Q) All are true about compartment syndrome of limb except?
a) Diagnosis is unlikely if pulse is felt distally
b) There is pain on passive stretching of the limb
c) Pain is out of proportion to the signs
d) Muscles of calf and forearm are commonly involved
Correct Answer: a) Diagnosis is unlikely if pulse is felt distally
Explanation:
Compartment syndrome occurs when hydrostatic pressure within a fascial compartment increases enough to compromise circulation, leading to muscle ischemia and necrosis.
- The calf, forearm, hand, and foot muscles are most commonly involved.
- It is a clinical diagnosis with key features: severe pain out of proportion to the signs, increasing pain, and pain on passive stretch.
- Other late signs include paralysis, paresthesia, pallor, and pulselessness (which is an extremely late sign).
- Importantly, peripheral pulses are generally not affected early. This means a patient can still have palpable distal pulses despite having compartment syndrome.
- Diagnostic thresholds include: absolute compartment pressure ≥30 mmHg or a delta pressure (diastolic BP – compartment pressure) ≤30 mmHg.