[Compartment syndrome].
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Anterior Compartment Syndrome↗
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Acute compartment syndrome of the lower extremity secondary to noncontact injury.
We retrospectively reviewed the cases of three patients with injuries similar to the mechanism of an ankle sprain which resulted in compartment syndrome of the lower extremity. All three patients presented with sharp, proximal, anterolateral pain in the leg after an indirect, twisting injury. None of the injuries involved direct contact. Two of the three athletes initially presented to local hospitals, where the injury was misdiagnosed as an ankle sprain. The mechanism appears to be a muscle strain or tear with resultant hemorrhage in the compartment. All three patients returned to high-level athletics after prolonged recovery periods.
Adolescent↗
Exercise-induced compartment syndrome: case report.
Exercise-induced rhabdomyolysis is a frequent event occurring after severe forms of exercise. This is usually a short-lived, uncomplicated phenomenon that is seldom of any clinical significance. The rare progression of this muscle injury to compartment syndrome is, however, a limb- and life-threatening condition that typically presents in the anterior compartment of the lower leg. A case is reported of a young man who participated in physical activity well beyond his normal level of exertion and subsequently developed bilateral lower extremity compartment syndrome requiring surgical decompression. To our knowledge, this is the only description of this complication occurring in a multicompartment, bilateral distribution. The combination of the rarity and morbidity of this condition, as well as the multitude of very common benign injuries that present in the same manner as the problem discussed, make this insult especially dangerous.
Adult↗
The surgical treatment of exertional compartment syndrome in athletes.
We studied the cases of twelve patients who had bilateral exertional compartment syndrome involving one or all of the compartments of the lower extremities. The patients were divided into three groups based on the clinical findings. Group I consisted of seven patients with symptoms involving the anterior or lateral compartments only; Group II, of three patients with involvement of the deep posterior compartments alone; and Group III, of two patients with involvement of both the anterior and deep posterior compartments. On the basis of their clinical signs and symptoms each patient underwent dynamic tissue-pressure measurements using a slit catheter before, during, and for as long as thirty minutes after exercise. All patients had elevated resting and peak-to-peak dynamic pressure measurements. Treatment consisted of bilateral compartmental fasciotomy, as indicated. All of the patients in Group I had complete relief of symptoms; however, one patient in Group II and one in Group III had a recurrence of symptoms in the deep posterior compartment.
Adolescent↗
Cystic degeneration and calcification of muscle: late sequelae of compartment syndrome.
Cystic degeneration and calcification of the leg are uncommon late sequelae of compartment syndrome. Previously reported cases have all involved the anterior compartment of the leg. We present a 68-year-old man with a mass in the superficial posterior compartment of the leg who presented 37 years after the initial trauma and ischemic myonecrosis. MRI was useful in establishing the diagnosis and early surgical intervention. The mass was excised and closed primarily over a drain. Patient was followed up for 29 months, and there were no secondary infections, chronic sinus formation, or recurrences. Based on our experience and the available literature review, we recommend considering either excision and primary closure, or repeated needle aspiration of the mass. Packing the wound and delayed closure may lead to secondary infection, chronic sinus formation, and lower limb amputation as potential complications.
Aged↗
[Experimental studies on a compartment syndrome caused by a tourniquet].
The muscle proteins of rabbits with the compartment syndrome caused by tourniquet were studied by SDS-polyacrylamide gel electrophoresis and the compartment pressure post-ischemia was measured. The post-ischemic pressure in the anterior compartment increased more than that in the deep-posterior compartment. The phoretic patterns of structural and soluble proteins changed after ischemia, and their degeneration appeared to depend on the degree of pressure increase. In ischemic contracture, the patterns of myosin light chains of type 1 fibers changed to those of type 2 fibers. This indicated the possibility of fiber type transformation from type 1 to type 2 in ischemic contracture.
Animals↗
Anterior compartment syndrome after revision hip arthroplasty.
We report a case of anterior compartment syndrome in the ipsilateral leg after a revision total hip arthroplasty. Possible causes include post-ischaemic swelling after occlusion of the vessels during prolonged surgery and vigorous repetitive stretching of the muscles of the anterior compartment from the intraoperative use of electrical calf stimulators. Epidural infusions for postoperative analgesia may mask symptoms, but when there is clinical suspicion, we recommend measurement of the compartment pressures and early fasciotomy.
Acute Disease↗
[Compartment syndrome after impact trauma from a car bumper].
A 67-year-old woman, having been hit in the lower leg by a car bumper in a road accident, developed a compartment syndrome in the lower leg without any bone injury. In the following weeks typical contractures of the affected muscles occurred with talipes equinus and clawfoot deformities. In addition there developed insertion tendinitis of the affected muscle groups of the anterior tibia. A year later magnetic resonance imaging (with normal radiological findings) revealed fatty degeneration and muscle fibrosis. The patient complained of pain at rest and on movement in the proximal tibia, and there was definite pain on pressure over the proximal end of the tibia. Conservative treatment having failed, the Achilles tendon and the long flexor muscle of the toes were lengthened by operation. Both signs and symptoms then improved. A compartment syndrome may develop after blunt trauma even in the absence of bony injury. If there are the appropriate clinical signs, intracompartmental pressure measurement is the procedure of choice to confirm the diagnosis quickly and thus avoid sequelae.
Accidents, Traffic↗
Calcaneal fracture with compartment syndrome of the foot.
