Title: Management of Vascularity Compromised Limb in A Rural Hospital
Authors: Dr Ishtyak Ahmed Mir, Dr Shamim Akhter
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.28
Abstract
The study was conducted to know the presentation, symptomatology, clinical signs and management outcome of post traumatic painful and swollen limbs in a Community Health Centre. 21 patients managed for post traumatic edema and pain of the limb are presented. Males outnumbered females. Blunt trauma was the most common mode of injury, and lower limb was involved in majority. Majority were under treatment of quacks. Diagnosis of post traumatic swollen and vascular compromised limb (compartment syndrome) requiring some mode of treatment was made on clinical grounds, and pulse oxymetry. 10 patients underwent fasciotomy,6 were managed conservatively and 4 patients underwent amputation. All the patients managed by conservative and surgical therapy had successful outcome.
Key Words: Fasciotomy, Gangrene, Splints, Trauma Limbs
References
1. Volkmann R. Die ischaemischen Muskellahmungen and Kontrakturen. Centralbl chir 1881 ; 8: 801-3.
2. Jepson P N. Ischemic contracture : experimental study. Ann Surg 1926 Dec; 84 (6): 785-95.
3. Rorabeck CH. The treatment of compartment syndrome of the leg. J Bone Joint Surg Br 1984; 66: 93-7.
4. Lagerstrom CF, Reed RL II, Rowlands BJ, Fisher RP. Early fasciotomy for acute clinically evident posttraumatic compartment syndrome. Am J Surg, 1989 Jul; 158 (1): 36-9.
5. Mubarak SJ, Owen CA, Hargens AR, Garetto LP, Akeson WH. Acute compartment syndrome : diagnosis and treatment with the aid of a wick catheter. J Bone Joint Surg Am 1978; 60: 1091-5.
6. Turen CH, Burgess AR, Vanco B. Skeletal stabilization for tibial fracture associated with acute compartment syndrome. Clin Orthop 1995 Jun; 315: 163-8.
7. McQueen MM, Gaston P, Court-Brown CM. Acute compartment syndrome, Who is at risk ? J Bone Joint Surg Br 2000 Mar; 82 (2): 200-3.
8. Mullet H, Al Abed K, Prasad CVR, O’Sullivan M. Outcome of compartment syndrome following intramedulary nailing of tibial diaphyseal fractures. Injury 2001; 32: 411-13.
9. Gilberman RH, Garfin SR, Hergenroeder PT, Mubarak SJ, Menon J. Compartment syndrome of the forearm: diagnosis and treatment. Clin Orthop 1981 Nov-Dec; 161: 252-61.
10. Royal SG. Compartment syndrome following forearm fracture in children. Injury 1990; 21: 73-6.
11. Ascer E, Strauch B, Calligaro KD, Gupta SK, Veith FJ. Ankle and foot fasciotomy: an adjunctive technique to optimize limb salvage after revascularization for acute ischemia. J Vasc Surg 1989 Apr; 9 (4): 594-7.
12. Hallidav AW, Taylor PR, Wolfe JH, Mansfield AO. The management of popliteal aneurysm: the importance of early surgical repair. Ann R Coll Surg Engl 1991 Jul; 73 (4): 253-7.
13. Schwartz JT Jr, Brumback RJ, Lakatos R, Poka A, Bathon GH, Burgess AR. Acute compartment syndrome of the thigh; A spectrum of injury. J bone Joint Surg Am 1989 Mar; 71 (3): 392-400.
14. Justis DL, Law EJ, MacMillan BG. Tibial compartment syndrome in burn patients, a report of four cases. Arch Surg 1976 Sep; 111 (9): 1004-8.
15. Ouellette EA, Kelly R. Compartment syndromes of the hand. J Bone Joint Surg Am 1996 Oct; 78 (10): 1515-22.
16. Sheridan GW, Matsen FA III. Fasciotomy in the treatment of acute compartment syndrome. J Bone Joint Surg Am 1976; 58-A: 112-15.