Page 193 - ASOP ROT Study Guide

in the tissues is the same as that in the small blood vessels, circulation to the muscles stops
completely and they begin to die.
Why this process occurs is not fully understood. It is probably caused when the muscles in a
compartment are damaged while the fascia remains intact. If the muscle is damaged, and its fascia
is torn, it may swell without increasing pressure because it is no longer constricted by the fascia.
However, in severe cases even a tear in die fascia may not protect the patient from compartment
syndrome.
When a person with compartment syndrome is examined they complain of severe pain made worse
by trying to move the injured part and adjacent joints. This pain is far worse than one would
expect from the injury. The patient may not be able to use the muscles in the affected compartment
voluntarily and the nerves may be affected, causing numbness and tingling.
It is important to realize that the major blood vessel to the limb may still be pulsating normally
while the effects of compartment syndrome take place in the small, low pressure blood vessels in
the muscle itself. Remember that a normal pulse in the limb does not mean that there is no local
reduction in blood supply (ischemia) as a result of compartment syndrome.
Other causes of compartment syndrome are tight bandages or casts, as these can act like the tight
fascia. In acute treatment always consider the possibility of such a problem - use back-slabs and
flexible bandages wherever possible. If complete casts are used, they must be split to the skin, (see
Figure 5), to permit the limb to expand. This will not affect the efficiency of the splint, and in any
case, it is better to lose position of the fracture than to lose the limb.

http://www.rch.org.au/fracture-education/m
anagement_principles/Management_Princi
ples/

www2.aofoundation.org