Das akute Kompartmentsyndrom

Das Kompartmentsyndrom der Extremitäten stellt eine unfallchirurgische Notfallsituation dar, die bei verzögerter Therapie eine vitale Gefährdung des betroffenen Extremitätenabschnitts bedeutet. Wesentliches pathophysiologisches Charakteristikum ist – unabhängig von der Lokalisation – die intrakompartimentelle Gewebedruckerhöhung mit einer daraus resultierenden Mikroperfusionsstörung und nachfolgenden Hypoxie der betroffenen Muskulatur. Die Druckerhöhung kann aus einer direkt verletzungsbedingten Weichteileinblutung und aus einem ischämieinduzierten Ödem resultieren. Im Bereich der Extremitäten sind von besonderer klinischer Bedeutung

In Teil 1 werden die Ätiologie, Pathophysiologie und die Diagnostik beschrieben. In Teil 2 des Artikels (s. Hawel et al. [1]) sind das therapeutische Vorgehen inkl. der möglichen Komplikationen sowie das Outcome dargestellt.

• Quellenangaben

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• Zum Weiterlesen und Vertiefen

• 1 Heckman MM, Whitesides jr. TE, Grewe SR, Rooks MD. Compartment pressure in association with closed tibial fractures. The relationship between tissue pressure, compartment, and the distance from the site of the fracture. J Bone Joint Surg Am 1994; 76: 1285-1292
• 2 Heppenstall RB, Sapega AA, Scott R et al. The compartment syndrome. An experimental and clinical study of muscular energy metabolism using phosphorus nuclear magnetic resonance spectroscopy. Clin Orthop Related Res 1988; 138-155
• 3 McQueen MM, Christie J, Court-Brown CM. Acute compartment syndrome in tibial diaphyseal fractures. J Bone Joint Surg Br 1996; 78: 95-98
• 4 McQueen MM, Gaston P, Court-Brown CM. Acute compartment syndrome. Who is at risk?. J Bone Joint Surg Br 2000; 82: 200-203
• 5 Sterk J, Schierlinger M, Gerngross H, Willy C. [Intracompartmental pressure measurement in in acute compartment syndrome. Results of a survey of indications, measuring technique and critical pressure value]. Unfallchirurg 2001; 104: 119-126
• 6 Willy C, Gerngross H, Sterk J. Measurement of intracompartmental pressure with use of a new electronic transducer-tipped catheter system. J Bone Joint Surg Am 1999; 81: 158-168