Compartment Syndrome N540B Spring 2007 Mary Gaspar.

Slides:



Advertisements
Similar presentations
Musculoskeletal Emergencies
Advertisements

What are 3 things which present with complaints out of proportion to findings??
Acute Limb Ischaemia John Gan Vascular Surgeon Specialists Without Borders Seminar in Surgery Rwanda, September 2010.
Shoulder Impingement Syndrome
TRANSITION SERIES Topics for the Advanced EMT CHAPTER Soft Tissue Injuries: Crush Injury and Compartment Syndrome 39.
Compartment Syndrome: Introduction Acute Compartment Syndrome: occures when pressure rises in a compartment,resulting in a critical reduction of blood.
CRUSH INJURIES & COMPARTMENT SYNDROME. CRUSH INJURIES – Are a particular type of blunt trauma that applies force which stretches tissues beyond their.
By Sam Brooks.  Compartment syndrome is an acute medical condition when blood vessels and nerves are compressed causing tissue death and nerve damage.
Stroke Awareness.
Acute Compartment Syndrome
DONE BY :ASIM MAKHDOM 25/Nov/2008 ORTHOPEDIC H.O.
Compartment Syndrome IN EMS. Who Cares? Bandaging Bandaging Splinting Splinting Trauma Trauma IV’s IV’s Tourniquets Tourniquets Edema Edema Exercise Exercise.
Compartment Syndrome Kyle Miller. Compartment Syndrome Definition Definition Compartment Syndrome involves the compression of nerves and blood vessels.
Phlebitis and thrombophlebitis
Dr.AbdulWAHID M Salih Ph.D. Surgery
SPINAL TUMORS. GROUP MEMBERS:  Carlwyn Collins  Jennifer Haynes  Satrupa Devi Singh  Vanessa Wickham.
Spinal Cord Stimulators in Neuropathic Pain. Introduction Chronic pain is very common Immense physical, psychological, societal impact Financial burden.
Ulnar nerve palsy NORTON UNIVERSITY SURGICAL SEMIOLOGY Ass Prof. SEANG Sophat.
Fractures.
INJURY DIAGNOSIS AND TREATMENT REMEMBER, WE ARE NOT DOCTORS!! We can help NARROW down injuries and give basic first aid… ALWAYS CONSULT A DOCTOR!
Copyright © 2008 Delmar Learning. All rights reserved. Unit 41 Musculoskeletal System.
Orthopedic Emergencies Compartment Syndrome Acute Joint Dislocation
Orthopedic Assessment Jan Bazner-Chandler CPNP, CNS, MSN, RN.
Necrotizing Fasciitis
Cases Neuroscience. Case 4 A 45 year old woman with a history of hypertension experienced a brief "blackout". She had complained of severe headaches,
EXTREMITY TRAUMA Instructor Name: Title: Unit:. OVERVIEW Relationship of extremity trauma to assessment of life-threatening injury Types of extremity.
Buerger’s Disease A presentation by Jennifer Kent-Baker.
Derek Landreth and Chase Patrylak. Cerebrovascular Accident (Stroke) A stroke is when a clogged or burst artery interrupts blood flow to the brain. A.
Nathan McNeil, MD 11/22/2010.  “a condition in which increased pressure within a limited space compromises the circulation and function of the tissues.
Carpal tunnel Carpal Tunnel Syndrome is the pain, tingling and other problems in the wrist because of the nerves in the medial part of the wrist having.
Skills Practicum. You – Are working in the Poly- Clinic.
Gangrene By: Dajana, CJ, D’Angelo, Chris Date: February 9,2015 Period: 2B.
SHOCK. 2 What is Shock?  A condition of insufficient supply of blood reaching body tissues  Certain degree of shock is found in most illness or trauma.
Morgann Loaec and Laila Siddique MS2
What is Edema? What are Ulcers? How can Edematous Limbs be treated?
IED Blast Injury Right Femur Fracture and Left Lower Leg Amputation Skills Practicum.
Compartment Syndrome Related to Infusion Therapy
Complications of fractures General complications Hemorrhage and shock. Fat embolism. Venous thrombosis and pulmonary embolism. Crush syndrome. Complications.
COMMON ORTHOPAEDIC CONDITIONS OF THE HAND AND WRIST Korsh Jafarnia, MD Methodist Center for Orthopedic Surgery & Sports Medicine.
Cardiovascular & Lymphatic System Megan Thompson 02/05/09 Hour 5/6.
Joel Arudchelvam. 1. Sharp  knife  shrapnel 2. Blunt  joint dislocation  fracture.
BASILAR THUMB ARTHRITIS
Musculoskeletal Trauma Tissue is subjected to more force than it can absorb Severity depends on: ◦ Amount of force ◦ Location of impact.
COMPARTMENT SYNDROME. INTRODUCTION Compartment syndrome (CS) is a limb- threatening and life-threatening condition Compartment syndrome is a condition.
Dr Shrenik M Shah Shrey hospital Ahmedabad. Definition Definition: Increased tissue pressure compromises the circulation within the enclosed space of.
TITLE VOLKMANN’S ISCHAEMIC CONTRACTURE: A CASE REPORT OF NEGLECT
Herniated Disc Surgery. Anatomy A herniated disc most often occurs in the lumbar region (low back). This is because the lumbar spine carries most of the.
Musculoskeletal Disorders Part I Osteoporosis Osteomyelitis Osteoarthritis Rheumatoid Arthritis Gout.
Presented by: Mary L. Dombovy, MD, MHSA Paul K. Maurer, MD Anthony L. Petraglia, MD Patrick J. Reid, MD Matthew L. Dashnaw, MD, Pharm D M. Gordon Whitbeck,
Sports Injuries Matt Morris.
Prof. Mamoun Kremli AlMaarefa College
Open Fracture of the Hook of the Left Hamate
PHED 120 Krzyzanowicz- Fall ‘12
Presented By: Marieann McGhee
Time is of the Essence: Compartment Syndrome.
Presented by : Ahmed Khaled Alshammari
Guillain-Barre Syndrome (Polyneuritis)
DIABETIC FOOT CARE CARING FOR AND TREATING FOOT AND ANKLE CONDITIONS RELATED TO DIABETES.
By Waleed M. Awwad, MD, FRCSC
Necrotising FASCIITIS
Foot & Ankle Injuries Requiring Immediate Care
Considerations in the Management of Viper Bite
ACUTE COMPARTMENT SYNDROME
Compartment Syndrome By Patti Hamilton.
How a Man Can Tell if He Has a Male Organ Fracture and What to Do
Presentation transcript:

