UNLOCKING TENSIONS: THE SYNERGY OF POINT OF CARE ULTRASOUND AND FASCIOTOMY

Abstract

Compartment syndrome is an agonizing state arising from excessive pressure buildup within muscles, hindering blood circulation and depriving nerve and muscle cells of vital oxygen and nutrients. Usually, this condition arises following injury-induced bleeding or swelling. The elevated pressure characteristic of compartment syndrome impedes the circulation of blood, oxygen and essential nutrients to and from the impacted tissues. In some cases, it necessitates immediate surgical intervention to avert lasting damage. Consensus holds that prompt intervention offers the greatest opportunity for full recovery and for averting additional tissue necrosis. Treatment primarily relies on clinical presentation, supported by corroborative measurements of compartmental pressure. A fasciotomy is an emergency procedure used to treat acute compartment syndrome. We describe a scenario involving a 19-years-old male, where in the diagnosis and postoperative outcome was swiftly facilitated by point-of-care ultrasound (POCUS), revealing a substantial thigh hematoma within the anterior compartment with vascular compromise before fasciotomy revealed by color and pulse wave doppler. Using POCUS, restorage of circulation and local hemodynamics after fasciotomy were assured by detecting normal doppler signal of previously involved peripheral arteries. Although POCUS should not serve as the sole method for evaluating potential compartment syndrome, it can significantly contribute as a supplementary tool in the diagnostic process and especially when following up patients where therapeutic actions have been done.