One dangerous risk that can develop from severe orthopedic injury such
as a broken leg is compartment syndrome. If not identified quickly
enough, the muscle can die and the results can be debilitating.
A cast isn抰 always the only thing that is needed to repair a broken
bone. An uncommon but real threat following orthopedic injury is
compartment syndrome. Not only is the condition painful, but can result
in permanent disfigurement and lifelong disability if not treated
properly and immediately. It can be difficult to identify its presence,
and nurses will be required to make constant checks on the patient if
the risk is present.
A rare but exceedingly dangerous complication that can occur following a
complex bone break is called compartment syndrome. The pressure in the
area builds to extremes, and if left unattended, the blood flow can get
cut off, causing the tissue and muscle to suffer from necrosis, or
death. If identified quickly enough, the area will be opened up (covered
with a sterile dressing to help protect the surface) to relieve the
pressure and save the tissue. Fast action on the part of an orthopedic
doctor and nurse team can prevent necrosis or at the very least stop any
severe damage and infection. Inaction or a failure to act on the signs
of compartment syndrome may require multiple surgeries in order to
correct and save the affected limb.
Orthopedic nurses are instructed on the 5 揚s?of recognizing
compartment syndrome when they receive a patient who is at risk. Pain is
the first sign and can be somewhat ambiguous in meaning. All patients
will feel discomfort after a break. It is up to the medical staff to
ensure that the pain experienced is normal. Unusual pain that cannot be
relieved by morphine, seems extreme (can be difficult to ascertain
depending on the individual), and that worsens with any stretching of
the muscle is a sign. Paresthesia is the second symptom, which is more
colloquially known as a feeling of 損ins and needles?or a 揹ead?
sensation. Pallor or paleness of skin is the third, followed by
paralysis and lack of pulse. Not all five need to be present to signify
the presence of the problem, and indeed only one or two may occur,
making it necessary for nurses to be on high alert immediately following
the injury.
To treat compartment syndrome, the pressure must be removed. The only
method to do this is by cutting open the area until the swelling
subsides. A skin graft is then used to cover the wound. It may take
several surgeries to complete the process as in extreme cases where
tissue has died it must be monitored carefully and then removed as
needed. If enough muscle has died, it may be necessary to do an
extensive graft harvested from another area of the body. Depending on
how much muscle is lost, rehabilitation can be difficult. Another
concern is the issue of foot drop which can develop as a result of
complications. If the ankle muscles are unable to support and flex the
foot properly or there is nerve damage, the foot will fall at an
unnatural angle that makes walking impossible without the assistance of
orthotics. In some cases movement can be regained through physical
therapy.