Compartment syndrome

Introduction Compartment syndrome is a rare but serious complication of trauma, surgery, or repetitive muscle use that leads to muscle swelling and results in increased pressure within a fascial compartment. As compartment pressure increases, circulation is compromised leading to tissue hypoxia and loss of viability of nerve and muscle tissue. The increased pressure can occur from three basic scenarios: increase in content of the compartment, decrease in the volume of the compartment, or external pressure on the compartment. Normal compartment pressure <10 mmHg. Classic The hallmark presentation is pain that is out of proportion to injury or findings. Patients will describe the pain as “deep”, “burning,” and “unrelenting” with difficulty in localization. Pain with passive stretching of the muscle groups or tightness of the compartment is also common. Compartment syndrome can occur when the compartment is seemingly open, such as open fractures and stab wounds. In trauma, the anterior compartment of the leg is the most common location of compartment syndrome; however, it is possible for it to occur in any extremity compartment. Symptoms commonly arise within 2 hours of injury but can also present up to 6 days later.