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Compartment Syndrome

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Management of Musculoskeletal Injuries in the Trauma Patient

Abstract

Compartment syndrome (CS) is one of the true surgical emergencies in orthopaedic trauma, and the sequelae of a missed diagnosis can have serious implications. The development of a CS begins at the microvascular level with disruption of the homeostatic environment between venous pressure, arterial flow, and intracompartmental tissue pressure. While the pathophysiology has been previously described in the literature, there remain diagnostic challenges and some question regarding the clinical utility and reliability of clinical symptoms and the physical exam—particularly in the compromised, obtunded, or pediatric patient. Early and complete fasciotomy has been shown to decrease the rates of adverse complications, however is not without some morbidity. Some of the challenges and newer diagnostic modalities in the identification of CS are reviewed as well as different fasciotomy techniques and other important concepts in the pathophysiology, outcomes, and medicolegal implications of this condition.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Icahn School of Medicine at Mt. Sinai Hospital, 5 E. 98th St., 9th Floor, New York, NY, 10029, USA

    David A. Forsh MD

  2. Department of Orthopaedic Surgery, University of California – Davis Medical Center, Sacramento, CA, USA

    Philip R. Wolinsky MD

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  1. David A. Forsh MD
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  2. Philip R. Wolinsky MD
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Correspondence to David A. Forsh MD .

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Editors and Affiliations

  1. Department of Orthopaedics, Swedish Medical Center, Englewood, Colorado, USA

    Wade R. Smith

  2. Department of Orthopedics, Denver Health Medical Center, Denver, Colorado, USA

    Philip F. Stahel

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Forsh, D.A., Wolinsky, P.R. (2014). Compartment Syndrome. In: Smith, W., Stahel, P. (eds) Management of Musculoskeletal Injuries in the Trauma Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8551-3_10

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  • DOI: https://doi.org/10.1007/978-1-4614-8551-3_10

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