Compartment Syndrome
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Basics
Description
- Elevated tissue pressure in closed spaces that compromises blood flow through capillaries
- Normal tissue pressure is <10 mm Hg
- Capillary blood flow in a compartment is compromised at pressures >20 mm Hg
- Muscles and nerves can develop ischemic necrosis at pressures >30 mm Hg
- When distal pulses are diminished on exam, muscle necrosis is probably present
- The 4 compartments of the leg are most frequently involved, but compartment syndrome can occur in the arm, forearm, hand, foot, shoulder, buttocks, and thigh
Etiology
- Decreased compartment size: Circumferential cast, burn eschar, or military antishock trousers (MAST)
- Increased compartment contents: Compression of the compartment from edema or hematoma caused by direct trauma, fracture, overexertion of muscles, contrast extravasation, injection of recreational drugs, postischemic time, or limb compression during prolonged recumbency
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Basics
Description
- Elevated tissue pressure in closed spaces that compromises blood flow through capillaries
- Normal tissue pressure is <10 mm Hg
- Capillary blood flow in a compartment is compromised at pressures >20 mm Hg
- Muscles and nerves can develop ischemic necrosis at pressures >30 mm Hg
- When distal pulses are diminished on exam, muscle necrosis is probably present
- The 4 compartments of the leg are most frequently involved, but compartment syndrome can occur in the arm, forearm, hand, foot, shoulder, buttocks, and thigh
Etiology
- Decreased compartment size: Circumferential cast, burn eschar, or military antishock trousers (MAST)
- Increased compartment contents: Compression of the compartment from edema or hematoma caused by direct trauma, fracture, overexertion of muscles, contrast extravasation, injection of recreational drugs, postischemic time, or limb compression during prolonged recumbency
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