Acute Compartment Syndrome

  • Joshua L. GaryEmail author
  • Gregory E. CatlettJr.


Acute compartment syndrome is a pathological process where increased intra-compartmental pressures result in decreased tissue perfusion, leading to cellular anoxia and death if cellular perfusion is not restored. Compartment syndrome can occur in any location of the upper or lower extremities but is most commonly diagnosed in the leg and forearm. Diagnostic methods remain imperfect, with serial physical examinations as the mainstay of diagnosis. Direct pressure measurements with commercial devices or an arterial line setup can be made. A difference ≤30 mmHg between the diastolic blood pressure and intra-compartmental pressure (∆P) is a recommended threshold for fasciotomy. However, direct pressure measurements have been shown to be inaccurate with significant inter-observer variability and high false positive rates. Pressure measurements are best used in obtunded patients or those where physical examination is clouded due to other factors. Once diagnosed, treatment is simple with decompressive fasciotomies, which merely require a scalpel and anatomic knowledge.


Compartment syndrome Fasciotomies Acute compartment syndrome; 

Supplementary material

Video 41.1

Four compartment fasciotomies of the leg are demonstrated in a 37-year-old male status post motor vehicle collision with compartment syndrome and an ipsilateral tibial plateau fracture (MP4 343581 kb)


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryMcGovern Medical School at University of Texas Health Science Center at HoustonHoustonUSA

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