Compartmental Syndromes.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Friday, October 16, 2009
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Anatomical locationsWhere do compartmental syndromes occur? A compartmental syndrome may occur wherever tissue is surrounded by a limiting envelope.
Certain factors may favor the development of a compartmental
syndrome in a specific location. Examples include relatively
noncompliant fascia, exposure to trauma or ischemia, and vigorous use
of the compartmental musculature.
The frequency with which the different compartments are involved may vary from one geographical area to another.
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Anatomical locations of compartmental syndromes A compartmental syndrome may potentially occur wherever a limiting
envelope surrounds neuromuscular tissue. Certain anatomical locations
are particularly predisposed to the development of a compartmental
syndrome. This predisposition may result from the limited compliance of
the compartment. Whitesides et also found the human anterior
compartment of the leg to be significantly less compliant than the
superficial or deep posterior compartments of the leg. A high
susceptibility to trauma may be another predisposing factor. For
example, the anterior compartment of the leg is vulnerable to contusion
and is frequently injured in fractures of the tibia. The four
compartments of the leg are often affected by ischemic conditions of
the lower extremity, a situation that places them at risk for
compartmental syndromes resulting from postischemic swelling. The
muscles of the leg and forearm are often exercised vigorously; thus,
their compartments are potential sites of compartmental syndromes from
intensive use of muscles. Additionally, other factors predispose the
compartments of the upper and lower extremities to the development of
compartmental syndromes, including their accessibility for drug
injection and their vulnerability to burns.
The relative frequency of involvement of different compartments may
vary from one geographical area to another. The high incidence of the
anterior compartmental syndrome of the leg in the University of
Washington series is a reflection of the large number of trauma cases
seen in our hospital system. The relatively high incidence of
involvement of the gluteal, quadriceps, biceps, and deltoid
compartments in the series from the University of California at San
Diego is related to the frequency with which drug overdosage with limb
compression is seen there.
Each of most commonly involved compartments is surrounded by
relatively unyielding fascia and is in a location where it is
predisposed to trauma and other causes of tissue swelling that could
give rise to a compartmental syndrome.
Surgery for Compartmental Syndromes at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-BONE (2663) to make an appointment. Our clinical center is located in Seattle Washington, USA
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