Exercise-Induced Acute Compartment Syndrome in Bilateral Upper Extremities: A Clinical Case (original) (raw)
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Acute Compartment Syndrome of the Extremities and Paraspinal Muscles
Trauma and Emergency Surgery, 2022
Acute compartment syndrome (ACS) occurs when the pressure within the closed osteo-fascial compartment raises above perfusion pressure leading to irreversible tissue ischemia and necrosis. Any closed compartment in the body can be affected by ACS. The leg is the commonest site. Trauma is the common cause of compartment syndrome in young patients. In older patients, medical causes can cause it. The diagnosis in a conscious patient can be made based on clinical features. Pain out of proportion to the injury is the most important symptom. Exacerbation of pain on stretching the affected muscles and paresthesia are the common signs. Compartment pressure measurement is important for the diagnosis in unconscious and uncooperative patients. The treatment of established ACS is emergency fasciotomy. Untreated compartment syndrome can lead to neurovascular injuries and muscle contractures. In this chapter, we will see the etiologies, clinical features, investigations, and management of acute co...
Acute Compartment Syndrome of the Limbs: Current Concepts and Management
The Open Orthopaedics Journal, 2012
Acute compartment syndrome (ACS) of the limb refers to a constellation of symptoms, which occur following a rise in the pressure inside a limb muscle compartment. A failure or delay in recognising ACS almost invariably results in adverse outcomes for patients. Unrecognised ACS can leave patients with nonviable limbs requiring amputation and can also be life-threatening. Several clinical features indicate ACS. Where diagnosis is unclear there are several techniques for measuring intracompartmental pressure described in this review. As early diagnosis and fasciotomy are known to be the best determinants of good outcomes, it is important that surgeons are aware of the features that make this diagnosis likely. This clinical review discusses current knowledge on the relevant clinical anatomy, aetiology, pathophysiology, risk factors, clinical features, diagnostic procedures and management of an acute presentation of compartment syndrome.
Extremity Compartment Syndrome
2018
All surgeons caring for patients with trauma to the extremities or practicing vascular surgery must be able to recognize and surgically treat compartment syndromes. Compartment syndrome (CS) results from a variety of etiologies with the final common pathway being increased compartmental pressure that exceeds the arterial inflow with resultant ischemia and necrosis. Failure to identify and treat compartment syndromes in a timely fashion is associated with preventable morbidity and mortality and is a common source of litigation. The diagnosis of CS is largely clinical, but measurement of compartment pressures may be useful in patients with equivocal findings or altered level of consciousness. Below the knee, the lower extremity is most commonly affected, followed much less frequently by the forearm, thigh, buttock, foot, and hand. This chapter will briefly review the pathophysiology, diagnosis, and relevant anatomy of CS of the extremities. The surgical treatment of CS of the extremit...
Current thinking about acute compartment syndrome of the lower extremity
Canadian journal of surgery. Journal canadien de chirurgie, 2010
Acute compartment syndrome of the lower extremity is a clinical condition that, although uncommon, is seen fairly regularly in modern orthopedic practice. The pathophysiology of the disorder has been extensively described and is well known to physicians who care for patients with musculoskeletal injuries. The diagnosis, however, is often difficult to make. In this article, we review the clinical risk factors of acute compartment syndrome of the lower extremity, identify the current concepts of diagnosis and discuss appropriate treatment plans. We also describe the Canadian medicolegal environment in regard to compartment syndrome of the lower extremity.
Muscles, Ligaments and Tendons Journal, 2015
Acute compartment syndrome sion would lead to irreversible ischemic damage to muscles and peripheral nerves. Conclusion: acute compartment syndrome is a surgical emergency. There is still little consensus among authors about diagnosis and treatment of these serious condition, in particular about the ICP at which fasciotomy is absolutely indicated and the timing of wound closure. New investigations are needed in order to improve diagnosis and treatment of ACS.
International Journal of Sports Physical Therapy, 2016
Chronic Exertional Compartment Syndrome (CECS) causes significant exercise related pain secondary to increased intra-compartmental pressure (ICP) in the lower extremities. CECS is most often treated with surgery with minimal information available on non-operative approaches to care. This case report presents a case of CECS successfully managed with physical therapy. Case report. A 34-year-old competitive triathlete experienced bilateral anterior and posterior lower leg pain measured with a numerical pain rating scale of 7/10 at two miles of running. Pain decreased to resting levels of 4/10 two hours post exercise. The patient was diagnosed with bilateral CECS with left lower extremity ICP at rest measured at 36 mmHg (deep posterior), 36-38 mmHg (superficial posterior), and 25 mmHg (anterior). Surgery was recommended. The patient chose non-operative care and was treated with physical therapy using the Functional Manual Therapy approach aimed at addressing myofascial restrictions, neu...
Delay in diagnosis of acute on chronic exertional compartment syndrome of the leg
MUSCULOSKELETAL SURGERY, 2009
Exertional compartment syndrome is most commonly described in its chronic form in the young sportive patient. The acute form is a lot rarer and usually only unilateral. We report a case in which a chronic compartment syndrome became acute after intense effort. This was diagnosed rather late due to the lack of knowledge about this syndrome. The necrosis noticed during the fasciotomy was removed by iterative interventions. The wound was left in secondary healing because the patient refused a flap. Upon the patient's last follow-up visit, the wound was healed, but he had a complete deficit in dorsal flexion of the ankle, a foot drop and consequently a steppage gait.