title: Acute compartment syndrome risk in fracture fixation with regional blocks.
abstract: Acute compartment syndrome is a surgical emergency that most commonly occurs after trauma or reperfusion after prolonged arterial occlusion. It is caused by a build-up of blood and oedema fluid within a closed muscle compartment, and can be limb and life-threatening. It is therefore imperative that a prompt diagnosis is made. The risk of developing this condition is <1% in patients with distal radius fractures and 4-5% in those with tibial diaphyseal fractures. Pain management is an important aspect of treatment following any fracture. Regional anaesthesia can be used during surgical fixation of the fracture and has the potential to reduce the need for specialist postoperative care and analgesia, as well as to shorten the length of hospitalisation. With this case report, we hope to highlight the potential risk of masking symptoms of compartment syndrome while using regional blocks, as this can cause a delay in diagnosis and treatment, leading to associated complications.
authors.affiliation: Department of Orthopaedics, Pennine Acute Hospitals NHS Trust, Bury, UK.
authors.forename: Raghavendra Marappa
authors.initials: RM
authors.lastname: Ganeshan
authors.affiliation: Department of Orthopaedics, Leicester Medical School, Leicester, UK.
authors.forename: Neville
authors.initials: N
authors.lastname: Mamoowala
authors.affiliation: Department of Orthopaedics, North Manchester General Hospital, Manchester, UK.
authors.forename: Mathew
authors.initials: M
authors.lastname: Ward
authors.affiliation: Department of Orthopaedics, North Manchester General Hospital, Manchester, UK.
authors.forename: David
authors.initials: D
authors.lastname: Sochart
mesh_terms: D000368:Aged; D000765:Anesthesia, Conduction / Q000009:adverse effects*; D001860:Bone Plates; D001864:Bone Wires; D003161:Compartment Syndromes / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D012307:Risk Factors; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome