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OrthoVellum

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Trauma
intermediate
X-Type

Acute Compartment Syndrome of the Leg

Lower Limb Trauma

A 25-year-old male is 6 hours post-operativeafter intramedullary nailing of a closed mid-shaft tibial fracture sustained in a motorcycle accident. The ward nurse contacts you urgently because the patient is requiring escalating doses of morphine for severe calf pain that is "worse than before surgery." On examination, the calf is tense and woody on palpation. There is severe pain with passive dorsiflexion of the toes. The patient can weakly plantarflex the ankle but cannot dorsiflex the foot or extend the toes. Sensation in the first web space is diminished. Dorsalis pedis and posterior tibial pulses are both palpable. Regarding acute compartment syndrome of the leg:

Mark each as TRUE or FALSE

A

Acute compartment syndrome is a surgical emergency where elevated pressure in a closed fascial compa...

B

The leg has four compartments: anterior (tibialis anterior, EDL, EHL, deep peroneal nerve), lateral ...

C

Delta P (perfusion pressure) is calculated as diastolic BP minus compartment pressure; Delta P less ...

D

Conservative management with cast splitting, limb elevation above the heart, and ice application is ...

E

Emergency four-compartment fasciotomy is performed via two-incision technique: lateral incision (2cm...

Answer the questions to see explanations

Click T (True) or F (False) for each option