![]() ![]() įasciotomy to release the affected compartment is typically done in operating room under general or regional anesthesia after establishing the diagnosis of compartment syndrome. Previous studies show that delayed decompression of the affected compartments would lead to irreversible ischemic damage to muscles and peripheral nerves, with increased complication rate. Diagnosis of acute compartment syndrome depends both on clinical findings (pain out of proportion to the injury or surgery, pain with passive stretch of compartment muscles, increased narcotic requirement, tense swelling, and paresthesia) as well as on measurement of the intracompartmental pressure. In 1881, Volkmann recognized the association between acute ischemic events that are left untreated and late muscle contractures. As duration and magnitude of interstitial pressure increase, myoneural function is impaired, and necrosis of the soft tissues eventually develops. This is the first description in the literature for bedside fasciotomy under local anesthesia with a relatively large number of patients.Ĭompartment syndrome is defined as elevation of the interstitial pressure in a closed osteofascial compartment that results in microvascular compromise. The formal release of compartments in the operating room under general anesthesia continues to be the standard of care. The results of this study are encouraging, as all wounds healed satisfactory and there were no cases of deep infections. Conclusionīedside fasciotomy under local anesthesia is a feasible, safe, and effective choice for treating compartment syndrome in patients with delayed presentation or those with anticipated delay to undergo surgery in the operating theater under general or regional anesthesia. Superficial wound infection was noted in three patients one patient had persistent foot drop. ![]() There was no deep infection, chronic osteomyelitis, or amputation. One patient developed flexion contracture of the great toe. Thirty-two patients regained normal range of motion of adjacent joints. Thirty-three patients regained their normal muscle strength. ResultsĪll patients had immediate and marked improvement in pain. The minimum follow-up period was 6 months. This was a retrospective study of 34 cases of acute compartment syndrome for which fasciotomy was done at the bedside under local anesthesia. Bedside fasciotomy under local anesthesia can be done in these cases to avoid delay in compartment release. ![]() Various reasons can cause delay in performing the surgery. Delay in performing the procedure can lead to worse outcome. Burning or tingling in the skin or feelingsĬhronic (exertional) compartment syndromeĬhronic compartment syndrome is an overuse injury usually found in athletes and primarily affecting the legs (especially the quads or calves). The associated swelling and potential for tissue damage less severe than in acute compartment syndrome. Altering or ceasing activity may allow the muscle inflammation to subside, but if this does not work, a fasciotomy may be required.Fasciotomy for compartment syndrome is an emergent procedure that is usually done in the operating theater under general anesthesia.Unexpectedly intense pain in the muscle, which worsens with use.In these cases, loosening the constriction, if done in a timely manner, may avoid the need for surgery.Ĭommon symptoms of acute compartment syndrome are: It can also sometimes be caused by a splint, bandage or cast that is fitted too tightly. Anyone with this condition should go to the nearest emergency room.Īcute compartment syndrome is usually caused by an impact trauma, such as a bone fracture or severely bruised muscle. The condition is commonly associated with automobile and industrial accidents, as well as competitive sports. The surgery, called a fasciotomy, involves cutting open the fascia to allow the muscle to swell without causing additional damage. This is a medical emergency that requires immediate surgery to prevent the possible necrosis (death) of muscles, nerves and/or blood vessels. There are two major types of compartment syndrome. This leaves no room for the muscles to expand, leading to damage to the muscle tissue as well as to neighboring blood vessels and nerves. Unlike skin, ligaments or other soft tissues, fascia does not stretch. When the muscle group within one or more of the compartments swells, it is contained by the fascia. The leg, for example, contains four muscle compartments, each surrounded by tissue called the fascia. It most typically occurs in the leg or arm. Compartment syndrome refers to muscle swelling and resulting complications. ![]()
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