in the leg.

Prompt surgical decompression is the only means of preventing the late sequelae of ischaemic contracture in post-traumatic compartment syndromes. However, controversy exists regarding the length of dermotomy required for adequate decompression in the lower extremity. This study investigated the skin envelope as a potential contributing factor. Wide fascial releases were performed through limited 8 cm incisions in eight cases of post-traumatic lower extremity compartment syndrome. In nine of 29 compartments the pressure remained greater than 30 mmHg. Lengthening the skin incisions to an average of 16 cm decreased intracompartmental pressures significantly. This study documents the skin envelope as a contributing factor in acute compartment syndromes of the leg. The use of generous skin incisions is supported and the need for intra-operative compartment pressure measurements in the treatment of this condition is emphasised.

Acute Disease↗

PubMedDate not supplied

Lower extremity compartment syndrome in infants associated with child abuse: a report of two cases.

Compartment syndrome associated with child abuse is unreported in the literature. We describe two cases secondary to lower extremity fractures resulting from child abuse. The diagnosis and management of compartment syndrome are reviewed. Orthopaedic surgeons involved in the care of pediatric patients must be aware of this potentially devastating complication, and must be prepared for timely management.

Child Abuse↗

PubMed2004

Exercise induced compartment syndrome in a professional footballer.

Recurrent pain in the lower leg caused by exercise is a common problem in athletes. The main causes are exercise induced compartment syndrome, periostitis of the tibia, stress fracture, venous diseases, obliterative arterial diseases, and shin splints. Exercise induced compartment syndrome is the least common. A recurrent tightening or tense sensation and aching in anatomically defined compartments is pathognomonic. The symptoms are caused by abnormally high pressure in compartments of the leg during and after exercise. In this report, a case of exercise induced compartment syndrome in a professional footballer is described.

Adult↗

PubMed2000

A review of chronic exertional compartment syndrome in the lower leg.

Chronic exertional compartment syndrome (CECS) in the lower leg has been described as early as 1956. This review describes the five relevant anatomical compartments and the important clinical features on presentation used in diagnosis. Compartment pressure testing using various types of catheter is useful as a confirmatory investigation. Although the pathophysiology of this condition is poorly understood, current hypotheses are discussed. Surgical treatment is usually definitive and techniques for decompression of the five compartments are presented with comparison to available conservative treatments.

Anterior Compartment Syndrome↗

PubMed2001

Compartment syndrome associated with the Lloyd Davies position. Three case reports and review of the literature.

The Lloyd Davies position was developed to facilitate access to the pelvis for gynaecological, urological and colorectal procedures. Previous case reports have demonstrated that prolonged adoption (> 4 h) of this position has been associated with the development of bilateral compartment syndrome of the calves. All three patients reported here suffered severe bilateral calf pain despite the use of thoracic epidurals. All three cases required three-compartment fasciotomies and, 6 months after surgery, were all still severely disabled as a consequence of the compartment syndrome. These case reports stress the dangers of use of the Lloyd Davies position for prolonged procedures and demonstrate that some patients are at risk after relatively short periods (< 3 h). Previous case reports and clinical studies have focused on the effect of limb elevation in stirrups on the arterial pressure in the lower limb. We review the pathophysiology of compartment syndrome and consider factors other than a decrease in arterial pressure that may predispose to compartment syndrome during adoption of the Lloyd Davies position.

Compartment Syndromes↗

PubMed1991

[Diagnosis of compartment syndrome].

Clinical diagnosis remains the most important factor in the diagnosis of compartment syndrome. Parameters such as swelling, pain result from passive stretching, sensory disturbances, motor weakness and pulse rate should be carefully analysed and recorded using a checklist. As a compartment syndrome can already occur after 2 h but often not until 6 days later, monitoring at short intervals is necessary during this time period. If the clinical diagnosis is not clear-cut and the possibilities of differential diagnosis have been exhausted, or if there is doubt concerning the extent of the increase in pressure, pressure should be measured to help establish the diagnosis.

Compartment Syndromes↗

PubMed2005

One-portal endoscopically assisted fasciotomy for exertional compartment syndrome.

A newly described method of single-incision endoscopically assisted fasciotomy for chronic exertional compartment syndrome is outlined. The procedure affords a small 2- to 3-cm incision with visualization of the anterior compartment fascia, lateral compartment fascia, superficial peroneal nerve, perforating vessels, and underlying muscle. The single-portal endoscopically assisted fasciotomy for chronic exertional compartment syndrome in the anterior and lateral compartments of the lower leg is a safe and reliable technique with excellent outcomes and patient satisfaction. Moreover, this technique affords the patient an expeditious recovery because of the small incision and decreased soft tissue trauma throughout the lower leg.

