Compartment

Syndrome

Zulqaidandy Rahman
 Definition
O Symptoms and signs caused by increased
pressure within a limited space that
compromises circulation and function of the
tissues in that spaces.

3. Townsend, C. M., Beauchamp, R. D., Evers, B. M., & Mattox, K. L.

(2012). Sabiston Textbook Of Surgery. Philadephia: Elsevier Saunders.
 Anatomy
O Compartment syndrome may develop
whenever a compartment is present
O Possible sites: lower leg, forearm, wrist, and
hand

1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from

Medscape: http://emedicine.medscape.com/article/307668-overview#a4
 Patophysiology

1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from

Medscape: http://emedicine.medscape.com/article/307668-overview#a4
 Etiology
Decreased Compartment
Volume
Increase Compartment
Volume
Other Injuries
3. Townsend, C. M., Beauchamp, R. D., Evers, B. M., & Mattox, K. L.
(2012). Sabiston Textbook Of Surgery. Philadephia: Elsevier Saunders.
 Epidemiology
O Anterior distal lower extremity is the most
common
O Tibia fracture is most common precipitating
events (2-12% of all compartment syndrome
incidence)
O Much higher in patients who have an
associated vascular injury

1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from

Medscape: http://emedicine.medscape.com/article/307668-overview#a4
 Prognosis
O Outcome depends on both the diagnosis
and the time from injury to intervention
O Almost complete recovery of limb function if
fasciotomy was performed within 6 hours
O In the lower leg, the results of fasciotomies
for posterior compartment syndrome are not
as good as those for the anterior
compartment

1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from

Medscape: http://emedicine.medscape.com/article/307668-overview#a4
 Clinical Features
O High-risk injuries are fractures of the elbow,
forearm bones, proximal third of the tibia.
O Classic feature of ischemia (5P)
- Pain (feels like burning)
- Paresthesia
- Pallor
- Paralysis
- Pulselessness
5 P's are not clinically reliable; they may manifest
only in the late stages of compartment syndrome
1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from Medscape:
http://emedicine.medscape.com/article/307668-overview#a4
2. 2. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and
Fractures; Ninth Edition. London: HodderArnold.
 Clinical …(cont.)
O Early finding: pain (bursting sensation),
altered sensibility and paresis, wooden
feeling on deep palpation
O Confirm diagnosis measuring
intracompartmental pressures. A differential
pressure (ΔP) – of less than 30 mmHg (4.00
kilopascals)  indication for immediate
compartment decompression.

1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from Medscape:
http://emedicine.medscape.com/article/307668-overview#a4
2. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and
Fractures; Ninth Edition. London: HodderArnold.
1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from
Medscape: http://emedicine.medscape.com/article/307668-overview#a4
 Treatment
O Treatment  decompressed
O The ΔP should be carefully monitored; if it
falls below 30 mmHg, immediate open
fasciotomy is performed
O No pressure measurements decision to
operate based on clinical grounds.
O Follow up the clinical signs every 30 min 
no improvement after 2hr splitting of
dressing fasciotomy should be performed
O Muscle will be dead after 4-6 hr total
ischemia
2. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of
Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
3. Townsend, C. M., Beauchamp, R. D., Evers, B. M., & Mattox, K. L.
(2012). Sabiston Textbook Of Surgery. Philadephia: Elsevier Saunders.
1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from Medscape:
http://emedicine.medscape.com/article/307668-overview#a4
1. Abraham , R. T. (2017, January 17). Retrieved July 01, 2017, from
Medscape: http://emedicine.medscape.com/article/307668-overview#a4
 Video

apley
 References
1. Abraham , R. T. (2017, January 17). Retrieved
July 01, 2017, from Medscape:
http://emedicine.medscape.com/article/3076
68-overview#a4
2. Solomon, L., Warwick, D., & Nayagam, S.
(2010). Apley's System Of Orthopaedic and
Fractures; Ninth Edition. London: Hodder
Arnold.
3. Townsend, C. M., Beauchamp, R. D., Evers, B.
M., & Mattox, K. L. (2012). Sabiston Textbook
Of Surgery. Philadephia: Elsevier Saunders.
apley