Abstract
Acute compartment syndrome of the hand is a rare pathological condition in which the size of the compartments of the hand could be decreased or the volume of the fluid intro compartment could be increased, or both. This urgent condition, if remains undiagnostic, produce irreversible changes (which are strong related to elapsed time) and may leading to amputation or to threatening life of the patients. Most common causes presented in literature are traumatic (crush injuries, burns, closed fractures), medical (infection, bleeding disorders), iatrogenic (intravenous infiltration, arthroscopy) and vascular (arterial puncture or catheterization, venous occlusion). The purpose of this study is bimodal. Firstly, to present a 34 year-old male who, after a traffic accident, presented with open diaphyseal fractures IIIA of the left 2nd and 3rd metacarpals and a Bennett fracture of the thumb and who developed an acute compartment syndrome. Secondly, to develop a sense of suspicion of this kind of lesions in physicians in the emergency department with scope to the precocious diagnosis and treatment.
Keywords: Compartment syndrome, hand, edema, fasciotomy, metacarpal fractures.
References
- Chandraprakasam T, Kumar RA. Acute compartment syndrome of forearm and hand. Indian J Plast Surg 2011;44(2):212–8, doi:10.4103/0970-0358.85342.
- Rubinstein AJ, Ahmed IH, Vosbikian MM: Hand compartment syndrome. Hand Clin. 2018;34:41-52, org/10.1016/j.hcl.2017.09.005.
- Ashton H. Critical closure in human limbs. Br Med Bull. 1963;19;149-154, doi:10.1093/oxfordjournals.bmb.a070035.
- Belzunegui T, Louis CJ, Torrededia L, Oteiza J. Extravasation of radiographic contrast material and compartment syndrome in the hand: a case report. Scand J Trauma Resusc Emerg Med.2011;19:9, doi:10.1186/1757-7241-19-9.
- Braunlich PR, Braunlich K, Brink R, Ross R, Harker JN. Compartment syndrome of the hand presenting as bullous edema. 2020; 12(3):7290, doi:10.7759/cureus.7290.
- Stavrakakis IM, Daskalakis II, Detsis EPS, Karagianni CA, Papantonaki SN, Katsafarou MS, Hand compartment syndrome as a results of intravenous contrast extravasation. Oxford Medical Case Reports. 2018;12;425-428, doi:10.1093/omcr/omy098.
- Seiler III JG, Olvey S. Compartment syndromes of the hand and forearm. Hand Surgery. 2003;3(4):184-198, doi:10.1016/S1531-0914(03)00072-X.
- Gulli B, Templeman D. Compartment syndrome of the lower extremity. Orthop Clin North Am 1994;25(4):677-684.
- Oak NR, Abrams RA. Compartment syndrome of the hand. Orthop Clin North Am 2016;47(3): 609–16, doi:10.1016/j.ocl.2016.03.006.
- Reichman EF. Compartment syndrome of the hand: A little thought about diagnosis. Case Rep Emerg Med. 2016;2016: 2907067. doi:10.1155/2016/2907067.
- Hoover TJ, Siefert JA. Soft complications of orthopaedic emergencies. Emerg Med Clin North Am, 2000;18(1):115-39, doi:10.1016/s0733-8627(05)70110-3.
- Heppenstall RB, Sapega AA, Scott R, Shenton D, Park YS, Maris J, Chance B. The compartment syndrome: an experimental and clinical study of muscular energy metabolism using phosphorus nuclear magnetic resonance spectroscopy. Clin Orthop Relat Res. 1998;226:138-155.
- Di Felice A, Seiler III JG, T. E. Whitesides TE. The compartments of the hand: an anatomic study. J Hand Surg Am 1998;23(4):682-6, doi: 10.1016/S0363-5023(98)80055-5.
- Griffiths DL. Volkmann’s ischemic contracture. Br J Surg 1940; 28:239–60, doi:10.1002/bjs. 18002811007.
- Codding JL, Vosbikian MM, Ilyas AM. Acute compartment syndrome of the hand. J Hand Surg Am 2015;40(6):1213–6, doi:10.1016/jhsa.2015.01.034.
- Ouellette EA, Kelly R. Compartment syndromes of the hand. J Bone Joint Surg Am 1996;78(10): 1515–22, doi:10.2106/00004623-199610000-00009.
- Bae DS, Kadiyala RK, Waters PM. Acute compartment syndrome in children: contemporary diagnosis, treatment, and outcome. J Pediatr Orthop 2001;21(5):680-688.
- Ortij J A, Berger RA. Compartment syndrome of the hand and wrist. Hand Clinics. 1998;14(3): 405-418, doi: 10.1016/S0749-0712(21)00399-1.
- Halpern AA, Greene R, Nichols T, Burton DS. Compartment syndrome of the interosseous muscles: early recognition and treatment. Clin Orthop Relat Res.1979;140;23-5.
- Duckworth AD, McQueen MM. The diagnosis of acute compartment syndrome. A critical analysis review. JBJS Reviews. 2017;5(12):e1,doi:10.2106/JBJS.RVW.17.00016.
- Whitesides TE Jr, Haney TC, Morimoto K, Harada H: Tissue pressure measurements as a determinant for the need of fasciotomy. Clin Orthop Relat Res. 1975;113:43-51, doi: 1097/00003086-197511000-00007.
- Matava MJ, Whitesides TE Jr, Seiler JG III, Hewan -Lowe K, Hutton WC. Determination of the compartment pressure threshold of muscle ischemia in a canine model. J Trauma 1994;37(1):50–8, DOI:10.1097/00005373-199407000-00010.
- Lipschitz AH, Lifchez SD. Measurement of compartment pressures in the hand and forearm. J Hand Surg Am 2010;35(11):1893–4, doi:10.1016/j.jhsa.2010.07.006.
Corresponding Author
Grigorios Kastanis
Reconstructive Hand Surgery Unit, General Hospital of Heraklion –Venizeleio, Crete, Greece