Arthroscopy↗

PubMed2005

Forearm compartment syndrome following intravenous thrombolytic therapy for acute ischemic stroke.

INTRODUCTION: Minor and major bleeding complications have occurred following thrombolysis in acute ischemic stroke. However, compartment syndrome has not been reported among these incidences. METHODS AND RESULTS: This article presents a case of a forearm compartment syndrome in a patient with stroke who had fallen at the time of the infarction and was treated with tissue plasminogen activator. We wish to forewarn clinicians who may encounter similar cases. CONCLUSION: Patients suffering from stroke who fall are at risk of developing a compartment syndrome; the early diagnosis is often difficult, the sequelae can be devastating, and wrestling with the benefits and risks of reversing the coagulopathy in the acute phase of a cerebral infarction is a challenge.

Accidental Falls↗

PubMed1992

Compartment syndrome of the scapula. Definition on clinical, neurophysiological and magnetic resonance data.

Compartment syndromes of the scapula and pelvic girdle have received scant attention in the literature. In 1938, Comolli first described a clinical sign which he considered specific to fracture of the scapula. We report data on two patients, one presenting with prolonged pressure on the posterior surface of the scapula and the other with symptoms associated with scapular fracture. In one of these patients we were able to measure pressures around the scapula, perform neurophysiological assessment of nerve function and produce magnetic resonance images of the area. In the other case, surgical exploration revealed an established ischaemic contracture of the infraspinatus muscle within its compartment. These findings suggest that the muscles around the scapula are vulnerable to the development of compartment syndrome.

Action Potentials↗

PubMed1993

Acute compartment syndrome: an unusual presentation of gemfibrozil induced myositis.

OBJECTIVE: To present a case of gemfibrozil-induced myositis which precipitated an acute compartment syndrome. CLINICAL FEATURES: A 49-year-old woman with chronic renal failure was given gemfibrozil for hyperlipidaemia. She developed myositis in the sixth week of therapy. Her symptoms initially persisted despite withdrawal of gemfibrozil and she developed an acute compartment syndrome. INTERVENTION AND OUTCOME: Emergency fasciotomy was performed. She gradually improved and complete recovery occurred eight weeks after cessation of gemfibrozil therapy. CONCLUSION: Gemfibrozil may induce a local myositis which, in our patient, precipitated an acute compartment syndrome. One should be alert to symptoms of possible drug-induced myositis in patients receiving gemfibrozil. Extreme caution should be exercised in its use in patients with impaired renal function.

Acute Disease↗

PubMed2005

Compartment syndrome: time from diagnosis to fasciotomy.

A definitive safe time to fasciotomy for compartment syndrome has not been established. Therefore, the records of 28 patients who had a fasciotomy for compartment syndrome at two trauma centers (18 level I, 10 level II) were reviewed to determine time from diagnosis to fasciotomy and clinical outcome. Average times at the two trauma centers (level I: 160 minutes, range, 50-315 minutes; level II: 105 minutes, range, 51-185 minutes) were significantly different. Ten patients (5 level I, 5 level II) with an average time from diagnosis to fasciotomy of 122 minutes (range, 70-185 minutes) sustained residual deficits. There was no correlation between time from diagnosis to fasciotomy and residual deficits. A time from diagnosis to fasciotomy as short as 70 minutes was associated with residual deficit, but a time as long as 315 minutes (patient with deficits) was associated with no functional deficits.

Adult↗

PubMed2004

Minimally invasive subcutaneous fasciotomy for chronic exertional compartment syndrome of the lower extremity.

Chronic exertional compartment syndrome of the lower extremity can be debilitating in the active population. Open fasciotomy typically provides a cure or significant improvement in up to 90% of patients, provided that the compartments are adequately released. Cosmetic deformity from the surgery may be a major concern, especially in the young female athlete. A technique for minimally invasive subcutaneous fasciotomy is described that allows adequate compartment release and a favorable cosmetic result.

Chronic Disease↗

PubMed1993

Compartment syndromes of the foot after calcaneal fractures.

Approximately 10% of calcaneal fractures develop compartment syndromes of the foot, and of these, one half develop clawing of the lesser toes and other foot deformities, including stiffness and neurovascular dysfunction. Tense swelling and severe pain are the hallmarks of an impending compartment syndrome. The diagnosis is confirmed by multistick invasive catheterization, particularly of the calcaneal compartment in the hindfoot. Immediate fasciotomy is recommended to prevent the development of ischemic contracture. It is recommended that open reduction and internal fixation of a calcaneal fracture is performed on a delayed basis, after the fasciotomy wounds are closed.

