Talk:Compartment syndrome

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2020 and 31 January 2020. Further details are available on the course page. Student editor(s): ErBec. Peer reviewers: Asowers15.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 19:23, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 26 November 2018 and 21 December 2018. Further details are available on the course page. Student editor(s): Poseysfriend. Peer reviewers: Libbyburch.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 18:12, 16 January 2022 (UTC)

The 5 'p's of compartment syndrome

It may be worth adding the 5 'p's of compartment syndrome to this page.

All five of these 'p's are 'pain' highlighting the importance of this symptom in someone post fracture. These are more useful than the 6 'p's of ischaemia as ischaemia is a very late sign of compartment syndrome. More specifically the list is

5 'p's of compartment syndrome
Pain despite analgesia
Pain greater than would be expected for that injury
Pain on passive movement of the fingers or toes which continues while the digit is help in position
Pain in the presence of pulses - loss of pulses as indicated by the 6 'p's of ischaemia is a very late sign in compartment syndrome as compartment pressure would first have to exceed arterial pressure. By this point pain and damage has already occurs due to venous obstruction
Pain elicited by touching skin over the compartment - tenderness

I'm not an expert at editing pages so I will leave this, hopefully, for someone to edit.

--90.199.100.211 (talk) 17:06, 24 March 2008 (UTC) Oliver

This article needs to be this technical - for the technical audience that will mostly be using it. G - medical student —Preceding unsigned comment added by 78.150.17.100 (talk) 19:08, 2 July 2008 (UTC)

RE: My removal of "Action to take section"

It probably won't be a problem, but I linked WP:MEDICAL incorrectly in my edit summary. this is a correct link. Riffraffselbow (talk) 00:24, 20 May 2009 (UTC)

What about chronic exertional compartment syndrome?

I have added information on CECS that I know from personal experience with it. I am a college student though and not a medical expert. nef614 (talk) 16:02, 12 Sept 2014 (UTC)

I couldn't find anything about this here on Wikipedia, but the, apparently reputable, site below lists it as an exercise-related syndrome that typically results from exertion during exercise where the muscles swell but blood vessels and nerves do not, causing a tingling sensation.

I think that this is worth adding, but am hesitant to do it, since I am not a health professional.

Read more: http://www.livestrong.com/article/304555-numbness-after-exercise/#ixzz1BXN0xnKG —Preceding unsigned comment added by 129.72.188.198 (talk) 02:12, 20 January 2011 (UTC)

Quality

The quality of Symptoms and signs section is horrible, especially the first paragraph. Looks like it might even be plagerism. — Preceding unsigned comment added by 174.112.216.70 (talk) 03:40, 15 September 2013 (UTC)

I want to add that the first paragraph of Signs/Symptoms is incorrect, even according to the cited sources. Both sources indicate that numbness/tingling are not the first signs, but rather disproportional pain is. (70.68.155.207 (talk) 04:51, 1 April 2016 (UTC))

Lancet review

doi:10.1016/S0140-6736(15)00277-9 JFW | T@lk 21:29, 29 September 2015 (UTC)

Further reading

• Ahmet Bayar, MD; Selcuk Keser, MD; Mubin Hosnuter, MD; H. Alper Tanriverdi, MD; Ahmet Ege, MD. "Lower Limb Compartment Syndrome After an Uncomplicated Labor". Orthopedics. November 2007 – Volume 30 · Issue 11
• Floyd R. and Thompson C. Manual of Structural Kinesiology 17th Ed., McCrawHill. ISBN 978-0-07-337643-1
• Blackman, Paul G.. "A review of chronic exertional compartment syndrome in the lower leg." Medicine and Science in Sports and Exercise 32.3 (supp): S4-S10.
• Hamill, J and Knutzem KM. Biomechanical Basis of Human Movement, 3rd Ed. Lippincott Williams&Wilkins. ISBN 978-0-7817-9128-1
• Leung, Y.F., Ip, S.P., Chung, O.M., Wai, Y.L., (2003, June). Unimuscular neuromuscular insult of the leg in partial anterior compartment syndrome in a patient with combined fractures. Hong Kong Medical Journal, 9.
• Rankin, E.A., Andrews, G. (1981, December). Anterior tibial compartmental syndrome: an unusual presentation. Journal of the National Medical Association, 73.
• Rorabeck, C.H., (1984, January). The treatment of compartment syndromes of the leg. Journal of Bone and Joint Surgery-British, 66-B. Retrieved from http://web.jbjs.org.uk/cgi/content/abstract/66-B/1/93
• Shadgan, B., et al. (2010, October). Current thinking about acute compartment syndrome of the lower extremity, Canadian Journal of Surgery, 53.
• Shears, E., Porter, K. (2006). Acute compartment syndrome of the limb. Trauma, 8.
• Touliopolous, S., Hershman, E.B., (1999, March). Lower leg pain: diagnosis and treatment of compartment syndromes and other pain syndromes of the leg. Sports Medicine, 27.

