Problems concerning diagnosis and treatment of compartment syndromes after lower limb trauma.
Compartment Syndrome (CS) is characterised by an imbalance produced by increased pressure in an inextensible space (called "the Compartment"). Without being specific for orthopaedics, CS has increasing frequency in modern traumatology. Microcirculation disturbances generate the syndrome's self-augmenting physiopathological character. The pathognomonic feature of the clinical panel in CS of the lower limbs is increased consistency of the muscular groups, while peripheral pulse maintainance does not exclude CS. Although positive diagnosis is based on measuring the intra-compartmental pressure, (ICP) clinical suspicion is crucial. The correct treatment is surgical, consisting in early and large decompressive fasciotomy. Without proper treatment, CS endangers not only the vitality of the limb (due to Acute Peripheral Ischemia with onset in microcirculation and centripetal extension), but also the patient's life, thus becoming a life-threatening disorder. The authors underline the importance of correct clinical evaluation and early treatment in order to prevent the serious local and general complications of the CS.
Popescu
G I
GI
Orthopaedic and Trauma Clinic, Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
Lupescu
O
O
Nagea
M
M
Patru
C
C
Stoian
I
I
Vasilache
C
C
D003161:Compartment Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D006801:Humans; D007869:Leg Injuries / Q000150:complications* / Q000601:surgery; D035002:Lower Extremity / Q000293:injuries; D008833:Microcirculation; D019637:Orthopedic Procedures / Q000379:methods; D013848:Thigh / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome