Compartment SyndromeBethan Owen

SCGH ED 24 October 2013

Fractures ~ 75% Compartment Syndrome

May be open or closed

Measurement with art line kit.

provide adequate analgesia and IV hydration to maintain an adequate urine output in case of rhabdomyolysis.

Timing of fasciotomy

True orthopedic emergency• Within 6 hrs – almost complete recovary• Within 12 hrs ~ 60-70% normal limb function• More than 12 hrs ~ 8% had normal limb

function.

Serious Complications

• gangrene or loss of limb viability requiring amputation

• ischemic contracture and loss of function• rhabdomyolysis and renal failure

References

• Marx JA, Hockberger R, Walls RM. Rosen’s Emergency Medicine: Concepts and Clinical Practice, 7th edition (2009) Mosby, Inc. [mdconsult.com]

• Newton EJ, Love J. Acute complications of extremity trauma. Emerg Med Clin North Am. 2007 Aug;25(3):751-61, iv. PMID: 17826216.

• Perron AD, Brady WJ, Keats TE. Orthopedic pitfalls in the ED: acute compartment syndrome. Am J Emerg Med. 2001 Sep;19(5):413-6. PMID: 11555801.

• Simon RR, Sherman SC, Koenigsknecht SJ. Emergency Orthopedics — The Extremities (5th edition), McGraw-Hill, 2007.