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Acute compartment syndrome in lower extremity musculoskeletal trauma.

Publication ,  Journal Article
Olson, SA; Glasgow, RR
Published in: J Am Acad Orthop Surg
November 2005

Acute compartment syndrome is a potentially devastating condition in which the pressure within an osseofascial compartment rises to a level that decreases the perfusion gradient across tissue capillary beds, leading to cellular anoxia, muscle ischemia, and death. A variety of injuries and medical conditions may initiate acute compartment syndrome, including fractures, contusions, bleeding disorders, burns, trauma, postischemic swelling, and gunshot wounds. Diagnosis is primarily clinical, supplemented by compartment pressure measurements. Certain anesthetic techniques, such as nerve blocks and other forms of regional and epidural anesthesia, reportedly contribute to a delay in diagnosis. Basic science data suggest that the ischemic threshold of normal muscle is reached when pressure within the compartment is elevated to 20 mm Hg below the diastolic pressure or 30 mm Hg below the mean arterial blood pressure. On diagnosis of impending or true compartment syndrome, immediate measures must be taken. Complete fasciotomy of all compartments involved is required to reliably normalize compartment pressures and restore perfusion to the affected tissues. Recognizing compartment syndromes requires having and maintaining a high index of suspicion, performing serial examinations in patients at risk, and carefully documenting changes over time.

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Published In

J Am Acad Orthop Surg

DOI

ISSN

1067-151X

Publication Date

November 2005

Volume

13

Issue

7

Start / End Page

436 / 444

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Orthopedics
  • Musculoskeletal System
  • Lower Extremity
  • Ischemia
  • Humans
  • Compartment Syndromes
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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ICMJE
MLA
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Olson, S. A., & Glasgow, R. R. (2005). Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg, 13(7), 436–444. https://doi.org/10.5435/00124635-200511000-00003
Olson, Steven A., and Robert R. Glasgow. “Acute compartment syndrome in lower extremity musculoskeletal trauma.J Am Acad Orthop Surg 13, no. 7 (November 2005): 436–44. https://doi.org/10.5435/00124635-200511000-00003.
Olson SA, Glasgow RR. Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg. 2005 Nov;13(7):436–44.
Olson, Steven A., and Robert R. Glasgow. “Acute compartment syndrome in lower extremity musculoskeletal trauma.J Am Acad Orthop Surg, vol. 13, no. 7, Nov. 2005, pp. 436–44. Pubmed, doi:10.5435/00124635-200511000-00003.
Olson SA, Glasgow RR. Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg. 2005 Nov;13(7):436–444.

Published In

J Am Acad Orthop Surg

DOI

ISSN

1067-151X

Publication Date

November 2005

Volume

13

Issue

7

Start / End Page

436 / 444

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Orthopedics
  • Musculoskeletal System
  • Lower Extremity
  • Ischemia
  • Humans
  • Compartment Syndromes
  • 3202 Clinical sciences
  • 1103 Clinical Sciences