Notable cases

This article is starting to accrete a list of persons who have had the syndrome. WP:MEDCASE provides some guidance; we should not have such a list unless the case has significantly contributed to the public awareness of the condition. Otherwise it is nothing but a category. Kablammo (talk) 20:35, 25 September 2018 (UTC)

Yup. Have moved here. These cases should expand significantly public or professional awareness. The ones listed below are the in passing type. Doc James (talk · contribs · email) 16:00, 22 October 2018 (UTC)

Notable cases

PBS science correspondent Miles O'Brien had a compartment syndrome and had to have his left arm amputated.

NFL Player Rahim Moore.

Kara Goucher, professional long distance runner.

Tessa Virtue, Olympic ice dancer.

Proposed Workplan - December 2018

Mon 11/26 Course Day 1

•Have 2-3 possible articles in mind for editing this month •Have researched articles that need updating and/or are of interest to me •Have reviewed the tutorials and editing style guide for medical articles

Tues 11/27 Course Day 2

• Chosen 1 article to work upon and 1 article to review = Compartment Syndrome, Testicular Torsion
• Considered the rest of the timeline for the course

Mon 12/3 WP-WIP #1

•Definite timeline for the rest of the course, completed workplan •Identified sources •Contact Whit if difficulty identifying sources or running into trouble with citations, etc. •Attend WP-WIP via phone call •Edits of the article in the sandbox with plan to incorporate feedback and be ready to make live edits by WP-WIP #2

Tues 12/11 WP-WIP #2

•Asynchronous participation in WP-WIP (attending an interview at this time) •Continuing editing article in sandbox, making live edits

Fri 12/14 WP-WIP #3

•Attend WP-WIP via phone call •Started peer-review of testicular torsion article

Mon 12/17 WP-WIP #4

•Work on polishing the article •Consider using Hemingway tool as well as close read for spelling, grammar and avoidance of local (American) slang or “medicalese”.

Fri 12/21 Course Wrap-up

•Peer-review completed •Complete final review check list •Article finalized and feedback from peer-review, WP Medicine community incorporated •Travel for wrap-up session.

Why this article? Include WP rating scale? How fit with your interests. Other details as desired

• I am interested in the subject material as it is a topic relevant to emergency medicine.
• The article is graded as C-class and the topic is deemed to be mid-importance.
• I would like to add subsections for orbital compartment syndrome and/or hand.
• Of note, there are multiple, recent review articles accessible through PubMed that are not listed in the sources. The article could be enhanced by inclusion of these newer articles.

You WP editing team (up to 4)

• Libby Burch will be peer-reviewing my article. The WP: Medicine community has already provided useful comments for the project.

Initial Analysis of the article

• Overall, well-written at a level appropriate for a lay-person to grasp the fundamentals (in the lead paragraph especially) but also with opportunity to add sections on specific compartment syndromes (orbital, hand, etc.)

Overall organization, what changes

• Overall organization is clear: S/S, Etiology, Pathophysiology, Diagnosis, Treatment, Prognosis and Epidemiology in that order. *Usually, I would consider having epidemiology as the first section in an article like this but, with a lay readership in mind, I appreciate having the epidemiology section (dry by comparison to the other sections) last.

I will be adding subsections on orbital compartment syndrome and/or compartment syndrome of the hand as the anatomical considerations of these processes is of interest. Also, a discussion of compartment syndrome in children is currently lacking.

What will you add?

• Orbital compartment syndrome, hand compartment syndrome subsections.
• Discussion on compartment syndrome in children.
• Expanded information for the prognosis section.

What will you remove?

• “ACS” acronym. I think that the topic can be further expanded and am hesitant to remove sections.

What will you augment?

