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Síndrome compartimental - Treatment

Tratamiento:

Se requiere cirugía. Se hacen incisiones quirúrgicas largas a través de la fascia con el fin de aliviar la presión. Las heridas se pueden dejar abiertas (cubiertas con un apósito estéril) y cerrarlas durante una segunda cirugía, generalmente de 48 a 72 horas más tarde. Es posible que se requieran injertos de piel para cerrar la herida.

Si el problema lo está ocasionando un yeso o un vendaje, se debe aflojar o cortar el apósito para aliviar la presión.

Expectativas (pronóstico):

Con un diagnóstico y tratamiento oportunos, el pronóstico es excelente para la recuperación de los músculos y nervios que se encuentran dentro del compartimento. Sin embargo, el pronóstico general estará determinado por la lesión que lleva al síndrome.

Si el diagnóstico se retrasa, se puede presentar una lesión permanente en el nervio y pérdida de la función muscular. Esto es más común cuando la persona lesionada está inconsciente o demasiado sedada y es incapaz de quejarse del dolor. La lesión permanente del nervio puede ocurrir después de 12 a 24 horas de compresión.

Complicaciones:

Las complicaciones abarcan lesión permanente a los nervios y los músculos que puede llegar a deteriorar su desempeño de manera dramática. (Ver isquemia de Volkmann)

En casos más severos, se puede requerir la amputación.

Situaciones que requieren asistencia médica:

Consulte con el médico si ha sufrido una lesión y presenta hinchazón severa o dolor que no mejora con analgésicos.

  • Reviewed last on: 7/28/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Unviersity of Washington School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Twaddle BC, Amendola A. Compartment syndrome. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, Krettek C, eds. Skeletal Trauma. 4th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 13.

Geiderman JM, Katz D. General principles of orthopedic injuries. In: Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 46.

Jobe MT. Compartment syndromes and Volkmann contracture. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 71.

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