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Forearm compartment syndrome treatment8/24/2023 Depending on the length of time between injury and presentation to the emergency room, the patient may be complaining of one or more of the "5 P's". Arterial injuries, for example a partial laceration of the ulnar artery that do not retract and clot and cause severe swelling.Ī typical patient is often a young male who has sustained a high energy injury which frequently is an open injury.Nerve injuries - The median nerve can be injured or entrapped during distal radius fractures and create pain levels consistent with a compartment syndrome.Hematomas especially in patients on anticoagulants.Distal radius fractures in adults, 1% of distal radial fractures have associated compartment syndromes.In addition, the ECU muscle and/or the EPL muscle sometimes have separate myofascial compartements. Dorsal compartment - This compartment also has a superficial and deep layer.3 Within the deep layer the pronator quadratus may have a separate compartment that requires a surgical release of the epimysial fascia. This compartment has a superficial and deep layer. Volar Compartment - This compartment is the most commonly affected.However, prompt recognition and treatment of compartment syndrome is essential for preserving upper extremity function. After injury, it can take 12-16 hours before the signs of a compartment syndrome are evident. Depending on the duration of the microvascular circulatory disruption and the pressure levels reached, the tissue ischemia, cell death and functional loss can be mild or very severe. The longer the compartment pressure is elevated the greater the tissue damage and necrosis. The greater the initial soft tissue injury, the greater the intracompartmental pressure. Compartment syndrome occurs when edema associated with an insult or injury increases interstitial pressure in a closed fascial compartment, which in turn, disrupts normal microvascular circulation. Compartment syndrome in the upper volar forearm is the most common compartment syndrome.
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