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At least 19 recordsLinked to original sources
PubMed1992

Compartment syndrome.

Compartment syndrome results from increased pressure in the closed compartments of the lower or upper extremities. Although it is not a common occurrence, it should be considered a possible complication whenever a patient experiences acute arterial occlusion or revascularization. If left untreated, compartment syndrome can lead to the loss of neuromuscular function, contractures, myoglobinuric renal failure, and amputation. Nurses play an integral role in the detection and treatment of compartment syndrome. Treatment is aimed at minimizing tissue damage and loss of function.

Compartment Syndromes↗
PubMed1992

Bicondylar tibial plateau fracture complicated by compartment syndrome.

Compartment syndrome complicating tibial shaft fractures is a well-documented entity. However, the complication of compartment syndrome after tibial plateau fracture as described in this paper is relatively rare because of dissipation of tissue pressures into the knee-joint compartments. A thorough surgical decompression of all four compartments with continuous postoperative monitoring of compartment pressures was accomplished before the patient's fracture was stabilized. This strategy of delayed reconstruction of the tibial plateau worked well in this patient.

Bone Plates↗
PubMed1991

Acute lower leg compartment syndrome.

Acute compartment syndromes in the lower leg are well recognized following major trauma. However, although rare, they may occur following seemingly minor sporting injury. A case of acute compartment syndrome, following a football game and affecting the peroneal or lateral compartment, is described, in which prompt diagnosis and treatment led to a satisfactory outcome. The diagnosis and surgical management of acute compartment syndromes are discussed. Early recognition and treatment are important in the prevention of long-term disability.

Acute Disease↗
PubMedDate not supplied

Current concepts in pathophysiology and diagnosis of compartment syndromes.

A compartment syndrome is a neurovascular compromise resulting from an increased local tissue pressure. Compartment syndromes can have many etiologies and may arise in any area of the body that has little or no capacity for tissue expansion. The sequelae are severe in the absence of immediate diagnosis and treatment. The diagnosis is usually a clinical one but compartment pressure measurements are often helpful. Many methods of treatment have been investigated, but definitive treatment consists of immediate removal of the constricting force, most often accomplished with surgical fasciotomy.

Compartment Syndromes↗
PubMed2024

Proteomics analysis of deep fascia in acute compartment syndrome.

Acute compartment syndrome (ACS) is a syndrome in which local circulation is affected due to increased pressure within the compartment. We previously found in patients with calf fractures, the pressure of fascial compartment could be sharply reduced upon the appearance of tension blisters. Deep fascia, as the important structure for compartment, might play key role in this process. Therefore, the aim of the present study was to examine the differences in gene profile in deep fascia tissue in fracture patients of the calf with or without tension blisters, and to explore the role of fascia in pressure improvement in ACS. Patients with lower leg fracture were enrolled and divided into control group (CON group, n = 10) without tension blister, and tension blister group (TB group, n = 10). Deep fascia tissues were collected and LC-MS/MS label-free quantitative proteomics were performed. Genes involved in fascia structure and fibroblast function were further validated by Western blot. The differentially expressed proteins were found to be mainly enriched in pathways related to protein synthesis and processing, stress fiber assembly, cell-substrate adhesion, leukocyte mediated cytotoxicity, and cellular response to stress. Compared with the CON group, the expression of Peroxidasin homolog (PXDN), which promotes the function of fibroblasts, and Leukocyte differentiation antigen 74 (CD74), which enhances the proliferation of fibroblasts, were significantly upregulated (p all <0.05), while the expression of Matrix metalloproteinase-9 (MMP9), which is involved in collagen hydrolysis, and Neutrophil elastase (ELANE), which is involved in elastin hydrolysis, were significantly reduced in the TB group (p all <0.05), indicating fascia tissue underwent microenvironment reconstruction during ACS. In summary, the ACS accompanied by blisters is associated with the enhanced function and proliferation of fibroblasts and reduced hydrolysis of collagen and elastin. The adaptive alterations in the stiffness and elasticity of the deep fascia might be crucial for pressure release of ACS.

Humans↗
PubMed1989

Chronic compartment syndrome.

Chronic compartment syndrome typically affects young people who are engaged in endurance sports. The primary clinical feature is a sensation of tightness or aching pain in a defined compartment of the affected limb, starting during activity or hours after activity ceases and lasting for varying lengths of time. The diagnosis is based on the history and on measurement of compartmental pressures. Fasciotomy or partial fasciectomy is the definitive treatment.

