![]() ![]() ![]() ![]() The pain is made worse by passively stretching the muscle bellies traversing the affected fascial compartment. The most reliable symptom of compartment syndrome is severe pain, disproportionate to the injury, which is not readily improved with initial measures (such as analgesia, elevation to the level of the heart, and splitting a tight cast). Symptoms tend to present within hours, although it can develop up to 48 hours post-insult. Paraesthesia is therefore a common symptom.Īs the intra-compartmental pressure reaches the diastolic blood pressure, the arterial inflow will be compromised, and the leg will become ischaemic. This causes a sensory +/- motor deficit in the distal distribution. Next, the traversing nerves are compressed. This increases the intra-compartmental pressure further. This increases the hydrostatic pressure within them, causing fluid to move down its gradient and out of the veins in to the compartment. 2).Īs pressure increase, the veins will be compressed. Other causes include iatrogenic vascular injury, tight casts or splints, deep vein thrombosis, and post-reperfusion swelling.įascial compartments are closed and cannot be distended consequently, any fluid that is deposited therein will cause an increase in the intra-compartmental pressure (Fig. Figure 1 – Cross section of the muscles of the distal forearm, highlighting those of the posterior compartment PathophysiologyĬompartment syndrome typically occurs following high-energy trauma, crush injuries, or fractures that cause vascular injury. ![]()
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