Pathophysiology, diagnosis, and management of this orthopaedic emergency
- By: Robert W McNinch, John Kao, Richard Willoughby
During your time as a doctor you will be exposed to an extraordinary range of reactions by patients to painful stimuli, from the stoic, quiet patient, through the moaning, rolling patient, to the screaming thrashing patient. After someone has been seriously injured it is easy to understand why they might be in pain. Occasionally a patient may present in considerable pain and distress when they have had only what appears to be a relatively minor injury. It can be easy to attribute this to over-reacting or even drug seeking behaviour, but it is imperative that a medical cause is excluded. One cause that must never be missed is a compartment syndrome.
The limbs and body wall are wrapped in a membrane of fibrous tissue, the deep fascia. This varies in thickness at different sites of the body and allows the muscles to glide beneath it as they contract and relax.