Adult↗
PubMedDate not supplied

[The compartment syndrome].

The compartment syndrome is in fact secondary to intracompartmental hypertension which creates ischemia of the muscles, nerves, vessels, and anterior tibial and peroneal arteries in the leg. Described in the 19th century, the clinical picture is better known when progressing either in the acute form or in the chronic form. Diagnosis depends basically on the measurement of intramuscular pressure; treatment, at least initially, apart from subcutaneous aponeurotic decompression, also calls for hyperbaric oxygen therapy. The latter is particularly indicated in those cases bordering on surgical and medical treatment, for preventing deterioration and improving muscular possibilities in the post-surgical period. At the present time, the physiopathology of the condition is still poorly understood. The whiplash syndrome was well described by Martorelli and is due to rupture of the muscular veins of the calf. The clinical picture is often ambiguous and can suggest underlying phlebitis. The triad of symptoms --pain, disability and ecchymosis-- generally enables a diagnosis to be made, with treatment consisting primarily of immobilization. As for Bywaters' syndrome (crush syndrome), it is still very topical. The original description of the clinical picture by Bywaters during the bombardment of London in 1942 has been replaced by the picture resulting from large scale accidents that are part of modern society. The picture is still highly dramatic and if untreated progresses to acute renal insufficiency. Treatment has certainly changed and hyperbaric therapy (administered at two or three atmospheres) is a valid adjuvant to basic treatment and modifies the progress of the phenomenon with entirely satisfactory results.

Compartment Syndromes↗
PubMed1989

The significance of intracompartmental pressures in the diagnosis of chronic exertional compartment syndrome.

Chronic exertional compartment syndrome is one cause of pain in the lower extremity, a common disability in athletes. The significance of intracompartmental pressures in the diagnosis of chronic exertional compartment syndrome is somewhat controversial. The goal of this study was to review the compartment pressure tests in a group of patients that underwent fasciotomy for refractory exertional compartment syndrome and to compare these pressures with an asymptomatic control group. The results are presented and compared with those of previous studies.

Adolescent↗
PubMed1991

[Compartment syndrome. Principles of therapy].

Compartment syndrome can be classed as imminent, with moderate disturbances of muscular perfusion, no neurological symptoms and increasing tissue pressure, and manifest, with compromised circulation and loss of tissue function in the space and pathologic tissue pressure. When compartment syndrome is suspected, the most important immediate measure is wide splitting of any constricting dressings that have been applied. For decompression, the only adequate therapy, in imminent compartment syndrome, subcutaneous fasciotomy is required. The skin incision can be closed. Manifest compartment syndrome necessitates therapeutic fasciotomy, which means long incisions of skin and fascia, splitting of retinacula, excision of necrotic tissues, evacuation of hematoma and, if possible, rigid fixation of fractures. Skin closure is not permitted because of postoperative swelling, which can produce a rebound compartment syndrome. After 4-8 days edema decreases and the wound is closed by delayed sutures or a mesh graft. In the same session a second look operation for re-debridement of the tissues is done. Special problems arise in complex lesions of the foot, because of the thin layer of soft tissue coverage and the diminished blood supply to the bones of the foot. In the foot, decompression requires not only that the compartments of the short pedal muscles be opened, but also that the skin be adequately released.

Arm↗
PubMed1990

[Pressure conditions in adjoining spaces in a provoked compartment syndrome].

A compartment-syndrome can't be provoked experimentally in the upper arm sphere. The pressure does not change in adjoining spheres. In the tibial-anterior-loge enormous pressure values are reached by the extension of volume but adjoining and subcutaneous spheres are hardly influenced.

Anterior Compartment Syndrome↗
PubMed1991

[Functional rehabilitation of the upper extremity after compartment syndrome].

