![]() ![]() This chapter aims to present the current concepts regarding hand compartment syndrome. Correct timing of fasciotomies is of paramount importance, in order to achieve a good functional outcome. Intervention varies from simple actions, such as splitting a tight cast, to a surgical decompression. Once the diagnosis of an ACS is made, treatment should be implemented promptly. Disproportionate pain, severe swelling and a relevant mechanism should raise a strong suspicion of a compartment syndrome. Good knowledge of the special anatomy of the hand is necessary, in order to manage compartment syndrome appropriately. In case there is any doubt towards the diagnosis of ACS or for insensate patients, intracompartmental pressure measurement is used to aid the evaluation. Diagnosis of this urgent situation is challenging and it is based mainly on the clinical examination. Severe functional disability of the hand, due to muscles’ contractures, is the inevitable result of a neglected compartment syndrome. Acute compartment syndrome (ACS) of the hand is rare, as compared to other areas of the human body, but the consequences are detrimental if treated suboptimally. Appropriate figures of the clinical image and surgical decompression are presented as well.Ĭompartment syndrome is defined as an elevated pressure of an anatomical compartment up to a level where the tissue blood perfusion is impeded. Faciotomies’ indications and operative technique are described in details. Signs and symptoms are reported, as well as guidelines of the technique of intracompartmental pressure measurement. Special considerations regarding hand compartments are presented, 3. A brief description of the hand compartment syndrome is presented. Our chapter includes the following sections: 1. Failing to manage this emergent condition properly leads to a significant hand disability. Once the diagnosis of acute compartment syndrome has been made, decompression of all compartments is mandatory, in order to achieve a good outcome. Intracompartmental pressure measurement contributes to the diagnosis, but it is not always reliable. Pain out of proportion of injury and excessive swelling should raise suspicion towards a compartment syndrome. Diagnosis of compartment syndrome of the hand remains challenging. ![]() Eleven compartments are included in the hand and wrist. The hand is rarely affected, but if treated suboptimally, it results to a permanent loss of function. Compartment syndrome is defined by high pressures in a closed myofascial compartment, which affects initially the muscles and later the nerves and vessels. ![]()
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