We report the unusual case of a compartment syndrome of the foot that developed after a calcaneal fracture in a 68-year-old man. The diagnosis was suspected clinically because of pain in excess of his injury and was confirmed with direct tissue pressure measurements. Surgical decompression of all the compartments was required with evacuation of a plantar hematoma.
Aged↗
Acute anterior forearm compartment syndrome following wrist arthrodesis.
The authors report a case of anterior compartment syndrome in the forearm following total wrist arthrodesis via a dorsal approach. As far as they know this is the second case reported.
Acute Disease↗
[Diagnosis and treatment of the foot compartment syndrome].
The results of treatment of the patients with the foot compartment syndrome were analysed for the first time in the native literature. Etiology, anatomy of the foot fascial sheath, the subfascial pressure estimation method and the methods of the fasciotomy performance are adduced.
Adolescent↗
Hemophilia presenting as compartment syndrome in the arm following venipuncture. A case report and review of the literature.
A three-month-old male infant with undiagnosed hemophilia presented with fever and irritability. During the diagnostic evaluation a venipuncture in the right antecubital fossa led to hemorrhage and a compartment syndrome in the brachium. Differential diagnosis included osteomyelitis and septic arthritis but a 99technetium bone scan revealed only delayed washout of radioactive material from the right brachium without increased uptake. Despite elevated pressures in the muscle compartments of the right arm, surgical decompression was delayed until a complete blood coagulation profile was obtained. After replacement of deficient blood products, the compartment syndrome resolved without surgical decompression. Defective coagulation leading to hemorrhage into the muscle compartments of the arm resulted in a significant elevation of compartmental pressure. The unusual clinical presentation of the patient, as well as a lack of a positive family history, delayed the diagnosis of hemophilia and the subsequent replacement therapy.
Arm↗
Traumatic popliteal artery thrombosis and compartment syndrome of the leg following blunt trauma to the knee: a discussion of treatment and complications.
Blunt trauma to the knee has been associated with both musculoskeletal and neurovascular injury to the leg. Popliteal artery thromboses secondary to such trauma can be complicated by a compartment syndrome. The loss of distal pulses in the leg following blunt knee trauma should always be attributed to a suspected vascular lesion and not to the presence of the compartment hypertension. We present a case in which the diagnosis of a popliteal artery thrombosis was delayed because the loss of distal pulses was initially attributed to the compartment syndrome.
Aged↗
Postoperative compartment syndrome and the lithotomy position: a report of three cases and analysis of potential risk factors.
There exists a definite association between the placement of patients in the modified lithotomy position and the development of postoperative compartment syndrome. It must be appreciated that this syndrome is potentially life-threatening and frequently results in long-term sequelae. We report three cases which illustrate the problem and analyze the multifactorial etiology of this condition and propose a strategy for its prophylaxis. The combination of direct pressure on the posterior compartment of the calf, elevation of the legs above heart level, a number of intraoperative variables, the preexistence of any lower limb arterial insufficiency, and in some cases, the use of intraoperative compression boots, may lead to a state of hypoperfusion in the anterior and posterior compartment musculature. Upon completion of the operation, removal from the lithotomy position, and correction of the etiological factors, a reperfusion occurs with the development of a capillary leak with subsequent tissue edema causing an increase in compartmental pressure which may result in neurovascular compromise. This is the compartment syndrome. Emphasis must be placed on the identification of high-risk patients, the prevention or rapid correction of any etiological factors, the early diagnosis of the problem, and an aggressive approach to its treatment.
Adult↗
[Bilateral anterior tibial compartment syndrome following burn of lower extremities (author's transl)].
Authors report on a case of anterior tibial compartment syndrome following burn of lower extremities. They emphasise the difficulties in discovering the syndrome after burns. In cases of thermal injuries to lower extremities the possibility of the syndrome should be born in mind, and the necessary clinical investigations should be repeatedly performed. In case of positive diagnosis the only efficacious intervention for avoiding muscle necrosis, a wide fasciotomy of the crural fascia should be carried out.
Accidents, Occupational↗
[Intra-abdominal compartment syndrome as a rare complication after aortic reconstruction].
An intraabdominal compartment-syndrome developed due to ischemia and hemorrhage through a suture subsequent to partial reconstruction of the abdominal aorta, aorto-mesenterical and bilateral aorto-renal T-bypass. In order to decrease the elevated intraabdominal pressure, a decompression with secondary wound closure by an artificial net is the therapy of choice. The arising problems which determined the fatal outcome of this case are discussed.
Aged↗
[Compartment syndrome after femoral contusion. Case report and review of the literature].
Compartment syndromes of the lower arm and lower leg are quite well known by now and have been often described in the literature. Those of the upper arm and thigh are rarer and those after pure closed lesion of the soft parts of the thigh are the subject of only sporadic reports in the literature. A recently observed case of this kind prompted the present case report and review of the literature.
Adult↗
Compartment syndrome of the forearm and hand: a case report.
A severe compartment syndrome, involving all muscles of the forearm and hand, developed in a 25-year-old man following an erroneous injection of hypertonic saline for intravenous regional anesthesia. The treatment was complete fasciotomy of the forearm and hand musculature. The release of the hand musculature consisted of a longitudinal incision over the thenar and hypothenar muscles and a wide incision to expose the dorsal interossei. Release of the volar intrinsics included palmar fasciectomy. In this case, there was a marked toxic response to the injury in the form of disorientation, fever, leucocytosis, and urinary elevation of muscle degradation products.
Adult↗