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Compartment Syndrome and Orthopedic Surgery: Diagnosis and Management

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Perioperative Care of the Orthopedic Patient

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Abstract

Compartment syndrome is defined as an elevation of intracompartmental pressure to a level that impairs arterial flow. Compartment syndrome of the upper and lower extremities can have multiple etiologies, including traumatic, exertional, and iatrogenic in the peri-operative setting. Early identification and diagnosis enabling prompt intervention is essential to providing patients the best possible outcomes. In cases of acute compartment syndrome, emergent fasciotomy is generally indicated. Delayed fasciotomies more than 24 h after onset of symptoms is not recommended as it increases morbidity and mortality, however it is often difficult to establish a time zero for onset or irreversibility. Even with timely treatment, multiple surgeries are often necessary to ensure adequate wound debridement, appropriate soft tissue coverage and satisfactory wound closure. Long-term sequelae range from cosmetic concerns secondary to wound complications, the use of skin grafts, limb deformity, amputation, or systemic complications associated with rhabdomyolysis.

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Author information

Authors and Affiliations

  1. Department of Orthopaedics, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA

    Matthew R. Garner & John P. Lyden

  2. Department of Sports Medicine, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA

    Samuel A. Taylor

  3. Department of Orthopaedics, Harborview Medical Center, 722 10th Avenue East, Apartment 2, Seattle, WA, 98102, USA

    Milton T. M. Little

Authors
  1. Matthew R. Garner
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  2. Samuel A. Taylor
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  3. Milton T. M. Little
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  4. John P. Lyden
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Corresponding author

Correspondence to John P. Lyden .

Editor information

Editors and Affiliations

  1. Department of Medicine, Hospital for Special Surgery, New York, New York, USA

    C. Ronald MacKenzie

  2. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA

    Charles N. Cornell

  3. Department of Anesthesiology, Hospital for Special Surgery, New York, New York, USA

    Stavros G. Memtsoudis

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Garner, M.R., Taylor, S.A., Little, M.T.M., Lyden, J.P. (2014). Compartment Syndrome and Orthopedic Surgery: Diagnosis and Management. In: MacKenzie, C., Cornell, C., Memtsoudis, S. (eds) Perioperative Care of the Orthopedic Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0100-1_24

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  • DOI: https://doi.org/10.1007/978-1-4614-0100-1_24

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