• Prognosis section

What will you decrease coverage of?

• N/A

Additional Considerations

• There are entire sections (ie pathophysiology, epidemiology) that have a single citation. I will seek to include additional sources for these sections.
• The content in the article is relevant to the topic, is neutral and without biased sources.
• Some links to citations are missing – will attempt to rectify this.
• Also, a quick PubMed search shows that there are newer review articles that are not listed in the citations section of the article.

With respect to adding the sections on orbital and hand compartment syndrome, I would like to add photos via Wikimedia Commons. I will link to related articles for these topics. For these sections in the article, I will use textbooks and review articles.

• To ensure that I do not use “doctor-speak”, I will have my family members (none of whom are trained in medicine) review the article.

I welcome any feedback from the Wikipedia community on my proposed workplan and look forward to working on this article this month (Dec. 2018). Thank you!

Poseysfriend (talk) 17:47, 3 December 2018 (UTC)

Response

The lead needs to explain in clear and ordinary language what exactly it is: swelling and how that swelling in constrained. Right now it assumes too much knowledge. Kablammo (talk) 20:02, 3 December 2018 (UTC)

Peer Review

Hi Dan,

Overall: This page is well written, complete, and easy to read. Its strengths are its comprehensiveness and language. Organization is good, aside from a few ideas (enumerated below). I would like to know more about Prognosis (I know, the hardest thing to find, sorry!), but since readers will definitely want to know this, it's worth elaborating. Perhaps if you change it to "Complications", you could better summarize what is being avoided by fasciotomy (i.e. amputation/limb loss).

Category
Readability	At goal. Reads well. No obvious grammatical errors or hard-to-read sentence structures.
Target Audience	Educated non-doctor. There are some sections that are a bit medical (Complications, Causes), but link outs help.
Citation Quality	Citations are a good mix of text books, review articles, expert consensuses. There are a few cases thrown in (Footballer), and a RCT (hyperbaric O2), but those seem to be the only ones.
Citation Completeness	Citations needed for several statements: First sentences of Acute under Causes ("The most common cause of acute compartment syndrome (ACS) is fracture of a bone, which accounts for 69% to 75% of the reported cases. Importantly, there is no difference in the incidence of compartment syndrome between open and closed fractures. Leg compartment syndrome is found in 2% to 9% of tibial fractures.") Need citation for treatments (first few sentences of Acute again) Citation included in chronic compartment syndrome is actually about acute compartment syndrome, so need some chronic citations Need citation for statement about prognosis
Overall Organization	There are some redundancies. CECS symptoms are included both in symptoms and in causes There are treatment options given in Causes Sections Causes and Pathophysiology are very similar in my mind. Maybe use the text from Pathophys as a mini-lead for your Causes section? Or put Pathophys above Causes
Pictures/Media	Could include picture of a pressure transducer being used to diagnose? I would also recommend a different/elaborated caption for the lead picture. What surgery was this? Why is the wound open?
Link Outs	While many link outs are there, there are some that need adding. Would do a read through to make sure.
Clarity of Writing/Reading Level	Good!
US-Centric Idioms?	None that I found
Neutrality	Great!

Again, awesome work. I think a few changes, specifically with organization and taking out redundancies will really help. Let me know if you have questions. Libbyburch (talk) 06:03, 14 December 2018 (UTC)

Thanks for these excellent suggestions, Libby! I was on the fence about whether or not to edit the redundancies in s/s, causes, pathophys and the like - it seemed that other editors had arranged the page in a way that hadn't been overhauled in a few years. But, after reading your suggestions and re-reading the article I agree and so made those changes to the organization that you discuss above. I appreciate the close eye in reviewing the appropriateness of my sources and the use of citations for each point in the article. I've made edits to those sections you've identified as able. Unfortunately, I cannot find a sufficient review article to discuss prognosis in greater detail. Maybe that can be work a future editor when the next major review article is published! Thanks again for your help!

Poseysfriend (talk) 17:26, 21 December 2018 (UTC)

WikiProject Medicine

I am a 4th year medical student who has selected the Wikipedia article “Compartment syndrome” to help contribute to and improve over the next month. I will focus mostly on acute and chronic compartment syndrome of the leg and arm. If I see any blatant errors of the abdomen I will fix as well. My general plan is to fix grammar, add information to make the timeline from diagnosis to recovery more detailed, add new citations, and get more recent citations, Below are some examples of specifics I will focus on:

Signs and symptoms Add more of a description of initial occurrence and when to suspect it. Add that acute compartment syndrome is a medical emergency.

