A case of sub-acute compartment syndrome of bilateral pectoralis major, deltoid and triceps muscles

2021 ◽  
pp. 175857322110435
Author(s):  
A Kalaskar ◽  
J Paniker ◽  
P Gavai
Keyword(s):  
Emergency Department ◽  
Compartment Syndrome ◽  
Surgical Decompression ◽  
Pectoralis Major ◽  
Acute Compartment Syndrome ◽  
Creatinine Kinase ◽  
Upper Limbs ◽  
Left Elbow ◽  
Full Flexion ◽  
Secondary Closure

A 19-year-old healthy bodybuilder presented to the emergency department with gradually worsening pain in both his upper arms and shoulders and inability to fully flex his elbows. The haematological investigations revealed a markedly raised Creatinine Kinase (74,400 U/L) and myoglobinuria. The patient required an emergency surgical decompression of the pectoral and the anterior and posterior compartments of arms of both upper limbs with secondary closure after 48 h. The patient had an uneventful post-op and recovery of his functions with some initial restriction of full flexion of his left elbow and some weakness in his triceps, all of which gradually improved.

scholarly journals The Pathophysiology, Diagnosis and Current Management of Acute Compartment Syndrome

2014 ◽  
Vol 8 (1) ◽  
pp. 185-193 ◽  
Author(s):  
James Donaldson ◽  
Behrooz Haddad ◽  
Wasim S Khan
Keyword(s):  
Compartment Syndrome ◽  
Tissue Perfusion ◽  
Surgical Decompression ◽  
Acute Compartment Syndrome ◽  
Definitive Treatment ◽  
Interstitial Pressure ◽  
Compartment Pressure ◽  
Current Management ◽  
Ischaemic Damage

Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. Resultant ischaemic damage may be irreversible within six hours and can result in long-term morbidity and even death. The diagnosis is largely clinical with the classical description of ‘pain out of proportion to the injury’. Compartment pressure monitors can be a helpful adjunct where the diagnosis is in doubt. Initial treatment is with the removal of any constricting dressings or casts, avoiding hypotension and optimizing tissue perfusion by keeping the limb at heart level. If symptoms persist, definitive treatment is necessary with timely surgical decompression of all the involved compartments. This article reviews the pathophysiology, diagnosis and current management of ACS.

scholarly journals Acute upper limb compartment syndrome in children: special focus on nerve recovery

2020 ◽  
Vol 3 (3) ◽  
pp. e000158
Author(s):  
Terrence Jose Jerome
Keyword(s):  
Compartment Syndrome ◽  
Upper Limb ◽  
Full Range ◽  
Nerve Fibers ◽  
Surgical Decompression ◽  
Acute Compartment Syndrome ◽  
Time Interval ◽  
Special Focus ◽  
Sensory Recovery

BackgroundMany studies have discussed acute compartment syndrome in children associated with or without fractures and have given their visible perspectives. Little is known about the nerve involvement and the factors associated with recovery patterns in these patients. We intend to propose that ischemic nerve and muscles tend to regenerate after surgical decompression but in a different pattern and the given circumstances.MethodsTwenty-four children with acute compartment syndrome in the upper limb were analyzed between 2009 and 2015. Data included demographic features of these patients, the time interval between the injury and surgery, and the attempt to correlate with motor and sensory recovery.ResultsThe average follow-up was 67.3 months (range 59–80). Of the 24, 14 patients (58%) had immediate recovery of motor and sensory functions. The remaining 10 patients had variable recovery patterns with a mean time for the radial nerve, median nerve and ulnar nerve motor recovery of 6.0, 7.5 and 8.5 months, respectively, and sensory recovery at 12, 12 and 13 months, respectively. The overall study had a mean sensory recovery as per the Medical Research Council (MRC) of S3 in 3 (12%) and S4 in 21 (88%). The mean 2-point discrimination (2PD) was 6.9 mm (range 5–10). Twenty-one patients (88%) had a full range of movements at their final follow-up with a mean Visual Analog Scale score of 0.6; a quick Disabilities of the Arm, Shoulder and Hand score of 5.9 (range 2.3–25.0) and a Mayo wrist score of 79.ConclusionsThere was a definite motor and sensory recovery in patients who underwent surgical decompression in acute compartment syndrome of the upper limb irrespective of age, gender, delay in presentation and various etiologies. The motor and nerve fibers can regenerate after ischemic sequela of compartment syndrome.

Acute Compartment Syndrome of the Forearm Secondary to Hematoma after Playing Golf

2019 ◽  
Vol 24 (01) ◽  
pp. 93-95
Author(s):  
Gen Nakamura ◽  
Muneaki Abe ◽  
Hozumi Kumano
Keyword(s):  
Magnetic Resonance Imaging ◽  
Emergency Department ◽  
Magnetic Resonance ◽  
Compartment Syndrome ◽  
Severe Pain ◽  
Acute Compartment Syndrome ◽  
Left Forearm ◽  
Resonance Imaging ◽  
Compartment Pressure ◽  
Direct Trauma

Acute compartment syndrome of the forearm secondary to hematoma without direct trauma has been reported rarely. We report a case of acute compartment syndrome of the forearm following a hematoma after playing golf. A 55-year-old man felt pain in his left forearm while playing golf that gradually worsened. He could not continue to play and visited the emergency department of our hospital. The radial side of his left forearm was markedly swollen on presentation, and he suffered severe pain that worsened with ulnar flexion of the wrist; no paralysis or hypesthesia was observed. A hematoma in the brachioradialis was seen on magnetic resonance imaging, and radial compartment pressure was 120 mmHg. A diagnosis of acute compartment syndrome was made, and urgent fasciotomy was performed. The patient recovered with no dysfunction of the arm.

