Compartment Syndrome Essay

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Compartment Syndrome ` Compartment syndrome is defined as an elevated pressure of tissue fluid in a closed osseofascial compartment of a limb that interferes with the circulation to the muscles and nerves of that compartment (Baxter and Rorrabeck, 1990). In 1909, Thomas reviewed the medical literature and noted the association of compartment syndrome with number of medical and surgical conditions including fractures, arterial injuries, embolus and external compression (peter, 2001). Brooks in 1922 through the precipitating event to be acute venous obstruction resulting in swelling and diminished tissue perfusion. During and shortly after World War II, a number of high velocity gunshots wounds with associated long bone fracture and arterial injury were noted to have developed acute compartment syndrome. The cause of compartment syndrome was thought to be acute arterial spasm, and attention was drowning toward relieving the arterial spasm rather than fasciotomy itself (Whittle, 2001). Ellis in 1958 reported a 2% incidence of ischemic contracture in the lower extremity following tibial fractures. Before that most of attention had focused on upper extremity and specifically supracondylar fractures of humerus and fractures of the radius and ulna as precipitating events leading to compartment syndrome and subsequent contractures (Randall, 1999). Holden in 1979, reiterated the two possible causes of compartment syndrome (Volkmann’s ischemic contracture) type I is a proximal arterial injury resulting in ischemia distally, whereas type II is a direct injury giving rise to severe swelling and eventual ischemia (Holden, 1979). The early diagnosis and management of acute compartment syndrome are critical for the prevention of long term disability. Diagnosis may be delayed when the condition is unexpected and when symptoms are masked by the use of analgesia

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