Open Fracture With Compartment Syndrome - Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Open Fracture With Compartment Syndrome - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the condition open tibial fracture with associated compartment syndrome. my new book about compartment syndrome https://www.amazon.com/dp/B0C51X2CWB?... Compartment syndrome indicated increased pressure in a closed muscle compartment space. It usually occurs in the arm or the leg and it occurs in high energy fractures with major soft tissue and bony injury such as in a pedestrian's tibia. Be aware of compartment syndrome in open fractures if the patient has multiple trauma, a closed head injury, prolonged anesthesia or is on ventilatory support. Open fractures occur when the fractured bone penetrates through the skin. Open fractures typically occur by high energy injuries such as car accidents, falls, or sports related injuries. Compartment syndrome following tibia fractures are most common with closed fractures but may occur with open fractures. The physician must maintain a high index of suspicion to diagnose a compartment syndrome in the patient who has multiple trauma even if the fracture is opened. Failure to diagnose increased pressure within the muscle compartment may lead to nerve injury, muscle necrosis and loss of function. A hand held inter-compartmental pressure monitor is used for assessment of the compartmental pressure. Pressure equal to or greater than 30 mmHg is a sign of impending compartment syndrome. Pressure measurement usually supports the clinical diagnosis of the physician. The clinical diagnosis of impending compartment syndrome: •Pain more than injury or the surgery •Increased necrotic requirements •Pain is exaggerated by stretching of the involved compartment •Decreased sensation of the involved compartment •Tense swelling of the muscle compartment. Every attempt should be made to feel the compartment and assess the presence of compartment syndrome in open fractures. The surgeon may be misled by the presence of an open wound and ignore the need for fasciotomy, thinking the wound will drain by itself because it is open. Compartment syndrome can occur in the presence of an open fracture especially if the fascia is partially torn. The fascia can be partially torn by the trauma, but still, needs to be completely and adequately decompressed. When the fascia is torn by the trauma, an adequate fasciotomy should be performed to completely decompress the muscle compartment. Fasciotomy is usually done with a four compartment fasciotomy. Anterolateral incision is placed halfway between the fibular shaft and the tibial crest. 1-Opening of the anterior muscle compartment. 2-Opening of the lateral muscle compartment. Be careful not to injure the superficial peroneal n. Posteromedial incision is placed 2 cm posterior to the posterior margin of the tibia. 3-Opening of the superficial posterior muscle compartment. 4-Opening of the deep posterior muscle compartment. Become a friend on facebook:   / drebraheim   Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC