engleski

COMPARTMENT SYNDROME OF THE HAND

INTRODUCTION: The diagnosis and treatment of the acute compartment syndrome is of great importance. Unless the viscious cycle is intervened at an appropriately early time it will result in irreversible damage leading to disability. We present case of acute compartment syndrome of the hand. MATERIALS AND METHODS: In our Department 54 years old female was operated due to aneurysmatic bone cyst on second metacarpal. Tumor resection and reconstruction with structural autograft was preformed. First postoperative day patient suddenly started to feel pain and hand became swallen. Although cast was released and arm elevated, simptoms aggravated and we decided for emergency fasciotomy in regional anesthesia. All 10 compartments were released and hand left elevated with no immobilisation. Also we started with antibiotic profilaxis. On fourth and sixth postoperative days wounds were revised and closed with sutures. Ninth postoperative day patient was released home in good condition. RESULTS: After 6 weeks of imobilisation patient started with phisical therapy and 3 months postoperatively she had almost full range of motion in her hand. Radiograms showed complete bone remodeling of second metacarpal bone and no recurrence of bone tumor. DISCUSSION: Acute compartment syndrome of the hand is serius condition. The prognosis depends on the intensity and duration of the elevated compartment pressure. Therefore, time is of the essence in the management of compartment syndrome. When ever clinical findings and/or pressure readings are suggestive for compartment sindrome we should remember that the scar from a fasciotomy incision is of relatively minimal consequence compared to an untreated compartment syndrome that results in a Volkmann's ischemic contracture. Therefore fasciotomy should be done as soon as possible.

compartment syndrome, hand, fasciotomy

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