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Intramedullary Nailing pp 77–84Cite as

Soft Tissue Management and Postoperative Care

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Abstract

The acute compartment syndrome is a limb-threatening complication. Although the diagnosis is primarily based on clinical evaluation, intracompartmental pressure monitoring may be required in specific situations. Surgical decompression is the only adequate treatment. Any delay in surgical management increases the risk of late sequellae.

Early rehabilitation following surgical fracture fixation restores function and avoids local and systemic complications of prolonged immobilization. Postoperative care must be adapted individually. Postoperative radiographs are essential to evaluate fracture healing and recognize potential complications.

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References

  1. Hessmann M, Rommens P. Bilateral ureteral obstruction and renal failure caused by massive retroperitoneal hematoma: is there a pelvic compartment syndrome analogous to abdominal compartment syndrome? J Orthop Trauma. 1998;12(8):553–7.

    Article  CAS  PubMed  Google Scholar 

  2. Moore RE, Friedman RJ. Current concepts in pathophysiology and diagnosis of compartment syndromes. J Emerg Med. 1989;7(6):657–62.

    Article  PubMed  Google Scholar 

  3. Bhattacharyya T, Vrahas MS. The medico-legal aspects of compartment syndrome. J Bone Joint Surg Am. 2004;86-A(4):864–8.

    PubMed  Google Scholar 

  4. McQueen MM, Gaston P, Court-Brown CM. Acute compartment syndrome. Who is at risk? J Bone Joint Surg Br. 2000;82:200–3.

    Article  CAS  PubMed  Google Scholar 

  5. Matsen FR, Krugmire RB. Compartmental syndromes. Surg Gynecol Obstet. 1978;147:943–9.

    PubMed  Google Scholar 

  6. Mabvuure NT, et al. Acute compartment syndrome of the limbs: current concepts and management. Open Orthop J. 2012;6:535–43.

    Article  PubMed Central  PubMed  Google Scholar 

  7. McQueen MM, Christie J, Court-Brown CM. Acute compartment syndrome in tibial diaphyseal fractures. J Bone Joint Surg Br. 1996;78:95–8.

    CAS  PubMed  Google Scholar 

  8. Taylor RM, Sullivan MP, Metha S. Acute compartment syndrome: obtaining diagnosis, providing treatment, and minimizing medicolegal risk. Curr Rev Musculoskelet Med. 2012;5(3):206–13.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Badhe S, et al. The “silent” compartment syndrome. Injury. 2009;40(2):220–2.

    Article  CAS  PubMed  Google Scholar 

  10. Harrington P, et al. Acute compartment syndrome masked by intravenous morphine from a patient-controlled analgesia pump. Injury. 2000;31(5):387–9.

    Article  CAS  PubMed  Google Scholar 

  11. Köstler W, Strohm PC, Südkamp NP. Acute compartment syndrome of the limb. Injury. 2005;36:992–8.

    Article  PubMed  Google Scholar 

  12. Altay MA, et al. Comparison of intracompartmental pressures in a rabbit model of open and closed tibial fractures: an experimental study. Bone Joint J. 2013;95-B:111–4.

    Article  CAS  PubMed  Google Scholar 

  13. Willy C, Gerngross H, Sterk J. Measurement of intracompartment pressure with the use of a new electronic transducer-tipped catheter system. J Bone Joint Surg Am. 1999;81:158–68.

    CAS  PubMed  Google Scholar 

  14. McQueen MM, et al. The estimated sensitivity and specificity of compartment pressure monitoring for acute compartment syndrome. J Bone Joint Surg Am. 2013;95(8):673–7.

    Article  PubMed  Google Scholar 

  15. Elliott KGB, Johnstone AJ. Diagnosing acute compartment syndrome. J Bone Joint Surg Br. 2003;85-B:625–32.

    Google Scholar 

  16. Hargens AR, Hakeson WH, Mubarak SJ. Fluid balance within the canine compartment and its relationship to compartment syndromes. J Bone Joint Surg Am. 1978;60-A:499–505.

    Google Scholar 

  17. Zweifach SS, Hargens AR, Evans KL. Skeletal muscle necrosis in pressurized compartments associated with haemorrhagic hypotension. J Trauma. 1980;20:941–7.

