Compartment syndrome and new data in orthopaedic

ABSTRACT

Acute compartment syndrome consists of one of the few emergencies in orthopedics and traumatology. Compartment syndrome signifies a painful condition occurred due to the increase interstitial pressure (intra-compartmental pressure - ICP) within a closed osteofascial compartment where local circulation is impaired. Lower limb and especially legs are the mostly affected site however, arms, hands, feet, and buttocks can also be affected. Development of compartment syndrome usually comes out after severe injuries including high energy fractures or crush injuries, it can be although the result of minor or iatrogenic injuries. Diagnosing ACS is difficult in clinical practice, even among expert surgeons. Currently, the diagnosis is made on the basis of physical examination and repeated ICP measures. ICP higher than 30 mmHg of diastolic blood pressure is significant of compartment syndrome. Once diagnosis is made, fasciotomy to release the affected compartment should be performed as early as possible because delayed decompression would lead to irreversible ischemic damage to muscles and peripheral nerves. 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. Further research is mandatory to improve diagnosis and treatment of ACS.

Keywords: acute comparment syndrome, interstitial fluid, fasciotomy