![]() ![]() Complications of rhabdomyolysis and severe electrolyte derangements – i.e.Failure to recognize in compartments other than the calf – i.e., thigh.Vascular service – may perform the fasciotomy at the time of vascular repair if trauma surgery is not immediately available Orthopedic service – any extremity with a fracture or dislocation Anatomy of Compartments Arm 2 compartments Forearm 4 compartments Hand 4 compartments Thigh 3 compartments Leg 4 compartments Foot 9 compartments 19 2 Compartments of arm 1. ischemic vascular injury associated with shock.The anterior tibial artery and deep fibular (peroneal) nerve supply the anterior compartment. compartment syndrome unequivocally diagnosed on physical exam Compartments of the leg: Anterior compartment (blue): Tibialis anterior, extensor muscles of the foot, and fibularis (peroneus) tertius muscles.At the conclusion of the case, the primary surgeon will call the trauma faculty if a fasciotomy was not performed prior to leaving the OR. The Virtual Curriculum is a 12-month premium plan. ![]() Ultimately, the final decision to perform a fasciotomy is the responsibility of the attending trauma surgeon. The involved faculty should have a brief but focused discussion regarding priorities of care and the need for fasciotomy. Since it is common to underestimate the time from injury to restoration of blood flow, by default, all complicated extremity injuries will receive a complete fasciotomy unless all involved faculty members believe the fasciotomy is unnecessary based on known ischemic time and physiology. Patients are taken to the general trauma or hybrid OR (not HVI) at the discretion of the trauma faculty and orthopedic service with a vascular surgery consult as determined by the trauma attending. The coordination of multiple surgical services (Trauma, Orthopedic, Vascular, and Plastics) to expedite patient care is paramount for optimal outcome and is the responsibility of the Trauma Service. Any patient in the ED with suspected vascular injury and/or compartment syndrome should have prompt consultation with the trauma service prior to definitive imaging or compartment pressure evaluation. Trauma patients with combined orthopedic and vascular injuries are immediately evaluated by the trauma service. The anterior compartment is most common, followed by the deep posterior, lateral and then superficial posterior compartments 4. Purpose: To delineate management of peripheral compartment syndrome in multiply injured patients.
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