Summary
Early diagnosis of compartmental syndromes after trauma and surgery can be made from clinical symptoms and signs in most cases. These include burning, deep-seated pain, weakness and pain on passive stretch of the compartment muscles, hypoethesia in the area of peripheral nerves, swelling and tense fascial boundaries. Clinical examination -should be performed at frequent intervals, with the limb free from all dressings and placed At heart level. In high risk cases with severe soft tissue trauma, multiple trauma or ventilator treatment, intracompartmental pressure is measured by methods of Whitesides or Matsen, which indicate fasciotomy at pressures above 40 mm Hg. From 1975 to 1982, 96 compartmental syndromes were treated, with early diagnosis in 71.
Zusammenfassung
Leitsymptome des Kompartment-Syndroms sind brennend-bohrender Schmerz, Sensibilitätsstörung, Muskelschwäche, passiver Muskeldehnungsschmerz, erhöhter Muskeldruck bei Palpation der Muskelloge, intakte Makrozirkulation und geringer Lokalbefund. Diagnosesicherung: Wiederholte klinische Untersuchung der Extremität ohne Verbände oder Gips, Anstieg des subfascialen Gewebedrucks (0–5 mm Hg) auf Druckwerte über 40 mm Hg. Druckmessung vor allem bei bewußtlosen, beatmeten, nicht kooperativen Patienten sowie zur DD. gegenüber Nervenlähmung, Sudeck, Infektion, Entzündung. Erhöhtes Risiko: direktes Weichteiltrauma, Gefäßverletzung, gelenknahe Frakturen und Reposition im Gipsverband, Tibiaschaftfrakturen. Von 1975–1982 wurden 96 Kompartment-Syndrome diagnostiziert: 71 im Akutstadium, 25 im Spätstadium ischämiebedingter Defekte.
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Schmit-Neuerburg, K.P. 34. Diagnose und Differentialdiagnose des Kompartment-Syndroms. Langenbecks Arch Chiv 358, 221–226 (1982). https://doi.org/10.1007/BF01271786
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DOI: https://doi.org/10.1007/BF01271786