eMedicine Specialties > Emergency Medicine > Trauma & Orthopedics

Compartment Syndrome, Extremity: Follow-up

Author: Richard Paula, MD, Director of Research, Assistant Professor of Emergency Medicine, University of South Florida
Contributor Information and Disclosures

Updated: Dec 10, 2008

Follow-up

Transfer

  • Transfer if CS is suspected and any of the following are present:
    • Severe or multiple limb involvement that requires intensive care facilities
    • Inadequate surgical coverage
    • Inability to accurately diagnose CS because of lack of equipment or diagnostic imaging

Complications

Complications of compartment syndrome may include the following:

  • Permanent nerve damage
  • Infection
  • Loss of limb
  • Death
  • Cosmetic deformity from fasciotomy

Prognosis

  • The prognosis is excellent to poor, depending on how quickly CS is treated and whether complications develop.

Patient Education

  • Include the following discharge instructions for patients with injuries that predispose them to CS:
    • Timely follow-up examination with appropriate physician is necessary.
    • Immediately call or return to the hospital if severe pain, numbness, burning sensation, or weakness in the affected extremity develops.

Miscellaneous

Medicolegal Pitfalls

  • Failure to measure compartment pressures
    • In 1993, Templeman reported an average litigation award of $280,000 for 8 cases of missed CS.
    • In all 8 cases, compartment pressures were never measured.
  • Failure to investigate rhabdomyolysis if suspected.
  • Failure to consider potential errors in compartment pressure measurements
    • Equipment errors occur, and needles are misplaced into tendons, fascia, or a wrong compartment.
    • Interpret all pressure readings within the context of the clinical presentation.
 


More on Compartment Syndrome, Extremity

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References
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References

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Further Reading

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Keywords

compartment syndrome extremity, CS, compartmental syndrome, Volkmann contracture, Volkmann's contracture, intracompartmental pressure, extremity pain, perfusion pressure, capillary perfusion pressure, CPP, venous pressure, long bone fractures, vascular injury, ischemic injury, fasciotomy, paraesthesia, limb pain, high-energy trauma, penetrating injuries, venous injury, crush injuries, tetany, vigorous exercise, seizures, stationary bicycle use, horseback riding, burns, intraarterial injection, envenomation, decreased serum osmolarity, nephrotic syndrome, infiltrated infusion, hemorrhage, military antishock trousers, MAST

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Contributor Information and Disclosures

Author

Richard Paula, MD, Director of Research, Assistant Professor of Emergency Medicine, University of South Florida
Richard Paula, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

William K Chiang, MD, Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center
William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eric L Legome, MD, Chair, Department of Emergency Medicine, St Vincent's Hospital Manhattan; Associate Professor, Department of Emergency Medicine, New York Medical College
Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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