Compartment Syndrome Resulting From Tibial Fracture

Description: compartment syndrome following tibia fractures are most common in closed frx (upto 20% of frx) but may also occur following open frx; - cast immobilization may increase pressure; - it remains unclear whether IM nailing will increase or decrease compartment pressures, but on occassion the surgeon may find a significant decrease in pressure measurements following nailing; - references: - Compartment syndrome in open tibial fractures. - Compartment syndrome after intramedullary nailing of the tibia. - compartment pressures measurements: - most common finding is isolated elevation in the deep posterior compartment followed by isolated elevation in the anterior compartment; - be sure to measure pressure in the deep posterior compartment as well as anterior & superficial compartments; - associated factors: - cast immobilization may increase pressure; - intramedullary nailing: - it remains unclear whether IM nailing will increase or decrease compartment pressures, but on occassion the surgeon may find a significant decrease in pressure measurements following nailing; - compartment pressures measurements: - most common finding is isolated elevation in the deep posterior compartment followed by isolated elevation in the anterior compartment; - be sure to measure pressure in the deep posterior compartment as well as anterior & superficial compartments; - compartment pressure measurements should be taken as close to the frx site as possible (since these will give the highest readings); - peak compartment pressures will be located within 5 cm of frx; - measurements away from the frx site may underestimate compartment pressure; - sterile technique is a must when compartments are measured, otherwise the frx hematoma may become infected;