Orthopaedics & Sports Medicine  
  Home   |   Site Map   |   Contact Us   |   Links   |   News  
Orthopaedics & Sports Medicine  
Advanced Search
Orthopaedics & Sports Medicine
HomeAbout compartmental syndromesTissue pressure and its measurementPathophysiologyPressure toleranceEtiologiesAnatomical locationsDiagnosisTreatmentSequelaeClinical approachRecurrent compartmental syndromesChallenging casesReferences1. About compartmental syndromes2. Tissue pressure and its management3. Pathophysiology4. Pressure toleranceSupplemental reading dealing with the effect of is5. Etiologies6. Anatomical Locations7. Diagnosis8. Treatment9. Sequelae10. Recurrent compartmental syndromesAbout this article

Print Print Complete Article
View article with questions Hide Questions



Click here to request a referral online.

Compartmental Syndromes.

Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Thursday, February 10, 2005

<< Previous Page Next Page >>

References

1. About compartmental syndromes

  1. Sheridan GW, Matsen FA: Fasciotomy in the treatment of the acute compartment syndrome. J Bone Jt Surg (Am) 58:112115, 1976
  2. Parkes AR: Traumatic ischaemia of peripheral nerves with some observations on Volkmann's ischemic contracture. Br J Surg 32:403-414, 1945
  3. Thomson SA, Mahoney LJ: Volkmann's ischaemic contracture and its relationship to fracture of the femur. J Bone Jt Surg (Br) 33:336-347, 1951
  4. McQuillan WM, Nolan B: Ischaemia complicating injury. A report of thirty-seven cases. J Bone Jt Surg (Br) 50:482-492, 1968
  5. Holden CEA: Traumatic tension ischaemia in muscles. Injury 5:223-227, 1973
  6. Spinner MA, Mache A, Silver L, et al: Impending ischemic contracture of the hand. Plast Reconstr Surg 50:341-349, 1972
  7. Kirby NG: Exercise ischaemia in the fascial compartment of soleus. Report of a case. J Bone Jt Surg (Br) 52:738-745, 1970
  8. Tompkins DG: Exercise myopathy of the extensor carpi ulnaris muscle. Report of a case. J Bone Jt Surg (Am) 59:407-408, 1977
  9. Bradley EL: The anterior tibial compartment syndrome. Surg Gynecol Obst 136:289-297, 1973
  10. Reneman RS: The Anterior and the Lateral Compartment Syndrome of the Leg. The Hague, Mouton, 1968, p 176
  11. Reszel PA, Janes JM, Spittell JA: Ischemic necrosis of the peroneal musculature, a lateral compartment syndrome: report of a case. Mayo Clin Proc 38:130-136, 1963
  12. Weitz EM, Carson G: The anterior tibial compartment syndrome in a twenty month old infant. A complication of the use of a bow leg brace. Bull Hosp Jt Dis 30:16-20, 1969
  13. Zweifach SS, Hargens AR, Evans KL, et al: Skeletal-muscle injury in pressurized compartments associated with hemorrhagic hypotension. Microvasc Res 17 (Part 2):S125, 1979
  14. Fowler PJ, Willis RB: Vascular compartment syndromes. Can J Surg 18:157-161, 1975
  15. Carter AB, Richards RL, Zachary RB: The anterior tibial syndrome. Lancet II:928-934, 1949
  16. Mans on I W: Post-partum eclampsia complicated by anterior tibi al syndrome. Br Med J 2:1117-1118, 1964
  17. Sweeney HE, O'Brien GF: Bilateral anterior tibial syndrome in association with the nephrotic syndrome: report of a case. Arch Intern Med 116:487-490, 1965
  18. Puranen J: The medial tibial syndrome. Exercise ischaemia in the medial fascial compartment of the leg. J Bone Jt Surg (Br) 56:712715, 1974
  19. Klock JC, Sexton MJ: Rhabdomyolysis and acute myoglobinuric renal failure following heroin use. Calif Med 119:5-8, 1973
  20. Gaspard DJ, Cohen JL, Gaspar MR: Decompression dermotomy. A limb salvage adjunct. JAMA (J Am Med Assoc) 220:831-833, 1972
  21. Matsen FA: Compartmental syndrome. A unified concept. Clin Orthop Relat Res 113:8-14, 1975.


