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Compartment Syndrome of the Extremities: Pitfalls in Diagnosis and Management

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Compartment Syndrome

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Acute compartment syndrome of the extremities can occur in every muscular region of upper or lower limbs; it can be either traumatic or nontraumatic. The raise in intracompartmental pressure, secondary to congestion of microcirculation with extravasation of fluid in the interstitial space, produces ischemia to the whole content of the compartment (muscles, nerves, vessels). The initial signs and symptoms (severe pain, paresthesia, swollen and hard at palpation muscles) should be promptly detected; a measured pressure greater than 30 mmHg is thought to be a sensitive indicator for the diagnosis of acute compartment syndrome. Once the diagnosis is suspected and established, decompressive fasciotomy is mandated of all the compartments involved. Lower leg and forearm are the most frequently involved regions in acute compartment syndrome; late decompression more than 8 h after onset of symptoms is associated with adverse long-term outcomes.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Ospedale M. Bufalini, Cesena, FC, Italy

    Luigi Branca Vergano & Philip F. Stahel

  2. Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Luigi Branca Vergano & Philip F. Stahel

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  1. Luigi Branca Vergano
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  2. Philip F. Stahel
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Editors and Affiliations

  1. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. Intensive Care Unit, Ziekenhuisnetwerk Antwerpen Stuivenberg, Antwerpen, Belgium

    Manu L.N.G. Malbrain

  3. Regional Trauma Services, Foothills Medical Centre, Calgary, AB, Canada

    Andrew W Kirkpatrick

  4. Chief Physician in Intensive Care Unit and Trauma Management in Level-1 Trauma Center, “M. Bufalini” Hospital, CESENA, Forli/Cesana, Italy

    Emiliano Gamberini

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Branca Vergano, L., Stahel, P.F. (2021). Compartment Syndrome of the Extremities: Pitfalls in Diagnosis and Management. In: Coccolini, F., Malbrain, M.L., Kirkpatrick, A.W., Gamberini, E. (eds) Compartment Syndrome. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-55378-4_8

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