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Acute Compartment Syndrome

Increased pressure within fascial compartments compromises perfusion and threatens limb viability.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Acute Compartment Syndrome?

Acute compartment syndrome is a clinical entity in which pressure within a closed fascial compartment exceeds capillary perfusion pressure, leading to tissue ischaemia and necrosis.

Trauma, fracture, vascular injury and reperfusion injury are the most common causes; tibial shaft fractures and forearm fractures are classic examples.

Diagnosis is mainly clinical; intracompartmental pressure measurement is supportive. Failure to perform fasciotomy within six hours leads to permanent muscle necrosis and limb loss.

Symptoms

Pain disproportionate to the injury that increases progressively
Pain on passive stretch (early sign)
Tense, swollen and tender compartment
Paraesthesia and hypoesthesia (5 Ps)
Pallor and decreased capillary refill
Late findings of pulselessness and paralysis

Risk Factors

Tibial shaft, forearm and supracondylar humerus fractures
Crush injury and high-energy trauma
Vascular injury and reperfusion (acute ischaemia following revascularisation)
Tight casts and circumferential dressings
Burns and severe oedema
Anticoagulation and bleeding diathesis

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Pain disproportionate to injury and pain on passive stretch are red flags
  • Tense compartment, paraesthesia and pulselessness mandate immediate intervention
  • Suspicion within six hours of trauma is critical
  • Loosening of cast or circumferential dressing should be performed early

Treatment Methods

01
Removal of constricting cast or dressing and elevation
02
Intracompartmental pressure measurement (greater than 30 mmHg or DeltaP less than 30 supports the diagnosis)
03
Emergency fasciotomy (within six hours of symptom onset)
04
Decompression of all compartments and release of skin
05
Treatment of rhabdomyolysis (fluid, urine alkalinisation)
06
Delayed primary closure or skin grafting

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.