2. Tissue pressure and its management

  1. Wiederhielm CA: The capillaries, veins and Iymphatics, in Ruch TC, Patton HD (eds): Physiology and Biophysics. Circulation, Respiration and Fluid Balance, vol 2. Philadelphia, Saunders, 1974, p 136
  2. Hargens AR, Akeson WH, Mubarak SJ, et al: Fluid balance within the canine anterolateral compartment and its relationship to compartment syndrome. J Bone Jt Surg (Am) 60:499-505, 1978
  3. Ashton H: The effect of increased tissue pressure on blood flow. Clin Orthop Relat Res 113:15-26, 1975
  4. Wiederhielm CA: The interstitial space, in Fung YC, Perrone N. Anliker M (eds): Biomechanics: Its Foundations and Objectives. New Jersey, Prentice-Hall, 1970, p 273
  5. Guyton AC, Granger HJ, Taylor AE: Interstitial fluid pressure. Physiol Rev 51:527-563, 1971
  6. Ladegaard-Pedersen HJ: Measurement of the interstitial pressure in subcutaneous tissue in dogs. Circ Res 26:765770, 1970
  7. Prather JW, Bowes DN, Warrell DA, et al: Comparison of capsule and wick techniques for measurement of interstitial fluid pressure. J Appl Physiol 31:942-945, 1971
  8. Stromberg DD, Wiederhielm CA: Effects of oncotic gradients and enzymes on negative pressures in implanted capsules. Am J Physiol 219:928-932, 1970
  9. Gregg DE, Eckstein RW: Measurements of intramyocardial pressure. Am J Physiol 132:781-790, 1941
  10. Johnson JR, Di Palma JR: Intramyocardial pressure and its relation to aortic blood pressure. Am J Physiol 125:234-243, 1939
  11. Ryder HW, Molle WE, Ferris EB: The influence of the collapsibility of veins on venous pressure, including a new procedure for measuring tissue pressure. J Clin Invest 23:334-341, 1943
  12. Kjellmer I: An indirect method for estimating tissue pressure with special reference to tissue pressure in muscle during exercise. Acta Physiol Scand 62:31-40, 1964
  13. Henderson Y. Oughterson AW, Greenburg LA: Muscle tonus, intramuscular pressure and the venopressor mechanism. Am J Physiol 114:261-268, 1936
  14. Burch GE, Sodeman WA: The estimation of the subcutaneous tissue pressure by a direct method. J Clin Invest 16:845-850, 1937
  15. Wells HS, Youmans JB, Miller DG: Tissue pressure {intracutaneous, suboutaneous, and intramuscular) as related to venous pressure, capillary filtration, and other factors. J Clin Invest 17:489-499, 1938
  16. Reneman RS: The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop Relat Res 113:69-80, 1975
  17. Whitesides TE, Harada H. Morimoto K: Compartment syndromes and the role of fasciotomy, its parameters and techniques, in Instructional Course Lectures, The American Academy of Orthopaedic Surgeons, vol 26. St Louis, Mosby, 1977, p 179
  18. Hargens AR, Mubarak SJ, Owen CA, et al: Interstitial fluid pressure in muscle and compartment syndrome in man. Microvasc Res 14:1- 10, 1977
  19. Clayton JM, Hayes AC, Barnes RW: Tissue pressure and perfusion in the compartment syndrome. J Surg Res 22:333-339, 1977
  20. Scholander PF, Hargens AR, Miller SL: Negative pressure in the interstitial fluid of animals. Science 161:321328, 1968
  21. Snashall PD, Boother FA: Interstitial gel swelling pressure in human subcutaneous tissue measure with a cotton wick. Clin Sci Mol Med 46:241-251, 1974
  22. Mubarak SJ, Hargens AR, Owen CA, et al: The wick catheter technique for measurement of intramuscular pressure. A new research and clinical tool. J Bone Jt Surg (Am) 58:1016- 1021, 1976
  23. Zeluff GR: Absorbable versus nonabsorbable wick material in eompartment pressure monitoring. Paper presented at the Western Orthopedic Association Meeting, Seattle, Washington, 1-5, October 1978
  24. Matsen FA, Krugmire RB, King RV: Increased tissue pressure and its effect on muscle oxygenation in level and elevated human limbs. Nicholas Andry Award. Clin Orthop Relat Res 144:318-327, 1979
  25. Matsen FA, Mayo KA, Sheridan GW, et al: Monitoring of intramuscular pressure. Surgery (St. Louis) 79:702-709, 1976
  26. Matsen FA, Winquist RA, Krugmire RB: Diagnosis and management of compartmental syndromes. J Bone Jt Surg (Am) 62:286-291, 1980
  27. Katz MA: Validity of interstitial fluid hydrostatic pressure measurement in hollow porous polyethylene capsules. Microvasc Res 16:316-326, 1978
  28. McMaster PD: The pressure and interstitial resistance prevailing in the normal and edematous skin of animals and man. J Exp Med 84:473-494, 1946
  29. Swann HG, Montgomery AV, Davis JC, et al: A method for rapid measurement of intrarenal and other tissue pressures. J Exp Med 92:625-636, 1950
  30. Meyer F. Holland G: Die Messung des Druckes in Geweben. Arch Exp Pathol Pharmakol 168:580-602, 1932
  31. Landerer A: Die Gewebspannung in ihrem Einfluss auf die ortliche Blut und Lymphbewegung. Leipsig, FCW Vogel, 1884
  32. Matsen FA, Wyss CR, Krugmire RB, et al: The effects of limb elevation and dependency on local arteriovenous gradients in normal human limbs with particular reference to limbs with increased tissue pressure. Clin Orthop Relat Res 150, July-Aug 1980
  33. Dahn I, Lassen NA, Westling H: Blood flow in human muscles during external pressure or venous stasis. Clin Sci 32:467-473, 1967
  34. Ashton H: Effect of inflatable plastic splints on blood flow. Br Med J 4:1427-1430, 1966
  35. Thomson AE, Doupe J: Some factors affecting the auscultatory measurement of arterial blood pressures. Can J Res Sect E Med Sci 27:72-80, 1949/1950

