OVERVIEW

• Occurs When The Pressure within A Defined

Compartmental Space Increases. Past A Critical Pressure
Threshold, Thereby Decreasing The Perfusion Pressure
To That Compartment
ETIOLOGY

•Decrease Compartment Size : E.G Casts, Splint, Burn

Eschar, Lying On Limb For Long Period, Etc.

•Increase Compartment Contents : E.G Fractures,

Muscle Swelling Due To Overexercise, Intracompartmental
Hemorrhage, Etc.
CLINICAL
MANIFESTATION
Palpation of
tense or
PAIN PALLOR swollen
compartments

CLINICAL
PARAESTHESIA PULSELESSNESS
FEATURES
5P

First sign of nerve

ischaemia
PARALYSIS Late sign
INTRA COMPARTMENT PRESSURE
MEASUREMENT
• Simple Needle
• Wick Catheter
• Slit Catheter
• Side Port Catheter
• Transducer –Tipped Catheter

Objective Method Of Diagnosis Cs : Measurement

Of Intracompartment Pressure(icp)
TECHNIQUE

• WHITE SIDE TECHNIQUE

CRITICAL PRESSURE
ICP > 30 MMHG AS ABSOLUTE NUMBER
OR
P < 30 MMHG,
P =DIASTOLIC PRESSURE – COMPARTMENT PRESSURE
 PATOPHYSIOLOGY
Bleeding
Edema Intracompartmental Pressure
Inflammation
Capillary flow

• Myofibrin release • Release histamine-like

Tissue Ischemia substance > plasmaleaks
• Renal Injury
( > 6 hrs ) • Myocyte lyse >
Myofibrillar protein
Necrosis decomposed
Nerve >> Regenerate
Muscle >> Volkmanns contracture
TREATMENT

• DECOMPRESSION
• CASTS, BANDAGES, AND DRESSIG MUST BE COMPLETELYCREMOVED
• LIMB SHOULD BE NURSED FLAT
• FASCIOTOMY IS JUSTIFIED EVEN IF A PREDETERMINED PRESSURE TRESSHOLD HAS NOT BEEN REACHED
TO MEASURE PRESSURE IS NOT AVAILABLE
TREAT
MENT

FASCIOTOMY