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Compartment syndromes
S J Mubarak1, R A Pedowitz, A R Hargens
1University of California, Division of Orthopaedics and Rehabilitation, San Diego.
Current Orthopaedics
|January 1, 1989
Summary
Compartment syndrome, a condition of high pressure in muscle compartments, impairs tissue blood flow. Prompt treatment via decompressive fasciotomy is crucial to prevent irreversible tissue damage and Volkmann
Area of Science:
- Orthopedics
- Trauma Surgery
- Vascular Surgery
Background:
- Compartment syndrome involves elevated pressure within fascial compartments, compromising tissue perfusion.
- It can manifest acutely or chronically (exertional) and has diverse etiologies.
- Prolonged high intramuscular pressure may lead to irreversible tissue injury, including Volkmann's contracture.
Purpose of the Study:
- To review current knowledge on the pathophysiology, etiology, diagnosis, and treatment of acute compartment syndrome.
- To discuss controversies in critical pressure-time thresholds for surgical decompression.
- To explore optimal diagnostic methods for measuring intracompartmental pressures.
Main Methods:
- Literature review and synthesis of current scientific knowledge.
- Discussion of diagnostic techniques for intracompartmental pressure measurement.
- Analysis of treatment strategies, focusing on decompressive fasciotomy.
Main Results:
- Acute compartment syndrome is characterized by reduced capillary blood perfusion due to high intracompartmental pressure.
- Decompressive fasciotomy aims to reduce pressure and restore blood flow to ischemic tissues.
- Debate persists regarding precise pressure-time thresholds and diagnostic accuracy.
Conclusions:
- Effective management of compartment syndrome hinges on timely recognition and pressure reduction.
- Further research is needed to standardize diagnostic criteria and treatment guidelines.
- Understanding the pathophysiology is key to preventing severe complications like Volkmann's contracture.