3. Pathophysiology

  1. Ashton H: The effect of increased tissue pressure on blood flow. Clin Orthop Relat Res 113:15-26, 1975
  2. Rorabeck CH, Clarke KM: The pathophysiology of the anterior tibial compartment syndrome: an experimental investigation. J Trauma 18:299-304, 1978
  3. Rorabeck CH, MacNab I: The pathophysiology of the anterior tibial compartmental syndrome. Clin Orthop Relat Res 113:52-57, 1975
  4. Dahn I, Lassen NA, Pestling H: Blood flow in human muscles during external pressure or venous stasis. Clin Sci 32:467-473, 1967
  5. Sheridan GW, Matsen FA, Krugmire RB: Further investigations on the pathophysiology of the compartmental syndrome. Clin Orthop Relat Res 123:266-270, 1977
  6. Matsen FA, King RV, Krugmire RB, et al: Physiological effects of increased tissue pressure. Int Orthop (SICOT) 3:237-244, 1979
  7. Brantigan JW: Catheters for continuous in vivo blood and tissue gas monitoring. Crit Care Med 4:239-244, 1976
  8. Matsen FA, Krugmire, RB, King RV: Increased tissue pressure and its effects on muscle oxygenation in level and elevated human limbs. Nicholas Andry Award. Clin Orthop Relat Res 144:311-320, 1979
  9. Nicholas GG, Miller SH: The anterior tibial compartment syndrome: tissue gas tension measurement. J Surg Res 24:334-338, 1978
  10. Matsen FA, Krugmire RB, King RV: Physiological effects of increased tissue pressure and of elevation. Transactions of the 25th Annual Meeting, Orthop Res Soc 4:15, 1979
  11. Hargens AR, Romine JS, Sipe JC, et al: Peripheral nerve-conduction block by high muscle-compartment pressure. J Bone Jt Surg (Am) 61:192-200, 1979
  12. Matsen FA, Mayo KA, Krugmire RB, et al: A model compartmental syndrome in man with particular reference to the quantification of nerve function. J Bone Jt Surg (Am) 59:648-653, 1977
  13. Matsen FA, King RV, Wyss CR, et al: Effect of acute hemorrhage and arterial ligation on the tolerance of muscle for increased tissue pressure. Transactions of the 26th Annual Meeting, Orthop Res Soc 5, 1980
  14. Benjamin A: The relief of traumatic arterial spasm in threatened Volkmann's ischaemic contracture. J Bone Jt Surg (Br) 39:711-713, 1957
  15. Eaton RG, Green WT: Epimysiotomy and fasciotomy in the treatment of Volkmann's ischemic contracture. Orthop Clin North Am 3:175-186, 1972
  16. Foisie PS: Volkmann's ischemic contracture. An analysis of its proximate mechanism. N Engl J Med 226:671679, 1942
  17. Gardner RC: Impending Volkmann's contracture following minor trauma to the palm of the hand. A theory of pathogenesis. Clin Orthop Relat Res 72:261-264, 1970
  18. Matsen FA, Krugmire RB: Compartmental syndromes. Surg Gynecol Obst 147:943-949, 1978
  19. Matsen FA, Clawson DK: The deep posterior compartmental syndrome of the leg. J Bone Jt Surg (Am) 57:3439, 1975
  20. Mubarak SJ, Owen CA: Compartmental syndrome and its relation to the crush syndrome: a spectrum of disease. A review of 11 cases of prolonged limb compression. Clin Orthop Relat Res 113:81-89, 1975
  21. Burton AC: Relation of structure to function of the tissues of the wall of blood vessels. Physiol Rev 34:619642, 1954
  22. Burton AC: On the physical equilibrium of small blood vessels. Am J Physiol 164:319-329, 1951
  23. Henriksen O: Orthostatic changes of blood flow in suboutaneous tissue in patients with arterial insufficiency of the legs. Scand J Clin Lab Invest 34:103- 109, 1974
  24. Hargens AR, Akeson WH, Mubarak SJ, et al: Fluid balance within the canine anterolateral compartment and its relationship to compartment syndromes. J Bone Jt Surg (Am) 60:499-505, 1978
  25. Hargens AR, Mubarak SJ, Owen CA, et al: Interstitial fluid pressure in muscle and compartment syndrome in man. Microvasc Res 14:1 - 10, 1977
  26. Duffield FA, Harris I: Increase of pressure in veins to level of arterial pressure caused by constricting the limb in which the venous pressure is recorded. J Physiol (Lond) 81:283-285, 1934
  27. Matsen FA, Wyss CR, Krugmire RB, et al: The effects of limb elevation and dependency on local arteriovenous gradients in normal human limbs with particular reference to limbs with increased tissue pressure. Clin Orthop Relat Res 150, July-Aug 1980
  28. Ryder HW, Molle WE, Ferris EB: The influence of the collapsibility of veins on venous pressure, including a new procedure for measuring tissue pressure. J Clin Invest 23:334-341, 1943
  29. Kjellmer I: An indirect method for estimating tissue pressure with special reference to tissue pressure in muscle during exercise. Acta Physiol Scand 62:31-40, 1964
  30. Reneman RS: The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop Relat Res 113:69-80, 1975
  31. Matsen FA: Compartmental syndrome. A unified concept. Clin Orthop Relat Res 113:8-14, 1975
  32. Feigl EO: Physics of the cardiovascular system, in Ruch TC, Patton HD (eds): Physiology and Biophysics. Circulation, Respiration and Fluid Balance, vol 2. Philadelphia, Saunders, 1974, p 15
  33. Feigl EO: The arterial system, in Ruch TC, Patton HD (eds): Physiology and Biophysics. Circulation, Respiration and Fluid Balance, vol 2. Philadelphia, Saunders, 1974, p 121

4. Pressure tolerance

  1. Sheridan GW, Matsen FA, Krugmire RB: Further investigations on the pathophysiology of the compartmental syndrome. Clin Orthop Relat Res 123:266-270, 1977
  2. Matsen FA, King RV, Krugmire RB, et al: Physiological effects of increased tissue pressure. Int Orthop (SICOT) 3:237-244, 1979
  3. Rorabeck CH, Clarke KM: The pathophysiology of the anterior tibial compartment syndrome: an experimental investigation. J Trauma 18:299304, 1978
  4. Hargens AR, Romine JS, Sipe JC, et al: Peripheral nerve-conduction block by high muscle-compartment pressure. J Bone Jt Surg (Am) 61:192-200, 1979
  5. Matsen FA, Mayo KA, Krugmire RB, et al: A model compartmental syndrome in man with particular reference to the quantification of nerve function. J Bone Jt Surg (Am) 59:648-653, 1977
  6. Hargens AR, Mubarak SJ, Akeson WH, et al: Critical pressure and time relationships in compartment syndromes. International Research Society for Orthopaedics and 7. Traumatology (SIROT), First Meeting, Program and Abstracts, 15-20 October 1978, Kyoto, Japan, p 21
  7. Hargens AR, Evans KL, Hagan PL, et al: Skeletal muscle necrosis in pressurized compartments as assessed by technetium-99m stannous pyrophosphate. Transactions of the 24th Annual Meeting, Orthop Res Soc 3:48, 1978
  8. Lundborg G: Ischemic nerve injury. Experimental studies on intraneural microvascular pathophysiology and nerve function in a limb subjected to temporary circulatory arrest. Scand J Plast Reconstr Surg Suppl 6:3-113, 1970
  9. Sanderson RA, Foley RK, McIvor GWD, et al: Histological response of skeletal muscle to ischemia. Clin Orthop Relat Res 113t27-35, 1975 Vracko R. Benditt EP: Basal lamina: the scaffold for orderly cell replacement. Observations on regeneration of injured skeletal muscle fibers and capillaries. J Cell Biol 55:406-419, 1972
  10. Matsen FA, Wyss CR, King RV, et al: Effect of acute hemorrhage on transcutaneous, subcutaneous, intramuscular, and arterial oxygen tensions. Pediatrics 65, May 1980
  11. Zweifach SS, Hargens AR, Evans KL, et al: Skeletal-muscle injury in pressurized compartments associated with hemorrhagic hypotension. Microvasc Res 17(Part 2):S125, 1979
  12. Matsen FA, Wyss CR, Krugmire RB, et al: The effects of limb elevation and dependency on local arteriovenous gradients in normal human limbs with particular reference to limbs with increased tissue pressure. Clin Orthop Relat Res 150, July-Aug 1980
  13. Feigl EO: Physics of the cardiovascular system, in Ruch TC, Patton HD (eds): Physiology and Biophysics. Circulation, Respiration and Fluid Balance, vol 2. Philadelphia, Saunders, 1974, p 11
  14. Matsen FA, King RV, Krugmire RB, et al: Physiological effects of increased tissue pressure. Int Orthop (SICOT) 3:237-244, 1979


