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[Acute compartment syndrome in the post-traumatic leg]
1Clinique d'Orthopédie et de Chirurgie de l'Appareil Moteur, Département de Chirurgie, Hôpitaux Universitaires de Genève, Suisse.
Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur
|October 17, 1998
Summary
Acute compartment syndrome occurs in 8% of leg fractures, particularly in younger individuals with high-energy trauma. Prompt fasciotomy is crucial when perfusion pressure drops below 30 mmHg to prevent complications.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Clinical Diagnostics
Background:
- Compartment syndrome is a critical condition diagnosed through clinical signs and intracompartmental pressure measurement.
- Understanding its pathophysiology, diagnosis, and treatment is vital for effective patient management.
Purpose of the Study:
- To review the physiopathology, diagnosis, and treatment of acute compartment syndrome.
- To analyze clinical experience and literature data on the subject.
Main Methods:
- A review of literature and personal clinical experience.
- Study of 100 consecutive leg fractures, analyzing trauma mechanisms, fracture sites, and surgical timing for fasciotomy and wound closure.
Main Results:
- The incidence of compartment syndrome was 8% in the studied leg fractures.
- Younger age (<30 years), high-energy trauma, and trauma during physical activity were identified as risk factors.
- Fracture location along the leg did not influence the risk of compartment syndrome.
Conclusions:
- Compartment perfusion pressure is defined as diastolic blood pressure minus intracompartmental pressure.
- Fasciotomy is indicated if perfusion pressure is below 30 mmHg.
- Accurate pressure measurement near the fracture site is essential; intramedullary nailing does not appear to increase compartment syndrome risk.