![]() The reduction of venous outflow and arterial inflow result in decreased oxygenation of tissues causing ischemia. If the intracompartmental pressure becomes higher than arterial pressure, a decrease in arterial inflow will also occur. This causes venous pressure and, thus, venous capillary pressure to increase. When there is an increase in compartmental pressure, there is a reduction in venous outflow. There is normally an equilibrium between venous outflow and arterial inflow. As the compartment pressure increases, hemodynamics are impaired. Īcute compartment syndrome occurs due to decreased intracompartmental space or increased intracompartmental fluid volume because the surrounding fascia is inherently non-compliant. In children, supracondylar fractures of the humerus and both ulnar and radial forearm fractures are associated with compartment syndrome. ![]() Other causes of acute compartment syndrome include burns, vascular injuries, crush injuries, drug overdoses, reperfusion injuries, thrombosis, bleeding disorders, infections, improperly placed casts or splints, tight circumferential bandages, penetrating trauma, intense athletic activity, and poor positioning during surgery. After fractures, the most common cause of acute compartment syndrome is soft tissue injuries. Seventy-five percent of cases of acute compartment syndrome are associated with fractures. Acute compartment syndrome can occur without any precipitating trauma but typically occurs after a long bone fracture, with tibial fractures being the most common cause of the condition, followed by distal radius fractures. Īcute compartment syndrome can occur with any condition that restricts the intracompartmental space or increases the fluid volume in the intracompartmental space. Therefore, acute compartment syndrome is still predictable. This is especially pertinent for open Gustilo type 2 and 3 lesions in proximal intra-articular tibia fractures. Recent retrospective studies indicate that skin laceration would not relieve the pressure inside the muscle compartments. Significant attention should be paid to patients with open fractures. ![]() It can also be seen in the abdomen, but more commonly, it presents in the limbs. Other locations in which acute compartment syndrome is seen include the forearm, thigh, buttock, shoulder, hand, and foot. This compartment contains the extensor muscles of the toes, the tibialis anterior muscle, the deep peroneal nerve, and the tibial artery. The anterior compartment of the leg is the most common location for compartment syndrome. In the leg, there are four muscle compartments: anterior, lateral, deep posterior, and superficial posterior. However, a single normal ICP reading does not exclude acute compartment syndrome.įascia is a thin, inelastic sheet of connective tissue that surrounds muscle compartments and limits the capacity for rapid expansion. However, intracompartmental pressure (ICP) > 30 mmHg can be used as a threshold to aid in diagnosis. Generally, acute compartment syndrome is considered a clinical diagnosis. Acute compartment syndrome is considered a surgical emergency since, without proper treatment, it can lead to ischemia and eventually necrosis. Acute compartment syndrome occurs when there is increased pressure within a closed osteofascial compartment, resulting in impaired local circulation.
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