Supplemental reading dealing with the effect of is

Bowden REM, Gutmann E: The fate of voluntary muscle after vascular injury in man. J Bone Jt Surg (Br) 31:356-368, 1949

Clark MW, D'Ambrosia RD, Roberts JM: Equinus contracture following Bryant's traction. Orthopedics 1:311-312, 1978

Dahlback L-O: Effects of temporary tourniquet ischemia on striated musele fibers and motor end-plates. Scand J Plast Reconstr Surg Suppl 7:7-91, 1970

Hargens AR, Romine JS, Sipe JC, et al: Peripheral nerve-conduction block by high muscle-compartment pressure. J Bone Jt Surg (Am) 61:192-200, 1979

Harman JW, Gwinn RP: The recovery of skeletal muscle fibers from acute ischemia as determined by histologic and chemical methods. Am J Pathol 25:741 -755, 1949

Holmes W. Highet WB, Seddon HJ: Ischaemic nerve lesions occurring in Volkmann's contracture. Br J Surg 32:259-275, 1944

Lundborg G: Ischemic nerve injury. Experimental studies on intraneural microvascular pathophysiology and nerve function in a limb subjected to temporary circulatory arrest. Scand J Plast Reconstr Surg Suppl 6:3-113, 1970

Malan E, Tattoni G: Physio- and anatomo-pathology of acute ischemia of the extremities. J Cardiovasc Surg 17:212-225, 1963

Miller HH, Welch CS: Quantitative studies on the time factor in arterial inJuries. Ann Surg 130:428-438, 1949

Montagnani CA, Simeone FA: Observations on the liberation and elimination of myohemoglobin and of hemoglobin after release of muscle ischemia. Surgery 34:169-185, 1953

Parkes AR: Traumatic ischemia of peripheral nerves with some observations on Volkmann's ischaemic contracture. Br J Surg 32:403-414, 1945

Schreiber SN, Liebowitz MR, Bernstein LH: Limb compression and renal impairment (crush syndrome) following narcotic and sedative overdose. J Bone Jt Surg (Am) 54:1683-1692, 1972

Scully RE, Shannon JM, Dickersin GR: Factors involved in recovery from experimental skeletal muscle ischemia produced in dogs. Am J Pathol 39:721737, 1961

Speckman EJ, Caspers H. Bingmann D: Actions of hypoxia and hypercapnia on single mammalian neurons, in Bicher HI, Bruley DF (eds): Oxygen Transport to Tissue, Instrumentation, Methods, and Physiology, vol 37. New York, Plenum, 1973, p 245

Spinner MA, Mache A, Silver L, et al: Impending ischemic contracture of the hand. Plast Reconstr Surg 50:341-349, 1972

Whitesides TE, Harada H. Morimoto K: Compartment syndromes and the role of fasciotomy, its parameters and technique, in Instructional Course Lectures, The American Academy of Orthopaedic Surgeons, vol 26. St Louis, Mosby, 1977, p 179

Wright EB: A comparative study of the effects of oxygen lack on peripheral nerve. Am J Physiol 147:78-88, 1946


