[Compartment syndrome of the hand].
Crush injuries of the hand have a bad prognosis. The development of a compartment syndrome in crush injuries is feared but rare, and usually affects the radial interosseous muscle compartment due to certain anatomic features. The usual clinical presentation is an edematous hand held in a slightly intrinsic position with severe pain resistant to level 111 analgesia. Passive extension of the digits increases the pain. Diagnosis is confirmed by measuring compartmental pressure in all compartments so as not to miss a case. The aim of this work is to resolve differences in compartmental pressure measurements that may cause misdiagnosis and surgical error. The dermofasciectomy is the only treatment that stops muscle ischemia and avoids perpetuation of the viscious circle of irreversible damage. Functional prognosis is compromised in compartment syndrome and the dermofasciectomy cannot be delayed under any circumstance.
Service de chirurgie orthopédique et traumatologique, HIA Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France. renaudbreda@yahoo.fr
R
R
Breda
F
F
Bazile
B
B
Bauer
D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D050723:Fractures, Bone / Q000150:complications*; D006230:Hand Injuries / Q000150:complications*; D006801:Humans; D050279:Metacarpal Bones / Q000293:injuries*