FRACTURE SITES In the initial evaluation of any fracture, the examiner must identify the specific location of the fracture within the bone (see Plate 7-21). The different areas of bone…

Fibroblasts begin to proliferate in the base of the wound. The fibroblastic proliferation is followed immediately by the development of new capillaries bringing nutrients and oxygen to the newly formed…

The first step in the inflammatory phase is the formation of a blood clot, which controls bleeding and forms a thin fibrin network, bridging the wound margins. Simultaneously, an intense…

DECOMPRESSION OF COMPARTMENT SYNDROME There are no satisfactory nonsurgical methods for treating compartment syndromes; however, cooling of the tissue may prolong tolerance to ischemia and proper hydration may help avoid…

Postoperative care of the forearm includes a bulky dressing and splinting. The dressing is changed in 3 to 4 days in the operating room. Split-thickness skin grafts are almost always…

After the four-compartment fasciotomy, intraoperative monitoring of compartmental pressure should be performed to document the decompression. Very little muscle should be debrided at the time of initial decompression, because it…

Thermal injuries (burns), in addition to decreasing compartment space, are associated with massive edema. Measurement of intramuscular pressure is needed to document the underlying compartment tamponade and the need for…

Pulses Present and Pink Color. Unless there is a major arterial injury or disease, peripheral pulses are palpable and capillary refill is routinely present. Although compartment pressures are occasionally high…

If multiple compartments are involved and a significant amount of muscle infarction is present, the patient may develop crush syndrome, which refers to the systemic effects of myonecrosis on the…

Deep, unequivocally full-thickness burns may be excised to the level of the investing fascia using a scalpel, an electrocautery device, or even a laser. The excised wound must be covered…