5. Etiologies

  1. Owen CA, Woody PR, Mubarak SJ, et al: Gluteal compartment syndromes: a report of three cases and management utilizing the wick catheter. Clin Orthop Relat Res 132:57-60, 1978
  2. Patman RD, Thompson JE: Fasciotomy in peripheral vascular surgery. Arch Surg 101:663-670, 1970
  3. Gaspard DJ, Cohen JL, Gaspar MR: Decompression dermotomy. A limb salvage adjunct. JAMA (J Am Med Assoc) 220:831-833, 1972
  4. Gaspard DJ, Kohl RD: Compartmental syndromes in which the skin is the limiting boundary. Clin Orthop Relat Res 113:65-68, 1975
  5. Mann RJ, Wallquist JM: Early decompression fasciotomy in the treatment of high-voltage electrical burns of the extremities. South Med J 68:1103-1108, 1975
  6. Patman RD: Compartmental syndromes in peripheral vascular surgery. Clin Orthop Relat Res 113:103-110, 1975
  7. Justis DL, Law EJ, MacMillan BG: Tibial compartment syndromes in burn patients. A report of four cases. Arch Surg 111:1004 - 1008, 1976
  8. Eaton RG, Green WT: Epimysiotomy and fasciotomy in the treatment of Volkmann's ischemic contracture. Orthop Clin North Am 3:175-186, 1972
  9. Eaton RG, Green WT: Volkmann's ischemia. A volar compartment syndrome of the forearm. Clin Orthop Relat Res 113:58-64, 1975
  10. Volkmann R von: Ischaemic muscle paralyses and contractures. Bick EM (trans). Clin Orthop Relat Res 50:5-6, 1967
  11. Whitesides TE, Harada H. Morimoto K: Compartmental syndromes and the role of fasciotomy, its parameters and techniques, in Instructional Course Lectures, The American Academy of Orthopaedic Surgeons, vol 26. St Louis, Mosby, 1977, p 179
  12. Hargens AR, Akeson WH, Mubarak SJ, et al: Fluid balance within the canine anterolateral compartment and its relationship to compartment syndromes. J Bone Jt Surg (Aml 60:499-505, 1978
  13. Sheridan GW, Matsen FA: Fasciotomy in the treatment of the acute compartment syndrome. J Bone Jt Surg (Am) 58:112- 115, 1976
  14. Mubarak SJ, Owen CA, Hargens AR, et al: Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter. J Bone Jt Surg (Am) 60:1091-1095, 1978
  15. Sirbu AB, Murphy MJ, White AS: Soft tissue complications of fractures of the leg. Calif Med 60:53-56, 1944
  16. Leach RE, Hammond G: The anterior tibial compartment syndrome. Acute and chronic. J Bone Jt Surg (Am) 49:451-462, 1967
  17. Wolfort FG, Mogelvang LC, Filtzer HS: Anterior tibial compartment syndrome following muscle hernia repair. Arch Surg 106:97-99, 1973
  18. Reneman RS: The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop Relat Res 113:69-80, 1975
  19. Matsen FA, Clawson DK: The deep posterior compartmental syndrome of the leg. J Bone Jt Surg (Am) 57:34-39, 1975
  20. Horn JS, Sevitt S: Ischaemic necrosis and regeneration of the tibialis anterior muscle after rupture of the popliteal artery. J Bone Jt Surg (Br) 33:348-358, 1951
  21. Bradley EL: The anterior tibial compartment syndrome. Surg Gynecol Obst 136:289-297, 1973
  22. Tilney NL, McLamb JR: Leg trauma with posterior tibial artery tear. J Trauma 7:807-810, 1967
  23. McQuillan WM, Nolan B: Ischaemia complicating mjury. A report of thirty-seven cases. J Bone Jt Surg (Br) 50:482-492, 1968
  24. Fowler PJ, Willis RB: Vascular compartment syndromes. Can J Surg 18:157-161, 1975
  25. Zimmerman JE, Afshar F. Firedman W. et al: Posterior compartment syndrome of the thigh with a sciatic palsy. Case report. J Neurosurg 46:369-372, 1977
  26. Thomas HB: Some orthopaedic findings in ninety-eight cases of hemophilia. J Bone Jt Surg (Am) 18:140-147, 1936
  27. Bowden REM, Gutmann E: The fate of voluntary muscle after vascular injury in man. J Bone Jt Surg (Br) 31:356-368, 1949
  28. Robins RH, Murrell JS: Traumatic ischaemia in a haemophiliac. Re port of a case of prolonged haemostasis with cryoprecipitate during decompression and skin graftmg. J Bone Jt Surg (Br) 53:113-117, 1971
  29. Arnold WD, Hilgartner MW: Hemophilic arthropathy. J Bone Jt Surg (Am) 59:287-305, 1977
  30. Lancourt JE, Gilbert MS, Posner MA: Management of bleeding and associated complications of hemophilia in the hand and forearm. J Bone Jt Surg (Am) 59:451-460, 1977
  31. Macon WL, Futrell JW: Median-nerve neuropathy after percutaneous F puncture of the brachial artery in patients receiving anticoagulants. N Engl J Med 288:1396, 1973
  32. Neviaser RJ, Adams JP, May GI: Complications of arterial puncture in anticoagulated patients. J Bone Jt Surg (Am) 58:218-220, 1976
  33. Halpern AA, Mochizuki R. Long CE: Compartment syndrome of the forearm following radial-artery puncture in a patient treated with anticoagulants. J Bone Jt Surg (Am) 60:1136-1137, 1978
  34. Reneman RS: The Anterior and the Lateral Compartment Syndrome of the Leg. The Hague, Mouton, 1968, p 176
  35. Whitesides TE, Hirada H. Morimoto K: The response of skeletal muscle to temporary ischemia: an experimental study. J Bone Jt Surg (Am) 53:1027-1028, 1971
  36. Gitlitz GF: The anterior tibial compartment syndrome. A complication of a femoropopliteal bypass procedure. Vasc Dis 2:122-130, 1965
  37. Coupland GAE: Anterior tibial syndrome following restoration of arterial flow. Aust NZ J Surg 41:338-341, 1972
  38. Lytton B. Blandy JP: Anterior tibial syndrome after embolectomy. Br J Surg 48:346-348, 1960
  39. Ransford AO, Provan JL: Anterior tibial compartment syndrome complicating femoral embolectomy. Can J Surg 14:231-234, 1971
  40. Clayton JM, Hayes AC, Barnes RW: Tissue pressure and perfusion in the compartment syndrome. J Surg Res 22:333-339, 1977
  41. Elliott MJ, Glass KD: Anterior tibial compartment syndrome associated with ergotamine ingestion. Clin Orthop Relat Res 118:4447, 1976
  42. Rosengart R. Nelson RJ, Emmanoulides GC: Anterior tibial compartment syndrome in a child: an unusual complication of cardiac catheterization. Pediatrics 58:456-458, 1976
  43. LaForce FM: Crush syndrome after ethanol. N Engl J Med 284:1104, 1971
  44. Conner AN: Prolonged external pressure as a cause of ischemic contracture. J Bone Jt Surg (Br) 53:118-122, 1971
