Compartment
syndrome is ischaemia of muscle beds due to an increase in pressure in closed
muscle compartments. This ischaemia is due to obstruction to blood flow at capillary
and venous pressure levels. Arterial occlusion due to pressure rising above
artrial pressure is a much later event, and may never occur. Hence arterial
flow, pulses, and distal circulation may be preserved in the presence of frank
muscle necrosis. Symptoms of intractable pain over and above that which is expected
should lead to a diagnosis of compartment syndrome.
|
Compartment pressure monitoring provides little extra information in the awake patient. However it can be of use in the patient who is unable to feel or complain of pain - unconscious patients, patients with spinal cord injury and patients with epidural anaesthesia. |
 |
Treatment of compartment syndrome is full, open, four-part fasciotomy.