Forearm Compartment Syndrome in a Patient On Hemodialysis Following Failure Of an Arteriovenous Fistula

摘要

Compartment syndrome is a surgical emergency requiring rapid diagnosis and fasciotomy. The diagnosis can be established with clinical signs, including pain out of proportion to injury, pain on passive muscle stretch, swelling, sensory changes, and later, paralysis. This diagnosis may be confirmed by percutaneous pressure monitoring, which may be used to monitor a suspicious compartment after the development of soft tissue swelling (McQueen, Christie, & Court-Brown, 1996). Compartment syndrome is associated with a complication rate of up to 42%, including Volkman's ischemic contracture, loss of function, neurologic deficits, delayed fracture union, and chronic pain (Duckworth et al., 2012). Compartment syndromes not managed emergently may cause extensive muscle damage and even loss of limb (Brown, Greenhalgh, Kagan, & Warden, 1994). Although forearm compartment syndrome is well-documented, compartment syndrome in adults most commonly occurs following distal radius fractures. It may also take place following supracondylar fractures of the elbow in children (Kalyani, Fisher, Roberts, & Gianoudis, 2011).