Vascular ischaemia-reperfusion injury, haemorrhage, phlegmasia caerulea dolens.Prolonged limb compression - eg, immobilisation in a tight plaster cast.Fractures - especially fractures of the forearm and lower leg that have been internally fixed or infected.Arterial blood inflow is reduced when the pressure exceeds systolic blood pressure. Initial venous compromise may progress to reduced capillary flow, which increases ischaemia and may further increase the interstitial pressure, leading to a vicious cycle of increasing pressures. With increasing duration and magnitude of interstitial pressure, there is increasing impairment of muscle and nerve function and necrosis of soft tissues. Sudden release of the abdominal compartment syndrome may lead to an ischaemia-reperfusion injury causing acidosis, cardiac dysfunction and cardiac arrest.The diagnosis can be confirmed by the measurement of intra-abdominal pressure, either by a Foley's catheter in the bladder or a nasogastric tube in the stomach.It may cause acute kidney injury, cardiac dysfunction and an elevated central venous pressure.May occur in any multiple trauma patient who has undergone a period of profound shock.Uncommon and is often diagnosed late, resulting in muscle necrosis and sciatic nerve palsy.Peroneal compartment: deep and superficial peroneal nerves.Deep posterior compartment: posterior tibial nerves and vessels, peroneal artery.Superficial posterior compartment: no major nerves or vessels.Anterior tibial compartment: deep peroneal nerve, anterior tibial artery.Dorsal compartment: posterior interosseous nerve no major vessels.Ventral compartment: median and ulnar nerves radial and ulnar arteries.Forearm compartments and structures at risk:.Therefore, although the upper and lower limbs are most commonly affected, other sites may be affected, particularly the abdomen and gluteal regions: Chronic compartment syndrome is usually caused by exercise and presents with recurrent pain and disability, which subside when the cause (usually running) is stopped but return when the activity is resumed.Ĭompartment syndrome can occur wherever a compartment is present.Acute compartment syndrome requires prompt diagnosis and urgent treatment. Intense exercise can also cause acute compartment syndrome. Acute compartment syndrome is most often caused by trauma, which may be relatively minor.Compartment syndrome may be acute or chronic: This may result in temporary or permanent damage to muscles and nerves. Compartment syndrome is caused by an increased pressure within a closed anatomical space, which compromises the circulation and function of the tissues within that space.
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