Compartment Syndrome-Case-Compartment Syndrome

Case-Compartment Syndrome

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Compartment syndrome refers to a condition where the pressure within a closed anatomical compartment, such as the forearm, becomes elevated and leads to compression of nerves, blood vessels, and muscles within that compartment. This can occur due to various reasons, including trauma, strenuous exercise, or prolonged compression.<br /><br />In this case, a 23-year-old male presents with increasing forearm pain, which he attributes to recent intense training and use of dietary supplements. The initial evaluation involves considering differential diagnoses and conducting a physical examination. The patient is in obvious distress, and pain medications are ineffective.<br /><br />The next step in management is to consider forearm compartment syndrome as a possible diagnosis. Prompt treatment is crucial in order to prevent permanent damage to the nerves and muscles. Surgical intervention, known as compartment release, is typically required. This involves making incisions in the fascia surrounding the affected compartment to relieve the pressure.<br /><br />The decision to operate may be influenced by the delayed presentation of the patient, but compartment release is still necessary to prevent further damage. After the surgery, post-operative management includes the use of negative pressure wound therapy (wound VAC), timing for delayed primary closure, and the possibility of a skin graft.<br /><br />Summary: Early recognition and prompt treatment of compartment syndrome are crucial. Pain out of proportion is an early clinical sign. Compartment pressure measurement is often unreliable, especially in obtunded patients, but pressures greater than 40mmHg or within 30mmHg of diastolic pressure are concerning. Emergent surgical intervention, in the form of fasciotomies and debridement, is necessary to alleviate the pressure and prevent further damage.

Keywords

compartment syndrome

elevated pressure

compression

nerves

muscles

trauma

surgical intervention

compartment release

post-operative management

early recognition