Editorial
European Journal of Trauma and Emergency Surgery
Focus on Compartment Syndrome Compartment syndrome is seldom a subject of discussion in continuous medical education, symposia or congresses. Trauma surgeons seem to know all about it; repetition or actualization of knowledge is not asked for. Nevertheless, if we look through literature, numerous case reports of dramatic patient histories with compartment syndrome appear continuously. They all contain warnings and ask for a high index of suspicion. This shows that compartment syndrome still exists, is sometimes recognized too late with long-life sequels as a consequence. Many of them are the subject of court cases and lead to high compensation payments. This theme issue provides recognized and actual data on frequency, causes, diagnosis and treatment of compartment syndrome of the extremities. Janzing especially focuses on diagnosis [1]. What is the real value of several diagnostic procedures? Is invasive diagnosis compulsory in every patient with a lower leg fracture? If not, who are the patients at risk and what are the threshold values, which make decompression necessary? Burkhart et al. describe the compartment syndrome of the upper extremity, which certainly is an underestimated entity [2]. In their contribution, they describe in detail the specific signs of pathological pressure in the different compartments of the lower arm and the hand and how to decompress them safely. Hessmann et al. focus on the compartment syndrome of the lower extremity [3]. Specific attention is paid to the compartment syndrome of the pelvic region and the thigh. The article includes technical hints on how to decompress the deep compartment of the piriformis and the small exorotators. It also pays attention to the compartment syndrome of the foot.
Dorweiler et al. present a state of the art of the research on the pathophysiology of the ischemia– reperfusion syndrome [4]. What happens if compartments are decompressed, when ischemic organs are revascularized? What is the underlying mechanism of rebound effects, which can not only threaten the revascularized tissue but also remote organ functions? What evidence exists for the prevention and therapy of these complications? With this theme issue, we would like to renew the current knowledge on all aspects of the compartment syndrome of the extremities and of the ischemia– reperfusion syndrome, underestimated entities which deserve attention, understanding, early recognition of their devastating energy and adequate medical and surgical therapy. Pol Maria Rommens Editor
References 1.
2.
3.
4.
Janzing HJM. Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity. Eur J Trauma Emerg Surg 2007;33:576–83. Burkhart KJ, Prommersberger K-J, Mueller LM, Rommens PM. Acute Compartment Syndrome of the Upper Extremity. Eur J Trauma Emerg Surg 2007;33:584–8. Hessmann MH, Ingelfinger P, Rommens PM. Compartment Syndrome of the Lower Extremity. Eur J Trauma Emerg Surg 2007;33:589–99. Dorweiler B, Pruefer D, Andrasi TB, Maksan SM, Schmiedt W, Neufang A, Vahl CF. Ischemia-Reperfusion Injury Pathophysiology and Clinical Implications. Eur J Trauma Emerg Surg 2007;33:600–12.
Eur J Trauma Emerg Surg 2007;33:575 DOI 10.1007/s00068-007-2007-1 Pulished Online: November 22, 2007
Eur J Trauma Emerg Surg 2007 Æ No. 6 Ó URBAN & VOGEL
575
European Journal of Trauma and Emergency Surgery
Focus on Compartment Syndrome Compartment syndrome is seldom a subject of discussion in continuous medical education, symposia or congresses. Trauma surgeons seem to know all about it; repetition or actualization of knowledge is not asked for. Nevertheless, if we look through literature, numerous case reports of dramatic patient histories with compartment syndrome appear continuously. They all contain warnings and ask for a high index of suspicion. This shows that compartment syndrome still exists, is sometimes recognized too late with long-life sequels as a consequence. Many of them are the subject of court cases and lead to high compensation payments. This theme issue provides recognized and actual data on frequency, causes, diagnosis and treatment of compartment syndrome of the extremities. Janzing especially focuses on diagnosis [1]. What is the real value of several diagnostic procedures? Is invasive diagnosis compulsory in every patient with a lower leg fracture? If not, who are the patients at risk and what are the threshold values, which make decompression necessary? Burkhart et al. describe the compartment syndrome of the upper extremity, which certainly is an underestimated entity [2]. In their contribution, they describe in detail the specific signs of pathological pressure in the different compartments of the lower arm and the hand and how to decompress them safely. Hessmann et al. focus on the compartment syndrome of the lower extremity [3]. Specific attention is paid to the compartment syndrome of the pelvic region and the thigh. The article includes technical hints on how to decompress the deep compartment of the piriformis and the small exorotators. It also pays attention to the compartment syndrome of the foot.
Dorweiler et al. present a state of the art of the research on the pathophysiology of the ischemia– reperfusion syndrome [4]. What happens if compartments are decompressed, when ischemic organs are revascularized? What is the underlying mechanism of rebound effects, which can not only threaten the revascularized tissue but also remote organ functions? What evidence exists for the prevention and therapy of these complications? With this theme issue, we would like to renew the current knowledge on all aspects of the compartment syndrome of the extremities and of the ischemia– reperfusion syndrome, underestimated entities which deserve attention, understanding, early recognition of their devastating energy and adequate medical and surgical therapy. Pol Maria Rommens Editor
References 1.
2.
3.
4.
Janzing HJM. Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity. Eur J Trauma Emerg Surg 2007;33:576–83. Burkhart KJ, Prommersberger K-J, Mueller LM, Rommens PM. Acute Compartment Syndrome of the Upper Extremity. Eur J Trauma Emerg Surg 2007;33:584–8. Hessmann MH, Ingelfinger P, Rommens PM. Compartment Syndrome of the Lower Extremity. Eur J Trauma Emerg Surg 2007;33:589–99. Dorweiler B, Pruefer D, Andrasi TB, Maksan SM, Schmiedt W, Neufang A, Vahl CF. Ischemia-Reperfusion Injury Pathophysiology and Clinical Implications. Eur J Trauma Emerg Surg 2007;33:600–12.
Eur J Trauma Emerg Surg 2007;33:575 DOI 10.1007/s00068-007-2007-1 Pulished Online: November 22, 2007
Eur J Trauma Emerg Surg 2007 Æ No. 6 Ó URBAN & VOGEL
575