  45. Schreiber SN, Liebowitz MR, Bernstein LH: Limb compression and renal impairment (crush syndrome) following narcotic and sedative overdose. J Bone Jt Surg (Am) 54:1683-1692, 1972
  46. Spinner MA, Mache A, Silver L, et al: Impending ischemic contracture of the hand. Plast Reconstr Surg 50:341-349, 1972
  47. Dolich BH, Aiache AE: Drug-induced coma: a cause of crush syndrome and ischemic contracture. J Trauma 13:223-228, 1973
  48. Mubarak SJ, Owen CA: Compartmental syndrome and its relation to the crush syndrome: a spectrum of disease. A review of 11 cases of prolonged limb compression. Clin Orthop Relat Res 113:81-89, 1975
  49. Patterson VH, Boddie HG: Anterior tibial compartment syndrome associated with alcohol abuse. Br Med J 1:269-270, 1977
  50. Owen CA, Mubarak SJ, Hargens AR, et al: Intramuscular pressure with limb compression. Clarification of the pathogenesis of the druginduced compartment syndrome/crush syndrome. N Engl J Med 300:1169-1172, 1979
  51. Parkes AR: Traumatic ischaemia of peripheral nerves with some observations on Volkmann's ischaemic contracture. Br J Surg 32:403-414, 1945
  52. Ernst CB, Kaufer H: Fibulectomy-fasciotomy. An important adjunct in the management of lower extremity arterial trauma. J Trauma 11:365-380, 1971v
  53. Holden CEA: Traumatic tension ischaemia in muscles. Injury 5:223-227, 1973
  54. Horwitz T: Ischemic contracture of the lower extremity. Arch Surg 41:945-959, 1940
  55. Rorabeck CH, MacNab I: Anterior tibial-compartment syndrome complicating fractures of the shaft of the tibia. J Bone Jt Surg (Am) 58:549-550, 1976
  56. Onnerfalt R: Fracture of the tibial shaft treated by primary operation and early weight-bearing. Acta Orthop Scand Suppl 171:7-63, 1978
  57. Phalen GD: Ischemic necrosis of the anterior crural muscles. Ann Surg 127:112-120, 1948
  58. Carter AB, Richards RL, Zachary RB: The anterior tibial syndrome. Lancet II:928-934, 1949
  59. Hughes JR: The anterior tibial syndrome. Lancet II:1150, 1949
  60. Tillotson JF, Coventry MB: Spontaneous ischemic necrosis of the anterior tibial muscle: report of case. Proc Staff Meetings Mayo Clin 25:223-227, 1950
  61. Mavor GE: The anterior tibial syndrome. J Bone Jt Surg (Br) 38:513-517, 1956
  62. French EZ, Price WH: Anterior tibial pain. Br Med J 2:1290-1296, 1962
  63. Paton DF: The pathogenesis of anterior tibial syndrome. An illustrative case. J Bone Jt Surg (Br) 50:383-385, 1968
  64. Kirby NG: Exercise ischaemia in the fascial compartment of soleus. Report of a case. J Bone Jt Surg (Br) 52:738-745, 1970
  65. Patman RD: Compartmental syndromes in peripheral vascular surgery. Clin Orthop Relat Res 113:103-110, 1975
  66. Garfin S. Mubarak SJ, Owen CA: Exertional anterolateral compartmental syndrome. Case report with fascial defect, muscle herniation, and superficial peroneal-nerve entrapment. J Bone Jt Surg (Am) 59:404-405, 1977
  67. Tompkins DG: Exercise myopathy of the extensor carpi ulnaris muscle. Report of a case. J Bone Jt Surg (Am) 59:407-408, 1977
  68. Mubarak SJ, Owen CA, Garfin S. et al: Acute exertional superficial posterior compartment syndrome. Am J Sports Med 6:287-290, 1978
  69. Caldwell RK: Ischemic necrosis of the anterior tibial muscle: case report with autopsy findings, and review of the literature. Ann Intern Med 46:1191 - 1199, 1957
  70. Manson IW: Post-partum eclampsia complicated by anterior tibial syndrome. Br Med J 2:1117-1118, 1964
  71. Lees AJ: Anterior tibial compartment syndrome following prolonged tetany. J Neurol Neurosurg Psychiatry 39:406-408, 1976
  72. Morgan NR, Waugh TR, Boback MD: Volkmann's ischemic contracture after intra-arterial injection of secobarbital. JAMA (J Am Med Assoc) 212:476-478, 1970
  73. Hawkins LG, Lischer CG, Sweeney M: The main line accidental intra-arterial drug injection. Clin Orthop Relat Res 94:268-274, 1973
  74. Kaufer H. Spengler DM, Noyes FR, et al: Orthopaedic implications of the drug subculture. J Trauma 14:853-867, 1974
  75. Schrock RD: Peroneal nerve palsy following derotation osteotomies for tibial torsion. Clin Orthop Relat Res 62:172- 177, 1969
  76. Matsen FA, Staheli LT: Neurovascular complications following tibial osteotomy in children. A case report. Clin Orthop Relat Res 110:210-214, 1975
  77. Wiggins HE: The anterior tibial compartment syndrome-a complication of the Hauser procedure. Clin Orthop Relat Res 113:90-94, 1975
  78. Wall JJ: Compartment syndrome as a complication of the Hauser procedure. J Bone Jt Surg (Am) 61:185-191, 1979
  79. Glass TG: Cortisone and immediate fasciotomy in the treatment of severe rattlesnake bite. Tex Med 65:40-47, 1969
  80. Cywes S. Louw JH: Phlegmasia cerulea dolens: successful treatment by relievmg fasciotomy. Surgery 51:169-176, 1962
  81. Weitz EM, Carson G: The anterior tibial compartment syndrome in a twenty month old infant. A complication of the use of a bow leg brace. Bull Hosp Jt Dis 30:16-20, 1969
  82. Dennis C: Disaster following femoral vein ligation for thrombophlebitis; relief by fasciotomy; clinical case of renal impairment following crush injury. Surgery 17:264-269, 1945
  83. Sweeney HE, O'Brien GF: Bilateral anterior tibial syndrome in association with the nephrotic syndrome: report of a case. Arch Intern Med 116:487-490, 1965
  84. Maor P. Levy M, Lotem M, et al: Iatrogenic Volkmann's ischemia-a result of pressure-transfusion. Int Surg 57:415-416, 1972
  85. Halpern AA, Nagel DA: Bilateral compartment syndrome associated with androgen therapy. A case report. Clin Orthop Relat Res 128:243-246, 1977
  86. Scott NW, Jacobs B. Lockshin MD: Posterior compartment syndrome resulting from a dissecting popliteal cyst. Clin Orthop Relat Res 122:189-192, 1977
  87. Ashton H: The effect of increased tissue pressure on blood flow. Clin Orthop Relat Res 113:15-26, 1975
  88. Fuhrman FA, Crismon JM: Early changes in distribution of sodium, potassium and water in rabbit muscles following release of tourniquets. Am J Physiol 166:424-432, 1951