    Article  CAS  PubMed  Google Scholar 

  18. McQueen MM, Court-Brown CM. Compartment monitoring in tibial fractures: the pressure threshold for decompression. J Bone Joint Surg Br. 1996;78-B:99–104.

    Google Scholar 

  19. Ozkayin N, Aktuglu K. Absolute compartment pressure versus differential pressure for the diagnosis of compartment syndrome in tibial fractures. Int Orthop. 2005;29:396–401.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Mullett H, et al. Outcome of compartment syndrome following intramedullary nailing of tibial diaphyseal fractures. Injury. 2001;32:411–3.

    Article  CAS  PubMed  Google Scholar 

  21. Mubarak SJ, Owen CA. Double-incision fasciotomy of the leg for decompression in compartment syndrome. J Bone Joint Surg Am. 1977;59-A:184–7.

    Google Scholar 

  22. McQueen MM, Christie J, Court-Brown CM. Compartment pressures after intramedullary nailing of the tibia. J Bone Joint Surg Br. 1990;72-B:395–7.

    Google Scholar 

  23. Nassif JM, et al. Effect of acute reamed versus unreamed intramedullary nailing on compartment pressure when treating closed tibial shaft fractures: a randomized prospective study. J Orthop Trauma. 2000;14(8):554–8.

    Article  CAS  PubMed  Google Scholar 

  24. Tornetta P, French BG. Compartment pressures during nonreamed tibial nailing without traction. J Orthop Trauma. 1997;11(1):24–7.

    Article  PubMed  Google Scholar 

  25. Turen CH, Burgess AR, Vanco B. Skeletal stabilization for tibial fractures associated with acute compartment syndrome. Clin Orthop Relat Res. 1995;315:163–8.

    PubMed  Google Scholar 

  26. Reverte MM, et al. What is the effect of compartment syndrome and fasciotomies on fracture healing in tibial fractures? Injury. 2011;42(12):1402–7.

    Article  PubMed  Google Scholar 

  27. Janzing HM, Broos PL. Dermatotraction: an effective technique for the closure of fasciotomy wounds: a preliminary report of 15 patients. J Orthop Trauma. 2001;15(6):438–41.

    Article  CAS  PubMed  Google Scholar 

  28. Zannis J, et al. Comparison of fasciotomy wound closures using traditional dressing changes and the vacuum-assisted closure device. Ann Plast Surg. 2009;62(4):407–9.

    Article  CAS  PubMed  Google Scholar 

  29. Ojike NI, Roberts CS, Giannoudis PV. Review compartment syndrome of the thigh: a systematic review. Injury. 2010;41(2):133–6.

    Article  PubMed  Google Scholar 

  30. Blum J, et al. Biomechanical comparison of bending and torsional properties in retrograde intramedullary nailing of humeral shaft fractures. J Orthop Trauma. 1999;13(5):344–50.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Academic Teaching Hospital Fulda, Pacellialllee 4, Fulda, D-36043, Germany

    Martin H. Hessmann MD, PhD & Veit Winkelbach MD

  2. Center of Orthopedics and Traumatology, University Medical Center, Johannes Gutenberg-University, Langenbeckstrasse 1, Mainz, 55131, Germany

    Pol M. Rommens MD, PhD

Authors
  1. Martin H. Hessmann MD, PhD
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  2. Veit Winkelbach MD
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  3. Pol M. Rommens MD, PhD
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Corresponding author

Correspondence to Martin H. Hessmann MD, PhD .

Editor information

Editors and Affiliations

  1. Center for Orthopedics &Traumatology, University Medical Center Johannes Gutenberg University, Mainz, Germany

    Pol M. Rommens

  2. Academic Teaching Hospital Fulda, Fulda, Germany

    Martin H. Hessmann

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© 2015 Springer-Verlag London

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Hessmann, M.H., Winkelbach, V., Rommens, P.M. (2015). Soft Tissue Management and Postoperative Care. In: Rommens, P., Hessmann, M. (eds) Intramedullary Nailing. Springer, London. https://doi.org/10.1007/978-1-4471-6612-2_7

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  • DOI: https://doi.org/10.1007/978-1-4471-6612-2_7

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6611-5

  • Online ISBN: 978-1-4471-6612-2

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