Results from increased interstitial pressure in closed osteofascial compartments.
Can be caused by fracture, compartment haemorrhage, direct soft-tissue injury, or direct muscular injury.
High index of suspicion and early recognition are crucial.
Palpable pulses distal to the involved compartment do not rule out compartment syndrome.
Prompt decompression by fasciotomy is mandatory to prevent muscle ischaemia and rhabdomyolysis.
Compartment syndrome is a pathological condition characterised by elevated interstitial pressure in a closed osteofascial compartment that results in microvascular compromise (restriction of capillary blood flow). The compartments most commonly involved are those with relatively non-compliant osseous or fascial structures, such as the anterior and deep posterior compartments of the leg and the volar compartment of the forearm.
History and exam
Key diagnostic factors
- presence of risk factors
Other diagnostic factors
- pressure (muscle tightness)
- bleeding disorder
- compression support
- thermal injury
- intense muscular activity
- extravasation of intravenous infusion
- venous obstruction
1st investigations to order
- compartment pressure measurement
Investigations to consider
- serum creatine kinase
- urine myoglobin
acute with occlusive dressing
acute without occlusive dressing
Miren A. Schinco, MD, FACS
Critical Care Surgeon
MAS declares that she has no competing interests.
Victor J. Hassid, MD
Department of Plastic Surgery
The University of Texas MD Anderson Cancer Center
VJH declares that he has no competing interests.
Leslie Klenerman, ChM, FRCSEd, FRCSEng
Emeritus Professor of Orthopaedic and Accident Surgery
University of Liverpool
British Journal of Bone and Joint Surgery
LK declares that he has no competing interests.
Timothy Humphries, MD
Associate Program Director
Atlanta Medical Center
Department of General Surgery
- Deep vein thrombosis
- Stress fracture
- Acute ischaemia
- Management of acute compartment syndrome
- Clinical practice guidelines for the management of acute limb compartment syndrome following trauma
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