Compartment Syndrome and Orthopedic Surgery: Diagnosis and Management

  • Steven B. Orr
  • Matthew R. Garner
  • Samuel A. Taylor
  • Milton T. M. Little
  • John P. Lyden


Compartment syndrome is defined as an elevation of intracompartmental pressure to a level that impairs arterial flow to muscles, nerves, and other local tissues. Compartment syndrome of the upper and lower extremities can have multiple etiologies, including traumatic, exertional, and iatrogenic in the perioperative setting. Early identification and diagnosis enabling prompt intervention is essential to providing patients the best possible outcomes. In cases of acute compartment syndrome, emergent fasciotomy is generally indicated. Delayed fasciotomies more than 24 h after onset of symptoms is not recommended as it increases morbidity and mortality; however it is often difficult to establish a time zero for onset or irreversibility. Even with timely treatment, multiple surgeries are often necessary to ensure adequate wound debridement, appropriate soft tissue coverage, and satisfactory wound closure. Long-term sequelae range from cosmetic concerns secondary to wound complications, the use of skin grafts, limb deformity, amputation, or systemic complications associated with rhabdomyolysis.


Compartment syndrome Fasciotomy Orthopedic emergency Tourniquet Foot drop Myonecrosis Rhabdomyolysis Amputation 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Steven B. Orr
    • 1
  • Matthew R. Garner
    • 2
    • 3
  • Samuel A. Taylor
    • 4
  • Milton T. M. Little
    • 5
  • John P. Lyden
    • 4
  1. 1.New York University Langone Orthopedic Hospital, Department of Orthopedic Surgery, Division of Hand SurgeryNew YorkUSA
  2. 2.Milton S. Hershey Medical Center, Department of Orthopedic TraumaHersheyUSA
  3. 3.Pennsylvania State University College of Medicine, Department of Orthopedics and RehabilitationHersheyUSA
  4. 4.Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell MedicineNew YorkUSA
  5. 5.Orthopedic Trauma Surgery, Cedars-Sinai Medical Center, Department of Orthopedic SurgeryLos AngelesUSA

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