Medline ® Abstracts for References 2,26-28

In this review the aetiology, clinical signs, diagnosis and therapy of the acute compartment syndrome of the limb is discussed. It is a limb- and untreated life threatening emergency. For good results, early detection is necessary. It is important to educate those taking care of patients of risk, especially in the early symptoms and signs. In uncooperative, unconscious and sedated patients pressure monitoring is recommended. The critical level of the absolute intracompartmental pressure is unclear. It is recommended to use a delta p pressure of 30 mm Hg. Below this pressure in the presence of clinical signs a fasciotomy of all compartments is the treatment of choice.

Acute compartment syndrome of an extremity poses a threat to both life and limb. The usual cause in children is trauma, especially fractures and burns. Two recent cases of nontraumatic compartment syndrome of the extremities in children are presented, both owing to infection followed by myositis or fasciitis. Both cases required urgent decompression by fasciotomy, resulting in limb salvage and full recovery of neuromuscular function of the extremity. The value of prompt recognition and treatment of this condition is emphasized.

Acute spontaneous compartment syndrome is a rare orthopaedic emergency that usually presents to general physicians as an acute medical admission. Most cases reported to date, in patients with diabetes, are in those with long-standing disease or with evidence of diabetic complications. An acute spontaneous compartment syndrome in a girl with recent diagnosis of type 1 diabetes is reported here. Awareness of the condition allows early recognition and diagnosis, thereby preventing more severe muscle necrosis and disability.