6. Anatomical Locations

  1. Mubarak SJ, Owen CA, Hargens AR, et al: Acute compartment syndrome: diagnosis and treatment with the aid of the wick catheter. J Bone Jt Surg (Am) 60:1091-1095, 1978
  2. Eaton RG, Green WT: Volkmann's ischemia. A volar compartment syndrome of the forearm. Clin Orthop Relat Res 113:58-64, 1975
  3. McQuillan WM, Nolan B: Ischaemia complicating injury. A report of thirty-seven cases. J Bone Jt Surg (Br) 50:482-492, 1968
  4. Gelberman RH, Zakaib GS, Mubarak SJ, et al: Decompression of forearm compartment syndromes. Clin Orthop Relat Res 134:225-229, 1978
  5. Patman RD, Thompson JE: Fasciotomy in peripheral vascular surgery. Arch Surg 101:663-670, 1970
  6. Tompkins DG: Exercise myopathy of the extensor carpi ulnaris muscle. Report of a case. J Bone Jt Surg (Am) 59:407-408, 1977
  7. Green WT, Mital MA: Congenital radio-ulnar synostosis: surgical treatment. J Bone Jt Surg (Am) 61:738-743, 1979
  8. Spinner MA, Mache A, Silver L, et al: Impending ischemic contracture of the hand. Plast Reconstr Surg 50:341-349, 1972
  9. Reid RL, Travis RT: Acute necrosis of the second interosseous compartment of the hand. J Bone Jt Surg (Am) 55:1095-1097, 1973
  10. Salisbury RE, McKeel DW, Mason AD: Ischemic necrosis of the intrinsic muscles of the hand after thermal injuries. J Bone Jt Surg (Am) 56:1701-1707, 1974
  11. Kaufman G. Choi B: Ischemic necrosis of muscles of the buttock. A case report. J Bone Jt Surg (Aml 54:1079-1082, 1972
  12. Klock JC, Sexton MJ: Rhabdomyolysis and acute myoglobinuric renal failure following heroin use. Calif Med 119:5-8, 1973
  13. Owen CA, Woody PR, Mubarak SJ, et al: Gluteal compartment syndromes: a report of three cases and management utilizing the wick catheter. Clin Orthop Relat Res 132:57-60, 1978
  14. Tilney NL, McLamb JR: Leg trauma with posterior tibial artery tear. J Trauma 7:807-810, 1967
  15. Reneman RS: The Anterior and the Lateral Compartment Syndrome of the Leg. The Hague, Mouton, 1968, p 176
  16. Shrock RD: Peroneal nerve palsy following derotation osteotomies for tibial torsion. Clin Orthop Relat Res 62:172-177, 1969
  17. Bradley EL: The anterior tibial compartment syndrome. Surg Gynecol Obst 136:289-297, 1973
  18. Wiggins HE: The anterior compartment syndrome-a complication of the Hauser procedure. J Bone Jt Surg (Am) 55-A:1306, 1973
  19. Rorabeck CH, MacNab I: Anterior tibial-compartment syndrome complicating fractures of the shaft of the tibia. J Bone Jt Surg (Am) 58:549-550, 1976
  20. Garfin S. Mubarak SJ, Owen CA: Exertional anterolateralcompartment syndrome. Case report with fascial defect, muscle herniation, and superficial peroneal-nerve entrapment. J Bone Jt Surg (Am) 59:404405, 1977
  21. Reszel PA, Janes JM, Spittell JA: Ischemic necrosis of the peroneal musculature. A lateral compartment syndrome: report of a case. Mayo Clin Proc 38: 130-136, 1963
  22. Davies JAK: Peroneal compartment syndrome secondary to rupture of the peroneus longus. J Bone Jt Surg (Am) 61:783-784, 1979
  23. Kirby NG: Exercise ischaemia in the fascial compartment of soleus. Report of a case. J Bone Jt Surg (Br) 52:738-740, 1970
  24. Lowenberg EL: Acute ischemic infarction of the gastrocnemius muscle simulating deep vein phlebitis. J Cardiovasc Surg 6:104-110, 1965
  25. Mubarak SJ, Owen CA, Garfin S. et al: Acute exertional superficial posterior compartment syndrome. Am J Sports Med 6:287-290, 1978
  26. Matsen FA, Clawson DK: The deep posterior compartmental syndrome of the leg. J Bone Jt Surg (Am) 57:34-39, 1975
  27. Whitesides TE, Harada H. Morimoto K: Compartment syndromes and the role of fasciotomy, its parameters and techniques, in Instructional Course Lectures, The American Academy of Orthopaedic Surgeons, vol 26. St Louis, Mosby, 1977, p 179
  28. Sheridan GW, Matsen FA: Fasciotomy in the treatment of the acute compartment syndrome. J Bone Jt Surg (Am) 58:112-115, 1976

7. Diagnosis

  1. Dahn I, Lassen NA, Westling H: Blood flow in human muscles during external pressure or venous stasis. Clin Sci 32:467-473, 1967
  2. Clayton JM, Hayes AC, Barnes RW: Tissue pressure and perfusion in the compartment syndrome. J Surg Res 22:333-339, 1977
  3. Sheridan GW, Matsen FA, Krugmire RB: Further investigations on the pathophysiology of the compartmental syndrome. Clin Orthop Relat Res 123:266-270, 1977
  4. Rorabeck CH, Clarke KM: The pathophysiology of anterior tibial compartment syndrome: an experimental investigation. J Trauma 18:299-304, 1978
  5. Matsen FA, Krugmire RB, King RV: Increased tissue pressure and its effects on muscle oxygenation in level and elevated human limbs. Nicholas Andry Award. Clin Orthop Relat Res 144:311-320, 1979
  6. Matsen FA, King RV, Krugnure RB, et al: Physiological effects of increased tissue pressure. Int Orthop SICOT 3:237-244, 1979
  7. Matsen FA, Mayo KA, Krugmire RB, et al: A model compartmental syndrome in man with particular reference to the quantification of nerve function. J Bone Jt Surg (Am) 59:648-653, 1977
  8. Matsen FA, Winquist RA, Krugmire RB: Diagnosis and management of compartmental syndromes. J Bone Jt Surg (Am) 62:286-291, 1980
  9. Dahlback L-O: Effects of temporary tourniquet ischemia on striated muscle fibers and motor end-plates. Scand J Plast Reconstr Surg Suppl 7, 7-91, 1970
  10. Lundborg G: Ischemic nerve injury. Scand J Plast Reconstr Surg Suppl 6, 3-113, 1970
  11. Sheridan GW, Matsen FA: Fasciotomy in the treatment of the acute compartment syndrome. J Bone Jt Surg (Am) 58:112-115, 1976
  12. Matsen FA, Clawson DK: The deep posterior compartmental syndrome of the leg. J Bone Jt Surg (Am) 57:34-39, 1975
  13. Veith RG: Unpublished data
  14. Matsen FA, Staheli LT: Neurovascular complications following tibial osteotomy in children: a case report. Clin Orthop Relat Res 110:210-214, 1975

