Results from increased interstitial pressure in closed osteofascial compartments.
Can be caused by fracture, compartment hemorrhage, 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 ischemia and rhabdomyolysis.
Compartment syndrome is a pathologic condition characterized 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 noncompliant 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
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
- Deep vein thrombosis
- Stress fracture
- Acute ischemia
- Management of acute compartment syndrome
- Clinical practice guidelines for the management of acute limb compartment syndrome following trauma
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