Calcaneus↗

PubMedDate not supplied

Compartment syndrome of the arm: a complication of noninvasive blood pressure monitoring during thrombolytic therapy for myocardial infarction.

We report a rare case of tricep compartment syndrome caused by a hematoma which resulted from noninvasive blood pressure monitoring (NIBPM) during thrombolytic therapy. Clinicians administering thrombolytic agents should be aware of the risk of bleeding and compartment syndrome at the site of NIBPM. Appropriate preventative measures should be instituted when using automated pneumatic cuffs. An understanding of the pathophysiology and clinical presentation of an arm compartment syndrome will allow for prompt diagnosis and surgical treatment.

Aged↗

PubMed1986

Compartment syndrome and intraaortic balloon.

Intraaortic balloon (IAB) is a well accepted and useful therapeutic option; the complications reported with it's use are varied. We have observed 4 patients over a period of 6 years, who developed swollen tender calves and loss of sensation and/or function, yet who retained a warm limb with palpable peripheral pulses during or immediately after IAB pumping. At fasciotomy, they had bulging ischemic muscles. We hypothesize that this is compartment syndrome following temporary or partial ischemia due to balloon placement. We have prospectively studied 13 patients by measuring the pressure in the anterior compartment of the lower limb using the slit catheter technique. In 11 of these patients with no evidence of complications, pressure measurements remained below 7 mmHg. In one patient showing signs consistent with compartment syndrome, pressures up to 35 mmHg were recorded and at fasciotomy, the diagnosis was confirmed. A second patient with signs suggestive of compartment syndrome, had pressures below 15 mmHg. This patient was treated conservatively with resolution of the condition. Compartment syndrome after IAB placement has only been rarely described. We believe this is due to inadequate diagnosis and that slit catheter pressure measurements are a valuable tool in its management. We encountered no complications associated with the technique.

Aged↗

PubMed2004

Intra-abdominal hypertension and the abdominal compartment syndrome.

The pressure within the abdominal cavity is normally little more than atmospheric pressure. However, even small increases in intra-abdominal pressure can have adverse effects on renal function, cardiac output, hepatic blood flow, respiratory mechanics, splanchnic perfusion and intracranial pressure. Although intra-abdominal pressure can be measured directly, this is invasive and bedside measurement of intra-abdominal pressure is usually achieved via the urinary bladder. This cheap, easy approach has been shown to produce results that correlate closely with directly measured abdominal pressures. Significant increases in intra-abdominal pressure are seen in a wide variety of conditions commonly encountered in the intensive care unit, such as ruptured aortic aneurysm, abdominal trauma and acute pancreatitis. Abdominal compartment syndrome describes the combination of increased intra-abdominal pressure and end-organ dysfunction. This syndrome has a high mortality, most deaths resulting from sepsis and multi-organ failure. Detection of abdominal compartment syndrome requires close surveillance of intra-abdominal pressure in patients thought to be at risk of developing intra-abdominal hypertension. The only available treatment for established abdominal compartment syndrome is decompressive laparotomy. Prevention of abdominal compartment syndrome after laparotomy by adoption of an open abdomen approach may be preferable in the patient at significant risk of developing intra-abdominal hypertension, but this has not been demonstrated in any large trials. Most surgeons prefer to adopt a 'wait and see' policy, only intervening when clinical deterioration is associated with a significant increase in intra-abdominal pressure.

Abdomen↗

PubMedDate not supplied

Congenital muscular torticollis: sequela of intrauterine or perinatal compartment syndrome.

The etiology of congenital muscular torticollis remains a mystery despite intensive investigation. Magnetic resonance imaging (MRI) scans of 10 infants with this condition showed signals in the sternocleidomastoid muscle similar to those observed in the forearm and leg after compartment syndrome. Cadaver dissections and injection studies defined the sternocleidomastoid muscle compartment. Injection studies and pressure measurements performed at the time of bipolar release in three patients with congenital muscular torticollis confirmed the existence of this compartment in vivo. Clinical review of 48 children with congenital muscular torticollis showed a relation between birth position and the side affected by the contracture. Because of the association of congenital muscular torticollis with other intrauterine positioning disorders, we postulate that head positioning in utero can selectively injure the sternocleidomastoid muscle, leading to development of a compartment syndrome. Congenital muscular torticollis may represent the sequela of an intrauterine or perinatal compartment syndrome.

Child, Preschool↗