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ppt journal reading acute compartemen syndrome
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Acute Compartment Syndrome in Orthopedics:Causes, Diagnosis, and Management
Presented by: Arsan Rusli
Akhmad MuhajirResti Amelia
Ike Widyawati F.Muh. Zhafran Darwis
Advisorsdr. Aries F Hutabaratdr. Johannes Toban
Dr. Ery Willdan
Supervisordr. Muhammad Andry Usman T., PhD, Sp.OT
ORTHOPEDIC AND TRAUMATOLOGY DEPARTMENTHASANUDDIN UNIVERSITY
(Hasnain Raza and Anant Mahapatra Hindawi Publishing Corporation Advances in Orthopedics Volume 2015)
JOURNAL READINGON APRIL, 2016
Introduction
Pathophysiology
Epidemiology
Clinical Diagnosis
Intracompartment Pressure Monitoring
Infrared Spectroscopy
Intracompartment pH Monitoring
Fasciotomy
Wound Management after Treatment
Medicolegal Aspect
Conclusion
ACUTE COMPARTMENT SYNDROME IN ORTHOPEDICS: CAUSES, DIAGNOSIS, AND MANAGEMENT
Journal Reading Orthopedic and Traumatology Department Hasanuddin University
Dr. Volkmann, a German doctor in 1881 described ACS by reporting the hand contracture which was a consequence of this particular condition
Petersen in 1888 reported the management of ACS
Missed and left untreated it can lead to serious damage to the soft tissues of the limb including muscles, nerves, and vessels.
INTRODUCTION
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
PHATOPHYSIOLOGY Two factors are
responsible for this condition:• Decrease in a
compartment volume,
• Increase in the contents of a compartment,
Compartment syndrome is defined as:a condition in which a closed compartment’s pressure increases to such an extent that the microcirculation of the tissues in that compartment is diminished
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
PHATOPHYSIOLOGY
local trauma and soft tissue
destruction > bleeding and edema
Raised pressure at the venous
capillary end
Increases hydrostatic
pressure
Leading to arteriolar
compression
Hence reducing or diminishing
perfusion of the tissues.
Soft tissue ischemia, anoxia and death of the
cells.
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
PHATOPHYSIOLOGY
Extent of muscle death
the duration of ischemia
temperature of the tissues
the available residual
microcirculation
Pressures 40 to 80mmHg sustained for 4 hours do not cause permanent nerve dysfunction but, when applied for 12 hours or more, permanent neurological changes occurred
lower local temperature slow down the ischemic process
Sufficient collateral blood supply slow down the ischemic process
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
EPIDEMIOLOGY
The most common site of ACS
• Leg which is followed by forearm, arm, thigh, foot, gluteal region, hand, and abdomen.
Various risk factors are related to compartment syndrome
• Age• Type and site of injury
Males are more prone to develop ACS which is ten times higher than females
Incidence of ACS in open and closed fractures is equal.
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
EPIDEMIOLOGY
33%
25%
20%
6%
16%
Risk Factor: Type and site of injury
closed tibial shaft fracture
blunt and crushed soft tissue limb trauma
radius and ulna shaft fractures
Foot injuries in road traffic accidents
others
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
EPIDEMIOLOGY
Acute compartment syndrome can also result from non-accidental causes like medical condition, such us• nephrotic syndrome, • viral myositis, • hypothyroidism,• bleeding disorders, • malignancies, and• diabetes mellitus
Ruptured Baker’s cyst is also reported as a rarer cause of ACS
Journal Reading : Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and ManagementOrthopedic and Traumatology Department Hasanuddin University
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