Compartment syndrome of extremities

Compartment syndrome of the extremities is a surgical emergency that 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.

In cases of acute extremity compartment syndrome and where the clinical diagnosis is clear, 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).[1]Mubarak SJ, Owen CA. Double-incision fasciotomy of the leg for decompression in compartment syndromes. J Bone Joint Surg Am. 1977 Mar;59(3):184-7. http://www.ncbi.nlm.nih.gov/pubmed/15455478?tool=bestpractice.com 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.