Osteofascial compartment syndrome, know these symptoms early

The most common sites of compartment syndrome are the lower leg and the palmar forearm. Traumatic fracture is the main cause of this disease. Symptoms of ischemic muscle contracture and gangrene will appear. Timely treatment is required to avoid shock and renal failure.

1. Symptoms

It is often caused by hematoma and tissue edema caused by traumatic fracture, which increases the volume of the contents in the compartment, or by over-tight external bandage, which causes local compression and reduces the volume of the osteofascial compartment, leading to increased pressure within the osteofascial compartment. When the pressure reaches a certain level [8.7 kPa (65 mmHg) for the forearm and 7.3 kPa (55 mmHg) for the calf], the arterioles supplying the muscles will be closed, forming a vicious cycle of ischemia-edema-ischemia. Depending on the degree of ischemia,

1. On the verge of ischemic muscle contracture---In the early stage of ischemia, if blood supply is restored in time, no or only a very small amount of muscle necrosis may occur, and limb function may not be affected.

2. Ischemic muscle contracture - incomplete ischemia of a shorter duration or more severe degree. After the blood supply is restored, most of the muscles will be necrotic, forming a contracture deformity, which seriously affects the function of the affected limb.

3. Gangrene: extensive, prolonged and complete ischemia, massive muscle gangrene, often requiring amputation. If a large amount of toxins enter the blood circulation, it can also lead to shock, arrhythmia and acute renal failure.

2. Pathology

1. Ischemic muscle contracture: In the early stage of severe ischemia, after active rescue and timely restoration of blood supply, muscle necrosis can be avoided or only a very small amount can occur, which may not affect the function of the affected limb or the impact is very small.

2. Ischemic muscle contracture: In case of a short period of complete ischemia or a more severe incomplete ischemia, most of the muscle tissue will be necrotic after the blood supply is actively restored. The muscle tissue can still be repaired by fibrous tissue, but scar contracture will form unique deformities such as claw hands and feet, which will seriously affect the function of the affected limb.

3. Gangrene: Complete ischemia over a wide area and for a long time results in massive muscle gangrene that cannot be repaired and often requires amputation. Large amounts of toxins entering the blood can cause shock, arrhythmia and acute renal failure.