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1. COMPARTMENT SYNDROME Godwin D Fernandez 95

2. Contents Definition Causes Pathogenesis Complications Diagnosis Treatment

3. Definition

4. What is a compartment? Groupings of muscles, nerves, and blood vessels in your arms and legs Covered by a tough membrane, fascia

5. What is compartment syndrome? Rise of pressure in these compartments  “ A condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space”.

6. Causes

7. Any injury leading to oedema of muscle Contusion Crush Injury

8. Fracture hematoma within compartment High risk fractures Supracondylar humerus fracture Forearm bone fractures Closed tibial fractures Crush injuries to leg and forearm

9. Ischemia to the compartment leading to muscle edema Prolonged pressure on limb Prolonged immobilization Burns

10. Pathogenesis

11. Pathogenesis

12. Pathogenesis Increased pressure in compartment Compromise blood circulation in the compartment Further ischemia of muscle Initiation of vicious cycle End result: Ischemic muscle necrosis and nerve damage

13. Complications

14. Contractures Necrotic muscles heal by fibrosis leading to contractures

15. Nerve damage Motor and sensory loss

16. Gangrene Extreme cases

17. Diagnosis

18. Diagnosis High index of suspicion Excessive pain not relieved with usual doses of analgesics.

19. Diagnosis 3. Stretch test:  Pain on passive stretch. 

20. Diagnosis 4. Compartment pressure  > 40 mm of water

21. Diagnosis 5. Pallor 6. Pulselessness 7. Poikilothermia

22. Diagnosis 8. Paresthesia in the distribution of involved nerves. 9. Muscle weakness/paralysis

23. Treatment

24. Preventive measures On impending compartment syndrome Limb elevation Active finger movements --- prevent serious complications

25. Fasciotomy It is a surgical procedure where the fascia is cut to relieve the tension or pressure in order to treat the resulting loss of circulation to an area of tissue or muscle . Its a limb saving procedure when used to treat acute compartment syndrome.

26. Fasciotomy

27. Fibulectomy The middle third of fibula is excised in order to decompress all compartments of leg

28. Thank you!