Compartment Syndrome: Diagnosis, Management, and Unique Concerns in the Twenty-First Century

HSS Journal - Tập 10 Số 2 - Trang 143-152 - 2014
Matthew R. Garner1, Samuel A. Taylor2, Elizabeth B. Gausden2, John P. Lyden2
1Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
2Hospital for Special Surgery, New York, USA

Tóm tắt

Background Compartment syndrome is an elevation of intracompartmental pressure to a level that impairs circulation. While the most common etiology is trauma, other less common etiologies such as burns, emboli, and iatrogenic injuries can be equally troublesome and challenging to diagnose. The sequelae of a delayed diagnosis of compartment syndrome may be devastating. All care providers must understand the etiologies, high-risk situation, and the urgency of intervention. Questions/Purposes This study was conducted to perform a comprehensive review of compartment syndrome discussing etiologies, risk stratification, clinical progression, noninvasive and invasive monitoring, documentation, medical-legal implication, and our step-by-step approach to compartment syndrome prevention, detection, and early intervention. Methods A literature search was performed using the PubMed Database and the following search terms: “Compartment syndrome AND Extremity,” “Compartment syndrome AND Gluteal,” and Compartment syndrome AND Paraspinal.” A total of 2,068 articles were identified. Filters allowed for the exclusion of studies not printed in English (359) and those focusing on exertional compartment syndrome (84), leaving a total of 1,625 articles available for review. Results The literature provides details regarding the etiologies, risk stratification, clinical progression, noninvasive and invasive monitoring, documentation, medical-legal implication, and our step-by-step approach to compartment syndrome prevention, detection, and early intervention. The development and progression of compartment syndrome is multifactorial, and as complexity of care increases, the opportunity for the syndrome to be missed is increased. Recent changes in the structure of in-hospital medical care including resident work hour restrictions and the incorporation of midlevel providers have increased the frequency of “signouts” or “patient handoffs” which present opportunities for the syndrome to be mismanaged. Conclusion The changing dynamics of the health care team have prompted the need for a more explicit algorithm for managing patients at risk for compartment syndrome to ensure appropriate conveyance of information among team members.

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Tài liệu tham khảo

10.1097/00003086-199404000-00037

Beerle BJ, 1993, Reg Anesth, 3, 189

10.2106/00004623-200404000-00029

Carlson DA, 1995, Clin Orthop Relat Res, 320, 115

10.2106/00004623-200409000-00025

10.1111/j.1526-4637.2011.01109.x

10.1016/S0303-8467(89)80006-X

10.2106/JBJS.D.03044

10.5435/JAAOS-21-11-657

10.1097/00005373-199603000-00002

10.1093/bja/aem373

10.1177/107110070302400214

10.1302/0301-620X.88B3.16919

10.1016/S0363-5023(79)80160-4

10.2106/00004623-199409000-00002

Henson JT, 2009, Acta Orthop Belg, 2, 147

10.1097/00005131-200404000-00005

10.1302/0301-620X.78B3.0780499

10.1016/S0020-1383(01)00005-5

10.1177/0310057X9702500619

10.1177/230949900701500126

10.1016/j.arth.2011.06.028

10.2174/1874325001105010181

10.1093/bja/aen330

10.3113/JSOA.2013.0042

10.1097/00005373-199407000-00010

10.1097/00005131-200111000-00011

Matsen FA, 1976, Surgery, 6, 702

10.1097/00006534-198269010-00013

10.1097/00003086-198411000-00031

McQueen MM. Acute compartment syndrome. In: Fractures in Adults. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2010:689.

10.1302/0301-620X.82B2 .9799

10.1097/00003086-199305000-00018

10.1097/00003086-199110000-00033

10.1097/00005131-200011000-00006

Ojike NI, 2009, Acta Orthop Belg, 5, 573

Ovre S, 1998, Arch Orthop Trauma Surg, 1, 29

10.1302/0301-620X.83B5.11763

10.1097/BRS.0b013e3181ec4023

10.1097/01.ta.0000215444.05928.2f

10.2106/00004623-198668030-00015

10.1097/TA.0b013e3181607750

10.1001/archsurg.1981.01380230088014

10.1097/BOT.0b013e3181f18ad8

10.2106/00004623-197658010-00020

10.2106/JBJS.I.00411

10.2106/JBJS.I.00411

10.1097/00005131-199701000-00006

10.1111/j.1399-6576.1996.tb05556.x

10.1016/j.otsr.2009.03.014

10.1016/0072-968X(76)90045-0

10.1097/00003086-197511000-00007

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HSS Journal

Tập 10 Số 2

143-152

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