Which of the following statements regarding compartment syndromes following orthopedic injuries is true?
|A||The first sign is usually loss of pulse in the extremity|
|B||Passive flexion of the extremity proximal to the involved compartment will aggravate the pain|
|C||Surgical decompression (fasciectomy) is necessary only as a last resort|
|D||These syndromes are most commonly associated with supracondylar fractures of the humerus and tibial shaft|
|E||The syndrome is often painless|
These syndromes are most commonly associated with supracondylar fractures of the humerus and tibial shaft
a. Compartment syndromes result from increasing pressures in the fascial compartments of the arm or leg.
b. When the pressure in the muscles is greater than that of the capillaries, ischemia and necrosis of the muscles occur even though the arterial pressure is still high enough to produce pulses; pulselessness is an unreliable sign.
c. Extreme pain (out of proportion to the injury), pain on passive extension of the fingers or toes, pallor of the extremity, motor paralysis, and paresthesias are all components of the syndrome.
d. The patient will usually hold the injured part in a position of flexion to maximally relax the fascia and reduce the pain; passive extension will usually produce severe pain.
e. The diagnosis can be confirmed by measuring intracompartmental pressures, but whenever physical findings or symptoms are suspicious, immediate surgical decompression by fasciectomy is indicated since delay is likely to lead to irreversible damage.