Mr. Sharma, 55-yrs-old man with recent onset of atrial fibrillation presents with a cold, pulseless of left lower extremity. He complains of left leg paresthesia and is unable to dorsiflex his toes. Following a successful popliteal embolectomy, with restoration of palpable pedal pulses, the patient is still unable to dorsiflex his toes. The next step in management should be
|B||Measurement of anterior compartment pressure|
|C||Elevation of the left leg|
a. Myoglobinuria may persist for 2 to 4 days after reperfusion.
b. Acute renal failure may ensue from myoglobin casts developing in the renal tubules as well as direct toxic effects of the myoglobin on the tubules.
c. Serum creatine phosphokinase levels may increase dramatically (to >10,000 units) after reperfusion of ischemic muscle.
d. Myocardial contractility may become depressed; increased cardiac irritability in the setting of electrolyte disturbances (typically hyperkalemiA. may lead to life-threatening dysrhythmias.
f. The treatment for developing compartment syndrome is immediate fasciotomy and release of the compartment pressure.