COMPARTM间室综合征.pptVIP

* AP and lateral views of a Tscherne type 2 tibial shaft fracture. Within approximately one hour of presentation, the patient’s skin began to blister. A blood filled blister. A clear blister. The patient was brought to the operating room for treatment of his tibial shaft fracture. On examination in the operating room, his leg felt tense and he had pain on passive stretch of the anterior compartment before being anesthetized. Compartment pressures were therefore measured in all four compartments. The area to be tested is cleaned with betadine. There are multiple devices made for this technique. This image shows one of them. It is important that when using the device it is held parallel with the floor so as not to adversely affect the measurement. This is also the case when using other techniques, such as arterial line measurement, where the transducer must be at the level of the examination. The syringe is filled with fluid… and then zeroed Measuring compartment pressures using a location relatively close to the fracture site has been demonstrated to give slightly more accurate (increased) readings. This is done whenever possible. The pressure in the anterior musculature is taken first. After introducing the needle through the fascia, the plunger is gently advanced to cause inflow of a small amount of fluid and the pressure is allowed to equilibrate. The patient had a diastolic pressure before induction of anesthesia of 74mm of mercury. Thus a compartment syndrome was diagnosed in the anterior compartment (74 - 66 = 8).