At what pressure is operative decompression of a compartment mandatory?
a. Compartment syndrome is a serious condition that involves increased pressure in a muscle compartment. It can lead to muscle and nerve damage and problems with blood flow.
b. The hallmark symptom of compartment syndrome is severe pain that does not go away when you take pain medicine or raise the affected area. In more severe cases, symptoms may include: Decreased sensation ,Paleness of skin ,Severe pain that gets worse, Weakness
c. Signs are :
i. Pain when the compartment is squeezed;
ii. Severe pain when you move the affected area (for example, a person with compartment syndrome in the foot or lower leg will experience severe pain when moving the toes up and down);Swollen and shiny skin.
d. A compatible history, firmness of the compartment to palpation, and diminished mobility of the joint are suggestive. The presence or absence of a pulse distal to the effected compartment is notoriously unreliable in the diagnosis of a compartment syndrome.
e. However, it can be tested for by gauging the pressure within the muscle compartments.
f. If the pressure is sufficiently high, a fasciotomy will be required to relieve the pressure.
g. Pressure greater than 45 mmHg must need operative intervention. Patient with pressure between 30 and 45 mmHg should be carefully evaluated & closely watched.
h. Complications include permanent injury to nerves and muscles that can dramatically impair function. ( Volkmann's ischemia)