Compartment Syndrome N540B Spring 2007 Mary Gaspar

Overview of Compartment Syndrome Compartment syndrome occurs when blood supply is dramatically reduced to muscles in a closed body space, known as a compartment. Compartments are found in the hand, forearm, upper arm, abdomen, buttock and leg. The muscles most frequently involved are those on the front of the lower leg or palm side of the forearm.

Bleeding from a bone fracture Burn eschar Casts applied too tightly Crush injuries Leaking of IVF into the compartment Seizures that involve the muscles in a compartment Snake bite Swelling of the muscle itself Common causes of CS include:

What’s going on in the body? Compartments are groups of muscles surrounded by inelastic fascia. Increased pressure within a muscle compartment causes decreased blood supply to affected muscles. Any swelling of muscles leaves no room for expansion and blood supply is progressively shut off. If affected muscles are deprived of blood supply for > 6 hours, nerve and muscle tissue can be permanently damaged.

Hallmark Symptoms of Compartment Syndrome Severe pain or parasthesia disproportionate to the injury Increase in pain after pain medication has been administered. In severe cases there may be decreased sensation, weakness and paleness of the skin.

History and Physical Exam: Look for the 6 P’s Subjective info: Pain Pressure Parasthesia Objective info: Pallor Pulselessness Paresis

Why is compartment syndrome an emergency? If not diagnosed and treated promptly there can be permanent nerve injury and loss of muscle function. Permanent nerve injury can occur after hours. In severe cases limbs may need to be amputated because all of the muscles in the compartment have died from lack of O2.

Diagnosis A swollen limb, tense on palpation, in an intrinsic minimus position strongly indicates compartment syndrome. Diagnosis is based on high degree of clinical suspicion

Treatment A surgical procedure known as fasciotomy may be used to open the membrane leading to the affected muscles. Pressure is relieved and the blood flow can return to normal. Often the skin needs to be left open for a few days. It can be closed with sutures or a skin graft after swelling diminishes.

Prognosis Accurate and prompt diagnosis is necessary to assure a good outcome. Only 8% of patients will regain function if surgery is delayed. Little or no return of function can be expected if dx and tx are delayed. Surgery performed days after injury contraindicated due to severe infection and difficulty in managing necrotic muscle. If surgery performed within 12 hours after onset of acute CS, prognosis is good.

References: cfm?thread_id=287&topcategory=Genera l%20Information cfm?thread_id=287&topcategory=Genera l%20Information 39.htm 39.htm html html ment-syndrome-info.html

Test Question Iva Tript fell in her home and fractured her leg. She was found by her neighbor 36 hours after her fall. Her lower extremity was pale, numb and without peripheral pulses. Which of the following constitutes appropriate treatment for Iva’s diagnosis of compartment syndrome? A. Cast her leg, give her medicine for pain and have her return for follow-up in 1 week. B. Fasciotomy to be performed within 12 hours of hospital admission and her prognosis for recovery of function is good. C. Surgery to regain function of her leg is no longer possible. Her leg must be amputated. D. Iva is a candidate for surgery but should be informed that her chances of regaining function are about 8%.