Compartment syndrome is a dangerous condition caused by increased pressure within the closed muscle compartments of the body. It can result from fractures, surgery, or severe bruising. Symptoms include severe pain disproportionate to the injury that is not relieved by pain medication, tight muscles, numbness, and loss of pulse. An early diagnosis within 24 hours of onset through tests like the Whiteside maneuver and direct pressure measurement allows for fasciotomy surgery to release the pressure and prevent permanent nerve and muscle damage. Compartment syndrome requires prompt treatment to avoid complications.

1. Dr. Tamer Mohammed Aly Orthopedic and spine surgeon

2. What is a compartment? Closed area of muscles group, nerves & bl.vs surrounded by fascia Pressure: 5-15 mmhg

3. What is a compartment syndrome ? intra comp. pressure (35-40 mmhg ) capillaries collapse Blood flow to muscles and nerves Bl.Vs collapse

6. Why is it dangerous? Nerves: neuropraxia: will regenerate Ischemia: cell death Muscles: contracture (Volkmann's ischemic contracture) Gangrene

7. Causes Fracture of a long bone (Supracondylar humerus, forearm, hand,tibia and foot)

10. Drilling & reaming Dissection Tourniquet

12. Tight cast swelling Bluish discoloration numbness

13. Severe bruised muscle (even if there is no fracture) Don’t take contusion lightly

17. SYMPTOMS Severe pain inappropriate to the injury(not relieved even with morphia)

18. Burning of the affected limb Tight muscle(rigid) Numbness: bad sign

19. SIGNS & DIAGNOSIS Passive stretching of fingers or toes (muscle stretch)will lead to severe pain (diagnostic sign) Never wait for signs of ischemia (5 Ps): irreversible damage

21. Whiteside maneuver Wick hand held instrument syringe 3 way stopcock mmhg mano. electrode Direct reading

23. Don’t wait so long

24. Non surgical management: Remove any tight bandage, tubigrip or soaked dressing Cast should be removed completely Elevation

25. Surgical management: ( FASCIOTOMY ) Open skin and fascia down to a compartment

28. Close skin by 2ry sutures after oedema subsides

29. It may need skin graft

30. Compartment syndrome is a serious syndrome, Which needs to be diagnosed early. Palpable pulse doesn’t exclude compartment syndrome If diagnosis and fasciotomy were done within 24 hrs, the prognosis is good. If delayed, complications will develop. The earlier you diagnose, the safer you are

32. Thank you