8. Treatment

  1. Holden CEA: Traumatic tension ischaemia in muscles. Injury 5:223-227, 1973
  2. Eaton RG, Green WT: Volkmann's ischemia. A volar compartment syndrome of the forearm. Clin Orthop Relat Res 113:58-64, 1975
  3. Holden CEA: Compartmental syndromes following trauma. Clin Orthop Relat Res 113:95-102, 1975
  4. Matsen FA: Compartmental syndromes. A unified concept. Clin Orthop Relat Res 113:8-14, 1975
  5. Matsen FA, Clawson DK: The deep posterior compartmental syndrome of the leg. J Bone Jt Surg (Am) 57:34-39, 1975
  6. Sheridan GW, Matsen FA: Fasciotomy in the treatment of the acute compartment syndrome. J Bone Jt Surg (Am) 58:112-115, 1976
  7. Vracko R. Benditt EP: Basal lamina: the scaffold for orderly cell replacement. Observation on regeneration of injured skeletal muscle fibers and capillaries. J Cell Biol 55:406-419, 1972
  8. Sanderson RA, Foley RK, McIvor GWD, et al: Histological response of skeletal muscle to ischemia. Clin Orthop Relat Res 113:27-35, 1975
  9. Whitesides TE, Harada H. Morimoto K: Compartmental syndromes and the role of fasciotomy, its parameters and techniques, in Instructional Course Lectures, The American Academy of Orthopaedic Surgeons, vol 26. St Louis, Mosby, 1977, p 179
  10. Gaspard DJ, Kohl RD: Compartmental syndromes in which the skin is the limiting boundary. Clin Orthop Relat Res 113:65-68, 1975
  11. Masten FA, Winquist RA, Krugmire, RB: Diagnosis and management of compartmental syndromes. J Bone Jt Surg (Am) 62:286-291, 1980
  12. Patman RD: Compartmental syndromes in peripheral vascular surgery. Clin Orthop Relat Res 113:103-110, 1975

9. Sequelae

  1. Sheridan GW, Matsen FA: Fasciotomy in the treatment of the acute compartment syndrome. J Bone Jt Surg (Am) 58:112-115, 1976
  2. Albo D, Cheung L, Ruth L, et al: Effect of intra-arterial injections of barbiturates. Am J Surg 120:676-678, 1970
  3. Gaspar MR, Hare RR: Gangrene due to intra-arterial injection of drugs by drug addicts. Surgery 72:573-577, 1972
  4. Kaufer H. Spengler DM, Noyes FR, et al: Orthopaedic implications of the drug subculture. J Trauma 14:853-867, 1974
  5. Montagnani CA, Simeone FA: Observations on the liberation and elimination of myohemoglobin and of hemoglobin after release of muscleischemia. Surgery34:169-185, 1953
  6. Schreiber SN, Liebowitz MR, Bernstein LH, et al: Limb compression and renal impairment (crush syndrome) complicating narcotic overdose. N Engl J Med 284:368-369, 1971
  7. Spinner MA, Mache A, Silver L, et al: Impending ischemic contracture of the hand. Plast Reconstr Surg 50:341-349, 1972
  8. Klock JC, Sexton MJ: Rhabdomyolysis and acute myoglobinuric renal failure following heroin use. Calif Med 119:5-8, 1973
  9. Owen CA, Mubarak SJ, Hargens AR, et al: Intramuscular pressure with limb compression. Clarification of the pathogenesis of the druginduced compartment syndrome/crush syndrome. N Engl J Med 300:1169-1172, 1979
  10. Mubarak SJ, Owen CA: Compartmental syndrome and its relation to the crush syndrome: a spectrum of disease. A review of 11 cases of prolonged limb compression. Clin Orthop Relat Res 113:81-89, 1975
  11. Tsuge K: Treatment of established Volkmann's contracture. J Bone Jt Surg (Am) 57:925-929, 1975
  12. Miller DS, Markin L, Grossman E: Ischemic fibrosis of the lower extremity in children. Am J Surg 84:317-321, 1952
  13. Karlstrom G. Olerud S: Cavus deformity of the foot after fracture of the tibial shaft. J Bone Jt Surg (Am) 57:893-900, 1975
  14. Matsen FA, Clawson DK: The deep posterior compartmental syndrome of the leg. J Bone Jt Surg (Am) 57:34-39, 1975
  15. Clark MW, D'Ambrosia RD, Roberts JM: Equinus contracture following Bryant's traction. Orthopedics 1:311-312, 1978
  16. Coupland GAE: Anterior tibial syndrome following restoration of arterial flow. Aust NZ J Surg 41:338-341, 1972


10. Recurrent compartmental syndromes

  1. Mavor GE: The anterior tibial syndrome. J Bone Jt Surg (Br) 38:513-517, 1956
  2. Kunkel MG, Lynn RB: The anterior tibial compartment syndrome. Can J Surg 1:212-217, 1958
  3. French EZ, Price WH: Anterior tibial pain. Br Med J 2:1290-1296, 1962
  4. Leach RE, Hammond G: The anterior tibial compartment syndrome. Acute and chronic. J Bone Jt Surg (Am) 49:451-462, 1967
  5. Reneman RS: The Anterior and the Lateral Compartment Syndrome of the Leg. The Hague, Mouton, 1968, p 176
  6. Reneman RS: The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop Relat Res 113:69-80, 1975
  7. Barcroft J. Kato T: Effects of functional activity in striated muscle and the submaxillary gland. Philos Trans R Soc Lond B Biol Sci 207: 149- 182, 1915/1916
  8. Kjellmer I: An indirect method for estimating tissue pressure with special reference to tissue pressure in muscle during exercise. Acta Physiol Scand 62:31-40, 1964
  9. Arai M, Endoh H: Blood flow through human skeletal muscle during and after contraction. Tohoku J Exp Med 114:379-384, 1974
  10. Mubarak SJ, Hargens AR, Owen CA, et al: The wick catheter tech nique for measurement of intramuscular pressure. A new research and clinical tool. J Bone Jt Surg (Am) 58:1016-1021, 1976
  11. Garfin S. Mubarak SJ, Owen CA: Exertional anterolateralcompartment syndrome. Case report with fascial defect, muscle herniation, and superficial peroneal-nerve entrapment. J Bone Jt Surg IAm) 59:404-405, 1977
  12. Puranen J: The medial tibial syndrome. Exercise ischaemia in the medial fascial compartment of the leg. J Bone Jt Surg (Br) 56:712-715, 1974

Surgery for Compartmental Syndromes at the University of Washington

If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-7416 to make an appointment.


<< Previous Page Next Page >>


How useful was this page or article?

This article is rated ***0.6 out of 5 stars (386 ratings).

Not useful at all Not very useful Useful Very useful Extremely useful
* ** *** **** *****
Arthritis | Children | Foot & Ankle | Hand & Wrist | Hip & Knee | Metabolic Bone Disease | Research | Shoulder & Elbow | Spine | Sports | Trauma | Tumor Service
Team Physicians to the UW Huskies Varsity Athletes...And You!
Copyrights and disclaimer  | Privacy statement | Editorial policy
Problems or questions? Contact the webmaster.
Copyright © 2008 University of Washington - Seattle, WA. All rights reserved.