Download PDF
CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2017; 07(02): 042-049
DOI: 10.1055/s-0040-1708709
Review Article

Compartment Syndrome- Controversies and where are we Today

M. Shantharam Shetty
1   Pro Chancellor, Nitte University & Professor, Dept. of Orthopedics, Tejasvini Hospital
,
Ajith Kumar
2   Senior Consultant, Dept. of Orthopedics, Tejasvini Hospital
,
Lathika Shetty
3   Professor, Dept. of Radio diagnosis, K.S. Hegde Medical Academy
,
Anbuchezhian Palanivel
4   Senior Resident, Dept. of Orthopedics, Tejasvini Hospital
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Compartment Syndrome in Orthopedic practice is a night mare and has to be diagnosed and treated as an emergency to save the function of the limb. Importance of different criteria of early diagnosis, compartment pressure measurement and immediate fasciotomy are the controversies even today. The review emphasizes the importance of these concerns.

Definition

Compartment syndrome occurs due to an increased interstitial tissue pressure inside a closed 1 space especially in an osseo-fascial compartment , should be treated as an acute emergency.



Publication History

Received: 15 May 2017

Accepted: 07 June 2017

Article published online:
22 April 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 RorabeckCH, Clarke KM., “The pathophysiology of the anterior tibial compartment syndrome: an experimental investigation,” J Trauma.1978;18(5):299-304.
  • 2 R. Volkmann, “The ischemic muscular paralysis and trauma, "Zentralblatt fur Chirurgie” , vol. 8, pp. 801–803, 1881.
  • 3 McQueen MM,GasonP,Court-Brown CM., “Acute compartment syndrome. Who is at risk?,”JBJS(Br).2000;82B:200
  • 4 Elliot KG,Johnstone AJ., “Diagnosing acute compartment syndrome,”JBJS(Br).2003;85:625.
  • 5 F. A. Matsen III, R. A. Winquist, and R. B. Krugmire Jr., “Diagnosis and management of compartmental syndromes,” Journal of Bone and Joint Surgery—Series A, vol. 62, no. 2, pp. 286–291, 1980.
  • 6 Hammerberg EM,Whtesdes TE Jr,Seiler JG, “The reliability of measurement of tissue pressure in compartment syndrome,”JOrthop Trauma.2012;26:24.
  • 7 Reneman RS,Slaaf DW,Lindbom L, “Muscle blood flow disturbances produced by simultaneously elevated venous and total muscle tissue pressure,”Microvasc Res. 1980;20:307.
  • 8 McQueen MM,Court-Brown CM., “Compartment monitoring in tibialfractures,”JBJS (Br).1996;78:99.
  • 9 McQueen MM, Gaston P, Court-Brown CM: Acute compartment syndrome: who is at risk? J Bone Joint Surg Br. 2000; 82:200-3.
  • 10 Uliasz, A., Ishida, J.T., Fleming, J.K. et al, Comparing the methods of measuring compartment pressures in acute compartment syndrome. Am J Emerg Med. 2003;21:143.
  • 11 Gelberman R. H., Garfin S. R., Hergenroeder P. T., Mubarak S. J., Menon J. Compartment syndromes of the forearm: diagnosis and treatment. Clinical Orthopaedics and Related Research. 1981;161:252–261.
  • 12 G. J. Mar, M. J. Barrington and B. R. McGuirk, “Acute Compartment Syndrome of the Lower Limb and the Effect of Postoperative Analgesia on Diagnosis,” British Journal of Anaesthesia, Vol. 102, No. 1, 2009, pp. 3-11.
  • 13 Rorabeck CH, “The treatment of compartment syndromes of the leg,”JBJS (Br).1984;66:93-97.
  • 14 Mubarak SJ,Owen CA, “Double incision fasciotomy of the leg for decompression in compartment syndrome,”JBJS(Am).1977;59:184- 187.
  • 15 Kanlic EM,Pinski SE, Verwiebe EG, Saller J, Smith WR, “Acute morbidity and complications of thigh compartment syndrome”:a report of 26 cases, ”Patient Safety in Surgery.2010;4:13.
  • 16 Egol KA, Ong CC, walsh IM et al. Early complications in proximal humerus fractures (OTA type II) treated with locked plates. J.Orthop. Trauma 2008-22(3) 159-164.
  • 17 Jin Young GO, Yu-Sun Min, Tae-Du Jung. Delayed onset of Acute Limb Compartment Syndrome with Neuropathy after Venoarterial extracorporeal membrane oxygenation therapy. Ann Rehabil Med. 2014 Aug; 38(4): 575–580.
  • 18 John A. McLaughlin, Melyssa M. Paulson, Ronald E. Rosenthal. Delayed onset of anterior tibial compartment syndrome in a patient receiving low-molecular-weight Heparin. As case Report. J. Bone Joint Surg. Am, 1998 Dec; 80(12):1789-90.
  • 19 Robert J. Gaines, Craif J, Randall, Kerri L. Browne, Donald R. Carr and Jerome G. Enad. Delayed presentation of Compartment Syndrome of the Proximal Lower Extremity after Low-energy trauma in patients taking Warfarin. Am J Orthop. 2008 December; 37(12): E201-E204
  • 20 Nigel Tapiwa et al. Acute compartment syndrome of Limbs – current concepts and management. Open Orthop J. 2012; 6: 535–543.Brighton, UK
  • 21 Saikia KC, Bhattacharya TD, Agarwala V. Anterior compartment pressure measurement in closed fractures of leg. Indian J Orthop 2008;42:217-21.
  • 22 DK Meena et al. Results of Neurolysis in Established Upper Limb Volkmann's Ischemic Contracture Indian J Orthop 50 (6), 602-609. Nov-Dec 2016.
  • 23 Valliancourt C,ShrierI, Vandal A, Falk M, Rossignol M, Vernec A, Somogyi D, “Acute compartment syndrome: how long before muscle necrosis occurs?,” CJEM.2004;6(3):147-54.
  • 24 Mabvuure NT, Malahias M, Hindocha S, Khan W, Juma A, “Acute compartment syndrome of the limbs:Current concepts and management. Open Orthop J.2012;6:535-543.
  • 25 Zwipp H, “Reconstructive surgery of sequalae of compartment syndrome of the leg and foot. Presentation of a new classification,”Unfallchrurg.2008;111(10):776-784.
  • 26 Sheridan GW, Matsen FA 3rd. Fasciotomy in the treatment of the acute compartment syndrome. J Bone Joint Surg Am. 1976 Jan;58(1):112-5.
  • 27 Hak D. J., Lee M., Gotham D. R. Influence of prior fasciotomy on infection after open reduction and internal fixation of tibial plateau fractures. J Trauma, 2010:(69):886-8
  • 28 Bhargava R et al. Proximal Tibial fractures with impending Compartment Syndrome Original Article Indian Journal of Orthopaedics 2015 Vol. 49 p. 502-509
  • 29 Cole PA, Zlowodzki M, Kregor PJ. Compartment pressures after submuscular fixation of proximal tibia fractures. Injury, 2003:(34 Suppl 1):A43-6
  • 30 Personal communication with illustrations Dr. P.V Jayasankar, Medical Director, Sundaram Medical Foundation and Dr. Rangaraja Hospital, Chennai