scholarly journals Acute Compartment Syndrome After Isolated Soleus Tear in an Elderly Recreational Athlete

2021 ◽  
Vol 12 ◽  
pp. 215145932110362
Author(s):  
Conor N. O’Neill ◽  
Parker H. Johnsen ◽  
James T. Stefanski ◽  
Clarence Brian Toney
Keyword(s):  
Emergency Department ◽  
Clinical Outcome ◽  
Compartment Syndrome ◽  
Medical History ◽  
Soleus Muscle ◽  
Acute Compartment Syndrome ◽  
Leg Pain ◽  
Good Clinical Outcome ◽  
Muscle Tear ◽  
Compartment Pressures

Case: A 62-year-old man without significant medical history (no anticoagulation) presented to the emergency department with intense leg pain following a short track race, during which he felt a pop in his calf. His physical exam was highly concerning for acute compartment syndrome (ACS) despite the lack of a typical mechanism or fracture. Compartment pressures were measured and found to be significantly elevated. He underwent compartment releases revealing a medial soleus tear with 400–500 cc hematoma. Conclusion: The case presents a patient with ACS after a soleus muscle tear. Prompt recognition and fasciotomy led to a good clinical outcome. Physicians should recognize that not only gastrocnemius tears can lead to compartment syndrome.

Sequential spontaneous compartment syndrome in multiple limbs in a young adult with GYG1 gene mutation

2020 ◽  
Vol 13 (11) ◽  
pp. e236226
Author(s):  
Vinay Mathew Joseph ◽  
Mathias Thomas Nagy ◽  
Sohail Akhtar ◽  
Chye Yew Ng
Keyword(s):  
Young Adult ◽  
Compartment Syndrome ◽  
Gene Mutation ◽  
Genetic Predisposition ◽  
Surgical Decompression ◽  
Acute Compartment Syndrome ◽  
Medical Assessment ◽  
Compartment Syndromes ◽  
Alternative Diagnosis ◽  
Muscle Energy

Compartment syndrome is a surgical emergency requiring immediate intervention. Majority of compartment syndromes are associated with trauma or surgery. Spontaneous compartment syndrome in multiple limbs is rare and alternative diagnosis should be sought. We report a young adult man who developed compartment syndrome in all four limbs sequentially over 4 years. On further evaluation, he was found to have a gene mutation in exon 3 of GYG1 gene. Spontaneous compartment syndrome in patients with GYG1 gene mutation does not appear to have been previously recognised. Although a direct causality cannot be confidently drawn, this gene is involved in muscle energy utilisation and is known to cause metabolic defect. Acute compartment syndrome, once diagnosed, warrants emergency surgical decompression. The subsequent management of spontaneous compartment syndrome demands a thorough medical assessment to identify any underlying metabolic or genetic predisposition.

Acute Compartment Syndrome of the Thigh in Combat Casualties

2013 ◽  
Vol 22 (01) ◽  
pp. 42-49 ◽  
Author(s):  
Brendan D. Masini ◽  
Adam W. Racusin ◽  
Joseph C. Wenke ◽  
Tad L. Gerlinger ◽  
Joseph R. Hsu
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Combat Casualties

scholarly journals Does the shoe-lace technique aid direct closure of fasciotomy wounds after acute compartment syndrome of the lower leg? a retrospective case-control study

2021 ◽  
pp. 145749692110196
Author(s):  
P. Suomalainen ◽  
T.-K. Pakarinen ◽  
I. Pajamäki ◽  
M. K. Laitinen ◽  
H.-J. Laine ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Lower Leg ◽  
Conventional Technique ◽  
Tibia Fracture ◽  
Acute Compartment Syndrome ◽  
Retrospective Case ◽  
Direct Closure ◽  
Patient Database

Background & aim: Tibia fractures are relatively common injuries that are accompanied with acute compartment syndrome in approximately 2% to 20% of cases. Although the shoe-lace technique, where vessel loops are threaded in a crisscross fashion and tightened daily, has been widely used, no studies have compared the shoe-lace technique with the conventional one. The aim of this study was to compare the shoe-lace technique with the conventional technique. Materials and Methods: We identified 359 consecutive patients with intramedullary nailed tibia fracture and complete medical records including outpatient data between April 2007 and April 2015 from electronic patient database of our institute. The use of the shoe-lace technique was compared to conventional one (in which wounds were first left open with moist dressings). Main outcome measurement is direct closure of fasciotomy wounds. Results: From 359 consecutive patients with intramedullary nailed tibia fracture, fasciotomy was performed on 68 (19%) patients. Of these, the shoe-lace technique was used in 47 (69%) patients while in 21 (31%) patients, the shoe-lace technique was not applied. Side-to-side approximation was successful in 36 patients (77%) in the shoe-lace+ group and 7 patients (33%) in the shoe-lace– group (p = 0.002). Conclusion: The main finding of our comparative study was that the shoe-lace technique seems to ease direct closure of lower leg fasciotomy wounds, and thus reduces the frequency of free skin grafts. Our finding needs to be confirmed in a high-quality randomized controlled trial.

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