In established compartment syndrome discrimination between the different forms of flexion contracture, i.e., manifest Volkmann's contracture and intrinsic contracture is necessary. A combination of both is also possible. Classification is essential for determination of whether reconstruction is indicated and what procedure should be selected. Shortening osteotomies of the ulna and radius are now of historical interest only, as is carpalectomy. Lengthening of the flexor tendons is indicated only in mild and localized limited contracture of only some of the long fingers, but there is a danger of possible further adhesions limiting the range of motion. Thus, cases of stage I and II according to Tsuge with persisting partial flexor motor function are treated mainly by muscle sliding operation (Scaglietti) combined with microsurgery for internal neurolysis of the median and ulnar nerves. The latter is anteriorly transposed. In cases of solitary intrinsic contracture we prefer the Littler release procedure. The most useful repair in advanced compartment syndrome, however, consists in free microsurgical tissue transfer. The non-contractile, degenerated scarred flexor muscle remnants are excised and substituted orthotopic by transfer of free, neurovascular muscle, with salvage of flexor motor function in the forearm.

Arm Injuries↗
PubMed1990

Streptococcal toxic shocklike syndrome leading to bilateral lower extremity compartment syndrome and renal failure. Report of a case.

Compartment syndrome is considered a true emergency in orthopedic practice. To reduce morbidity and mortality from this condition, prompt diagnosis and appropriate treatment are absolutely essential. An unusual bilateral lower extremity compartment syndrome leading to renal failure and crush syndrome occurred in a 13-year-old girl with Streptococcal toxic shocklike syndrome. This situation seems not to have been previously reported. Early diagnosis and expeditious treatment produced minimal sequelae of the condition.

Acute Kidney Injury↗
PubMed1990

Compartment syndromes of the lower limb.

Compartment syndromes of the lower limb occur as an over-use type injury in athletes resulting in a chronic compartment syndrome. Alternatively they may occur as a result of trauma to the limb in the form of soft tissue injury or a closed fracture resulting in an acute compartment syndrome. Chronic compartment syndromes present as pain in the lower legs during exercise and are relieved after a variable period of rest. Diagnosis is aided by intracompartmental pressure monitoring during exercise and if symptoms have persisted for longer than 6 months treatment is by means of a subcutaneous fasciotomy. Acute compartment syndromes are relatively rare and often difficult to diagnose. If unrecognized they may lead to significant limb morbidity in the form of paraesthesia and muscle weakness. Diagnosis once again may be aided by intracompartmental pressure monitoring. Once the diagnosis has been made urgent surgical decompression in the form of an open fasciotomy is mandatory.

Acute Disease↗
PubMed1992

Neonatal compartment syndrome.

Two cases of forearm compartment syndrome in neonates are presented. The compartment syndrome may be initiated before actual delivery and may appear in an advanced stage. In both children good clinical results were achieved when standard guidelines for managing compartment syndrome and established Volkmann's contracture were applied. Although uncommon, compartment syndrome should be considered in the differential diagnosis of the neonate who is unable to move an extremity.

Compartment Syndromes↗
PubMed1989

MAST-associated compartment syndrome (MACS): a review.

Compartment syndromes occur following lower extremity injuries and have been associated with the use of pneumatic or "medical" antishock trousers (MAST). Review of 12 previously reported cases and 15 new cases suggests that lower extremity trauma and systemic hypotension are cofactors responsible for the development of compartment syndrome but MAST use also contributes to the process by prolonging muscle ischemia. Complications of lower limb compartment hypertension may be averted by early recognition and fasciotomy. Associated amputations and mortality are directly related to the severity of injury, or indirectly to delay in diagnosis and treatment of the compartment syndrome and its complications.

Abdominal Injuries↗
PubMed1990

Treatment of compartment syndrome in children.

A compartment syndrome is a symptom complex caused by elevated tissue pressure in a closed osseofascial compartment of a limb. Left unrecognized, it results in permanent damage to muscle and nerve in that compartment. The diagnosis of a compartment syndrome is contingent on the recognition of pain out of proportion with the injury as the most important early symptom. The pain is increased with passive stretching of the muscles in the involved compartment or on palpation of the involved muscles. Once the diagnosis is suspected, prompt treatment by appropriate fasciotomy should result in maintenance of normal limb function.

Adolescent↗
PubMed1990

Compartment syndromes in athletes.

Compartment syndromes occur frequently in the leg in association with athletics, but may occur in the forearm and many other muscular compartments as well. Similar inciting events may result in either acute or chronic forms with vastly different clinical presentations. With an understanding of the anatomy and pathophysiology, and the ability to directly measure compartment pressures, an accurate diagnosis can be readily made. Acute forms require immediate fascial release to minimize muscle and nerve injury. Surgical treatment of the chronic form is highly successful and usually allows an early return to athletics.

Athletic Injuries↗