Acute compartment syndrome in lower extremity musculoskeletal trauma.

Published

Journal Article (Review)

Acute compartment syndrome is a potentially devastating condition in which the pressure within an osseofascial compartment rises to a level that decreases the perfusion gradient across tissue capillary beds, leading to cellular anoxia, muscle ischemia, and death. A variety of injuries and medical conditions may initiate acute compartment syndrome, including fractures, contusions, bleeding disorders, burns, trauma, postischemic swelling, and gunshot wounds. Diagnosis is primarily clinical, supplemented by compartment pressure measurements. Certain anesthetic techniques, such as nerve blocks and other forms of regional and epidural anesthesia, reportedly contribute to a delay in diagnosis. Basic science data suggest that the ischemic threshold of normal muscle is reached when pressure within the compartment is elevated to 20 mm Hg below the diastolic pressure or 30 mm Hg below the mean arterial blood pressure. On diagnosis of impending or true compartment syndrome, immediate measures must be taken. Complete fasciotomy of all compartments involved is required to reliably normalize compartment pressures and restore perfusion to the affected tissues. Recognizing compartment syndromes requires having and maintaining a high index of suspicion, performing serial examinations in patients at risk, and carefully documenting changes over time.

Full Text

Duke Authors

Cited Authors

  • Olson, SA; Glasgow, RR

Published Date

  • November 2005

Published In

Volume / Issue

  • 13 / 7

Start / End Page

  • 436 - 444

PubMed ID

  • 16272268

Pubmed Central ID

  • 16272268

International Standard Serial Number (ISSN)

  • 1067-151X

Language

  • eng

Conference Location

  • United States