The ‘silent’ compartment syndrome

Badhe, Sachin; Baiju, D; Elliot, Robin; Rowles, J. M.; Calthorpe, D.

doi:10.1016/j.injury.2008.07.023

Cited by 53 publications

(44 citation statements)

References 19 publications

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“…Of the sporting reports that noted sex, 100% were male with mean age of 22.8 years 6 38 39 41 43 46 54 56. The propensity for young, muscular, athletic males to develop ACS has been noted in the literature4 40 70 and reflects our presented case. McQueen et al 4 suggests that young men may have larger muscle volumes relative to a fixed compartment size, which reduces the amount of free space available for swelling after injury.…”

Section: Discussionsupporting

confidence: 64%

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Acute compartment syndrome of the thigh in a rugby player

2015

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SUMMARYIn the absence of obvious trauma, diagnosis of acute compartment syndrome (ACS) of the thigh can easily be delayed, as disproportional pain is not always present. We present a case of ACS of the anterior right thigh compartment in a healthy, semiprofessional rugby player with normal coagulation, who sustained a seemingly innocuous blow during a rugby match. Following early surgical fasciotomy, he returned to his preinjury playing standards within 12 months. Our literature review suggests that high muscle mass, young, athletic males participating in a contact sport are mostly at risk of developing ACS of the thigh. BACKGROUND

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Section: Discussionsupporting

confidence: 64%

“…While pain has been reported as a reliable indicator of ACS of the thigh in some circumstances,57 62 70 71 the pain may be less prominent because the femoral nerve is not entirely enclosed within the anterior compartment 41. Diminished pain can also be the result of underlying nerve damage 66 72.…”

Section: Discussionmentioning

confidence: 99%

Acute compartment syndrome of the thigh in a rugby player

2015

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“…Pain with passive stretch and rest pain are both usually present; however, pain can be absent in established or late-stage compartment syndrome. In addition, pain can be absent in the setting of central or peripheral nerve deficit or regional anesthesia [15].…”

Section: Clinical Diagnosismentioning

confidence: 99%

Acute compartment syndrome: obtaining diagnosis, providing treatment, and minimizing medicolegal risk

Taylor

Sullivan

Mehta

2012

Curr Rev Musculoskelet Med

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Acute compartment syndrome (ACS) is a surgical emergency. Diagnosis depends on a high clinical suspicion and an understanding of risk factors, pathophysiology and subtle physical exam findings. The typical high risk scenario for ACS is a male patient younger than 35 years of age, involved in a high energy sport or roadway collision, resulting in a tibial shaft fracture. He will go on to develop acute compartment syndrome of the leg in less than 10 hours and require emergent fasciotomy. Diagnosis of ACS in this patient is primarily a clinical one but can be confirmed with invasive intracompartmental pressure monitoring or noninvasive near infrared spectroscopy (NIRS). Delaying the diagnosis will likely result in some degree of permanent disability and places the surgeon at high risk for litigation. This article reviews the salient features of acute compartment syndrome that should be understood by all orthopaedic residents and surgeons.

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“…Assessment of the unconscious or sedated patient, unable to communicate their symptoms, is notoriously difficult. Recently, the phenomenon of 'silent compartment syndrome', where patients develop compartment syndrome in the absence of many or all of the recognised clinical symptoms and signs, is being increasingly described in the literature (Elliott and Johnstone, 2003;Badhe et al, 2009). These factors coupled with the devastating consequences of a missed compartment syndrome, in a predominantly young population, have led investigators to seek other, more objective means, of diagnosis.…”

Section: Current Means Of Diagnosismentioning

confidence: 99%

The diagnosis of acute lower limb compartment syndrome: Applications of near infrared spectroscopy

Barker

Midwinter²,

Porter

2011

Trauma

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Acute compartment syndrome of the lower limb is a significant problem in surgical practice, the successful management of which depends upon swift diagnosis and intervention. Conventionally, diagnosis has been based upon clinical assessment; however, this can be unreliable and the potential for missed compartment syndrome remains. The supplementary use of compartment pressure monitoring has addressed some of these issues, but it remains an invasive technique, the exact role of which is still debated in the literature. Near infrared spectroscopy (NIRS) is an emerging technique in medical practice which provides a non-invasive, continuous and real time measure of local tissue oxygenation. Early experimental work and subsequent clinical studies have demonstrated that NIRS provides an accurate means of detecting compartment syndrome, and that its sensitivity in some circumstances may exceed that of monitoring compartment pressures. Despite this promise, limitations of the technique, such as difficultly monitoring the deep posterior compartment of leg using current systems, and the relative expense of the equipment, have hindered broader adoption.

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The ‘silent’ compartment syndrome

Cited by 53 publications

References 19 publications

Acute compartment syndrome of the thigh in a rugby player

Acute compartment syndrome of the thigh in a rugby player

Acute compartment syndrome: obtaining diagnosis, providing treatment, and minimizing medicolegal risk

The diagnosis of acute lower limb compartment syndrome: Applications of near infrared spectroscopy

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