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Compartment syndrome

On the human body, the limbs can be divide into segments, such as the arm and the forearm of the upper limb, and the thigh and the leg of the lower limb. more...

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If these segments are cut transversely, it is apparent that they are divided into multiple sections. These are called fascial compartments, and are formed by tough connective tissue septa.

These compartments usually have a separate nerve and blood supply to their neighbours. The muscles in each compartment will often all be supplied by the same nerve.

Compartment syndrome

Knowledge of these compartments not only simplifies the learning of innervation, it is also important in situations where pressure can build up in one compartment and potentially damage the contents.

This problem is called compartment syndrome and can happen acutely (sometimes caused by a fracture) or gradually, as with an athlete's overuse of a muscle.

Because the connective tissue that defines the compartment does not stretch, a small amount of bleeding into the compartment, or swelling of the muscles within the compartment can cause the pressure to rise greatly. Increased pressure within the compartment compresses the nerves, and also decreases blood perfusion. The pressure in the capillaries is approximately 30mm Hg. If the pressure in the compartment rises above this level the blood supply to the muscles can be completely cut off leading to death of the tissue in the compartment. This is a medical emergency requiring immediate treatment by fasciotomy to allow the pressure to return to normal. Because the pressure in the large blood vessels of the limbs is much greater than the compartment pressure required to cause death of the tissue, a patient whose muscles are dying from compartment syndrome, and who is in danger of losing their limb will usually have intact pulses. Severe pain is the most common symptom of acute compartment syndrome.

When compartment syndrome is caused by from repetitive heavy use of the muscles, as in a runner, it is known as chronic compartment syndrome (CCS). This is usually not an emergency, but the loss of circulation can cause temporary or permanent damage to nearby nerves and muscle.

While CCS was first identified in the 1980s, it has been increasingly recognized as a significant source of chronic leg pain. A common indicator of the condition is muscle fatigue and pain in the calf region after sustained physical exercise (such as running). Once the exercise is stopped, the pain gradually disappears.

CCS can be tested for using by gauging the pressure within the muscle compartments. If the pressure is sufficiently high, a fasciotomy may be required.

Fascial compartments of the body

The thigh is usually divided into three compartments:

  • Anterior - supplied by the femoral nerve, contains the knee extensors and hip flexors.
  • Medial - supplied by the obturator nerve, contains the hip adductors.
  • Posterior - supplied by the sciatic nerve, contains the knee flexors and hip extensors.

The (lower) leg is divided into three compartments also:

Read more at Wikipedia.org


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Compartment Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References $34.95 Abdominal compartment syndrome. : An article from: Journal of Trauma Nursing $5.95
Acute Extremity Compartment Syndrome. : An article from: Journal of Trauma Nursing $5.95 Intra-Abdominal Hypertension and Abdominal Compartment Syndrome.(Brief Article) : An article from: Journal of Trauma Nursing $5.95
Compartment Syndromes and Volkmann's Contracture (Saunders Monographs in Clinical Orthopedics, Vol 3) $224.99 Abdominal compartment syndrome.(Review Article) : An article from: Indian Journal of Critical Care Medicine $5.95
Compartment Syndrome of the Leg after Less Than 4 Hours of Elevation on a Fracture Table. : An article from: Southern Medical Journal $5.95 Compartment Syndromes: Diagnosis, Treatment, and Complications $128.72
The Acute Compartment Syndrome, a Complication of Fractures and Soft Tissue Injuries of the Extremities: A Clinical Study About Diagnosis and Treatment of the Compartment Syndrome (Acta Biomedica Lovaniensia 199) $285.00 Chronic Abdominal Compartment Syndrome.(Brief Article)(Statistical Data Included) : An article from: Family Practice News $5.95

Chronic compartment syndrome: tips on recognizing and treating: the patient's history offers more important clues than physical exam
Practice recommendations * A patient's description of symptoms and pattern of occurrence is the most reliable clinical guide. Confirm suspicion of ...
Pathophysiology and management of abdominal compartment syndrome
Abdominal compartment syndrome is a potentially lethal condition caused by any event that produces intra-abdominal hypertension; the most common cause ...
Compartment syndrome and systemic hypertension
We present two rare variations related to compartment syndrome. The first is a 69-year-old hypertensive man with compartment syndrome of the arm. The second is a 58-year-old man with compartment synd
A spontaneous compartment syndrome in a patient with diabetes
A compartment syndrome is an orthopaedic emergency which can result from a variety of causes, the most common being trauma. Rarely, it can develop spontaneously ...
Oral vitamin C reduces the injury to skeletal muscle caused by compartment syndrome
Compartment syndrome is a unique form of ischaemia of skeletal muscle which occurs despite patency of the large vessels. Decompression allows the influx ...
How to recognize and manage ABDOMINAL COMPARTMENT SYNDROME
Although rare, the expansion of abdominal contents can be fatal. Here's how to recognize warning signs and respond appropriately. ABDOMINAL COMPARTMENT ...
How to recognize and manage ABDOMINAL COMPARTMENT SYNDROME
Although rare, the expansion of abdominal contents can be fatal. Here's how to recognize warning signs and respond appropriately. ABDOMINAL COMPARTMENT ...
SURGICAL TREATMENT OF COMPARTMENT SYNDROME OF THE LEG COMPLICATED BY MUSCLE NECROSIS AFTER APONEUROTOMY
Purpose: Compartment syndrome of the leg is an exceptional (0.8% of leg fractures) hut serious complication with a risk of muscle necrosis. The purpose ...

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