![]() Clinical signs and symptoms might be nonspecific, especially in the early stages therefore, knowledge of predisposing risk factors and signs and symptoms of acute compartment syndrome is necessary to prevent long-term complications and amputation. ![]() Prompt diagnosis is crucial to avoid permanent functional restriction or even the loss of the affected limb. Un seguimiento prospectivo y un mayor número de pacientes podrían permitir dilucidar más de dichos factores.Īcute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Encontramos que el porcentaje de amputación parece verse afectado de manera estadísticamente significativa por factores como un International Severity Score (ISS) elevado (media de 24), las parestesias al ingreso, la realización de fasciotomía tardía (> 6 h), la reactividad muscular al momento de la cirugía, la infección del sitio operatorio y la reintervención por trombosis del injerto vascular.Įxisten factores de riesgo que pueden indicar la pérdida de la extremidad inferior luego de ser sometido a fasciotomía en el contexto de trauma. La mayoría de los individuos fueron menores de 30 años y casi la totalidad del sexo masculino. Se realizó un estudio retrospectivo, observacional, analítico en el cual se recolectó información de pacientes con traumatismo de miembro inferior que requirieron fasciotomía de muslo o pierna durante un periodo de 10 años en busca de factores que pudieron influir en la pérdida de la extremidad.Ģ1 pacientes cumplían los criterios de inclusión de los cuales 6 (28,57%) fueron amputados y 2 fallecieron (9,52%). Existen pocas descripciones sobre factores de riesgo para la necesidad de amputación de miembro inferior luego de haber sido sometido a fasciotomía en pacientes con lesiones traumáticas. La pérdida de la extremidad afectada es su complicación con mayor carga de enfermedad. Una vez instaurado, la fasciotomía se constituye como el único tratamiento efectivo. In this chapter, we will see the etiologies, clinical features, investigations, and management of acute compartment syndrome of the extremities and the paraspinal region.Įl síndrome compartimental del miembro inferior tiene el potencial de causar morbilidad devastadora en los pacientes y altos riesgos médico-legales para los médicos involucrados en su tratamiento. Untreated compartment syndrome can lead to neurovas-cular injuries and muscle contractures. The treatment of established ACS is emergency fasciotomy. Compartment pressure measurement is important for the diagnosis in unconscious and uncooperative patients. Exacerbation of pain on stretching the affected muscles and paresthesia are the common signs. Pain out of proportion to the injury is the most important symptom. The diagnosis in a conscious patient can be made based on clinical features. In older patients, medical causes can cause it. Trauma is the common cause of compartment syndrome in young patients. Any closed compartment in the body can be affected by ACS. For the treatment of ACS with tibial fracture, immediate internal fixation and changing from external fixation to internal fixation did not affect the clinical course.Īcute compartment syndrome (ACS) occurs when the pressure within the closed osteo-fascial compartment raises above perfusion pressure leading to irreversible tissue ischemia and necrosis. The time to bone union, the need for additional surgery, and the incidence of complications in Group I and Group II were not statistically different. Complications occurred in 4 cases, but no deep infection was reported. Five patients needed additional surgery for bone union. ![]() Thirty-five patients who underwent surgery for ACS with tibial shaft fractures were evaluated, and the results of initial internal fixation (Group I, 20 patients) and initial external fixation (Group II, 15 patients) were analysed. For the treatment of fractures with ACS, fasciotomy is conducted, and the method to stabilise the fracture has to be considered. Acute compartment syndrome (ACS) after tibial fracture carries a risk of various complications, including infection, delayed union, nonunion, nerve damage, and poor prognosis.
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