Extremity Problems Compartment Syndromes and Longterm Complications

Most rattlesnake envenomations occur to the extremities and can result in large amount of swelling and discoloration along with the development of blebs and/or tissue necrosis. Despite the swelling and discoloration, increased compartmental or subcutaneous pressures usually do not play an important role in the development of myonecrosis or functional disabilities. Increased tissue pressures are not severe enough to cause ischemia of enven-omated extremities in most patients bitten by rattlesnakes. Early surgical intervention is not recommended in patients who demonstrated only decreased skin temperatures (57).

Diamondback rattlesnake bites to the upper extremity consistently result in severe envenomations. Cowan looked at the long-term complications of snake bites to the upper extremity and found that 4 of 46 patients had continued pain and tissue atrophy at the bite site (58).

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