Early Detection of Compartment Syndrome With Minimal Symptoms: A Case Report on Continuous Pressure Monitoring

症状轻微时早期发现筋膜室综合征:一例基于连续压力监测的病例报告

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Abstract

Compartment syndrome (CS) arises from various etiologies but is most commonly associated with severe traumatic injuries. It is a difficult diagnosis to make in a timely fashion because clinical signs and symptoms are subjective. Missing the diagnosis is a devastating mistake for the patient and the physician. There has been protracted debate over the effectiveness of clinical signs and symptoms, particularly concerns over their sensitivity and specificity. Both missed diagnoses and unneeded prophylactic releases are costly to the health system. A desired device would be an objective tool that decreased false positives and negatives while ensuring diagnosis in a timely fashion of true positives. The treatment for CS is immediate fasciotomy, but fasciotomy is not a complication-free procedure. Physicians need to be sure of the diagnosis both in order not to have the devastating consequence of a missed case but also not to perform with prophylactic fasciotomies that add to patient complications and the cost of treatment. Previous care maps usually resulted in fasciotomy being performed in extremities that will not or have not yet developed CS. New technology that allows monitoring of continuous pressure monitoring seems to currently be the best aid to diagnosis. We present our experience in using continuous pressure monitoring in decreasing time to diagnosis in a case post-trauma of a lower limb with minimal pain.

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