Causes: There are other causes that are well defined that can be added for acute compartment syndrome. (Vigorous exercise, cocaine, anabolic steroids). Additionally, I will touch on newer evidence for differing tibial fractures leading to compartment syndrome of the leg. As well as add evidence for little difference between management of compartment syndrome caused by open vs closed fractures.

Pathophysiology: Plan to make more comprehensive with more citations and details of how this can cause damage to other organs. Diagnosis: Add noninvasive diagnostic tools (such as NIRS). MRI similar to ICP for CECS

Treatment: Will discuss wound vac placement prior to closing if needed. Additionally, will discuss physical therapy in settings such as removal of necrotic muscle or in CECS

Prognosis: Will add possibility of permanent nerve damage (foot drop/ loss of sensation), additionally will add limb amputation as possible if compartment syndrome missed early.

These are a few additions I hope to add. As I search the literature I will update more. I look forward to working with others to contribute to this page. — Preceding unsigned comment added by ErBec (talk • contribs) 23:54, 8 January 2020 (UTC)

Peer Review Wikimedicine

Hey, just reviewing your stuff. I'll list a couple of my thoughts here for us to discuss.

-Readability is pretty good. Some sections get a bit complicated, but I believe that is the nature of the beast, and your links help by providing more information.

-Most sources are great. There are a couple that are single studies, which is not ideal. However, I know some of the treatment options coming out are new and not much data may be available for them.

-Followed your work plan quite well, one thing to possibly consider, is expanding a bit more on NIRS, like how it works. Just so someone reading doesn't have to search everywhere for that answer. Or hyperlink it to another article that can expand on it.

-I think everything flows quite well and follows a logical order. It is also nice being able to easily identify sections where the information desired is so it is easy to skip around.

-Plenty of sources, good job getting most sentences to have citations.

-Prognosis section, perhaps a bit more statistics on the different locations of compartment syndrome and their prognosis. Unclear what outcomes are in the majority of cases.

-Great job!

Response: Thanks, Sounds good,I'll be able to make some good changes off that. ErBec (talk) 02:28, 31 January 2020 (UTC)

Better Image

Hi -- I've never edited a page before, but would like to request that someone change the image. That particular image is unnecessarily gruesome and triggering for this topic. I was just looking for info about the syndrome, didn't need that image to be above the fold and unavoidable. A medical illustration would be better. Thank you. — Preceding unsigned comment added by 67.168.173.70 (talk) 13:16, 29 May 2020 (UTC)

While I agree that the photos on the page are too graphic for some people (including children) I don't agree with replacing them completely. Instead, using a content warning method that will obscure the image could allow anyone reading the article to decide if they want to click on the image to see it or not. And rather than replacing the photos with drawings, maybe adding another, less gruesome photo, could accomplish the same thing. MandieJ1975 (talk) 03:08, 23 November 2022 (UTC)

Redirect from "Arm pump" needed?

From following sports, particularly motorcycle racing, I know that compartment syndrome in the forearm is commonly referred to as "arm pump" or "arm-pump." I suggest that the term (used in several articles about individual motorcycle racers such as here) should be mentioned in this article, and that a redirect for it to this article be created. However, I lack the expertise both to find Reliable sources for the term and its meaning, and to create redirects. Would anyone care to take this on? {The poster formerly known as 87.81.230.195} 90.197.27.217 (talk) 16:19, 25 May 2021 (UTC)

Compartment syndrome

compartment syndrome 5Ps 1-pain 2-pallor 3-paresthesia 4-pulselessness 5-paralysis 134.35.177.251 (talk) 21:37, 13 August 2022 (UTC)

Compartment syndrome Abdulelah khalil abdulrab Mohamed (talk) 21:51, 13 August 2022 (UTC)

Compartment syndrome

compartment syndrome 5Ps 1-pain 2-pallor 3-paresthesia 4-pulselessness 5-paralysis Abdulelah khalil abdulrab Mohamed (talk) 21:44, 13 August 2022 (UTC)

Edema

How does this relate to edema? · · · Peter Southwood ^(talk): 18:20, 17 December 2022 (UTC)