COMPARTMENT SYNDROME - Definition,Pathophysiology, Causes, Clinical Features,Diagnosis and Treatment скачать в хорошем качестве

COMPARTMENT SYNDROME - Definition,Pathophysiology, Causes, Clinical Features,Diagnosis and Treatment

Compartment Syndrome Compartment syndrome is a painful condition, with muscle pressure reaching dangerous levels. Acute compartment syndrome is a medical emergency, usually caused by trauma, like a car accident or broken bone. Chronic (or exertional) compartment syndrome is caused by intense, repetitive exercise and usually stops with rest or changes in routine. What is compartment syndrome? Compartment syndrome occurs when pressure rises in and around muscles. The pressure is painful and can be dangerous. Compartment syndrome can limit the flow of blood, oxygen and nutrients to muscles and nerves. It can cause serious damage and possible death. Compartment syndrome occurs most often in the lower leg. But it can also impact other parts of the leg, as well as the feet, arms, hands, abdomen (belly) and buttocks. What is a compartment? A compartment is a group of muscles, nerves and blood vessels. A thin but firm membrane (covering) called a fascia lies over each compartment. It keeps the muscles in place. But the fascia isn’t meant to stretch or expand much. What causes compartment syndrome? A serious injury or too much physical exertion can cause swelling or bleeding in a compartment. The fascia won’t expand to make room, so the swelling or bleeding puts pressure on the nerves and muscles. Healthcare providers call this compartmental pressure. If the pressure gets too high, the tissues can’t get enough blood, which contains oxygen and nutrients. The tissues can die, leading to permanent damage to the area. These complications can also threaten your life. What types of injuries can cause compartment syndrome? Examples of injuries that can cause compartment syndrome include: Badly bruised muscle. Car accident. Crush injury, such as when something falls on you. Fracture (broken bone). Sudden return of blood flow after something blocks circulation, such as surgery or loss of consciousness. Anabolic steroids can also cause compartment syndrome by increasing muscle size too quickly. Other causes include casts or large bandages that are too tight and worn for a while What are the symptoms of compartment syndrome? The symptoms of compartment syndrome can include: Bulging or visible swelling of the muscle. Feeling like the muscle is fuller, swollen or somehow larger than normal. Numbness. Muscle pain that is stronger than you’d expect from the injury. Severe pain when you stretch the muscle. Tightness in the muscle. Tingling or burning sensation in or under your skin, called paresthesias. DIAGNOSIS AND TESTS How is compartment syndrome diagnosed? If you think you have acute compartment syndrome, go to an emergency room right away. It’s a medical emergency that needs treatment. If you think you have exertional compartment syndrome, call your healthcare provider. A healthcare provider will do a few things to diagnose compartment syndrome: Physical exam: The healthcare provider will look for signs you might have something else. For example, the provider will check your tendons for tendinitis and your shins for shin splints. X-ray: The healthcare provider may ask for an X-ray to see if you have a fracture. Compartment pressure measurement test: If the provider suspects compartment syndrome, you’ll need a test to measure the pressure. The provider will insert a needle into the muscle. A machine attached to the needle will give the pressure reading. The healthcare provider may insert the needle in several different places. Repeat pressure test: For exertional compartment syndrome, the test gets repeated after you exercise. The healthcare provider will compare before and after results. MANAGEMENT AND TREATMENT How do you treat acute compartment syndrome? Acute compartment syndrome must get immediate treatment. A surgeon will perform an operation called a fasciotomy. To relieve pressure, the surgeon makes an incision (cut) through the skin and the fascia (compartment cover). After the swelling and pressure go away, the surgeon will close the incision. Sometimes that can’t happen right away. The surgeon may do a skin graft, taking skin from another area of your body to put over the incision. Softer surfaces for workouts (running on tracks instead of concrete, for example). If those options don’t work, fasciotomy may be an option.