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Compartment syndrome

Compartment syndrome
A forearm following emergency surgery for acute compartment syndrome
SpecialtyOrthopedics
SymptomsPain, numbness, pallor, decreased ability to move the affected limb[1]
ComplicationsAcute: Volkmann's contracture[2]
TypesAcute, chronic[1]
Causes
Diagnostic methodBased on symptoms, compartment pressure[5][1]
Differential diagnosisCellulitis, tendonitis, deep vein thrombosis, venous insufficiency[3]
Treatment

Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space.[6][7][8] There are two main types: acute and chronic.[6] Compartments of the leg or arm are most commonly involved.[3]

Symptoms of acute compartment syndrome (ACS) can include severe pain, poor pulses, decreased ability to move, numbness, or a pale color of the affected limb.[5] It is most commonly due to physical trauma such as a bone fracture (up to 75% of cases) or crush injury, but it can also be caused by acute exertion during sport.[3][9] It can also occur after blood flow returns following a period of poor blood flow.[4] Diagnosis is generally based upon a person's symptoms[5] and may be supported by measurement of intracompartmental pressure before, during, and after activity. Normal compartment pressure should be within 12-18 mmHg; anything greater than that is considered abnormal and would need treatment.[10] Treatment is by surgery to open the compartment, completed in a timely manner.[5] If not treated within six hours, permanent muscle or nerve damage can result.[5][11]

In chronic compartment syndrome (aka chronic exertional compartment syndrome), there is generally pain with exercise but the pain dissipates once activity ceases.[1] Other symptoms may include numbness.[1] Symptoms typically resolve with rest.[1] Common activities that trigger chronic compartment syndrome include running and biking.[1] Generally, this condition does not result in permanent damage.[1] Other conditions that may present similarly include stress fractures and tendinitis.[1] Treatment may include physical therapy or—if that is not effective—surgery.[1]

Acute compartment syndrome occurs in about 3% of those who have a midshaft fracture of the forearm.[12] Rates in other areas of the body and for chronic cases are unknown.[12][13] The condition occurs more often in males and people under the age of 35, in line with the occurrence of trauma.[3][14] Compartment syndrome was first described in 1881 by German surgeon Richard von Volkmann.[5] Untreated, acute compartment syndrome can result in Volkmann's contracture.[2]

  1. ^ a b c d e f g h i j k l "Compartment Syndrome-OrthoInfo – AAOS". www.orthoinfo.org. October 2009. Archived from the original on 14 March 2017. Retrieved 29 July 2017.
  2. ^ a b El-Darouti MA (2013). Challenging Cases in Dermatology. Springer Science & Business Media. p. 145. ISBN 978-1-4471-4249-2. Archived from the original on 2017-07-29.
  3. ^ a b c d e Ferri FF (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 317. ISBN 978-0-323-52957-0. Archived from the original on 2017-07-29.
  4. ^ a b Schmidt AH (July 2016). "Acute Compartment Syndrome". The Orthopedic Clinics of Northern America. 47 (3): 517–25. doi:10.1016/j.ocl.2016.02.001. PMID 27241376.
  5. ^ a b c d e f g Donaldson J, Haddad B, Khan WS (2014). "The pathophysiology, diagnosis and current management of acute compartment syndrome". The Open Orthopaedics Journal. 8: 185–93. doi:10.2174/1874325001408010185. PMC 4110398. PMID 25067973.
  6. ^ a b "Compartment Syndrome – National Library of Medicine". PubMed Health. Archived from the original on 10 September 2017. Retrieved 25 July 2017.
  7. ^ Peitzman AB, Rhodes M, Schwab CW (2008). The Trauma Manual: Trauma and Acute Care Surgery. Lippincott Williams & Wilkins. p. 349. ISBN 978-0-7817-6275-5. Archived from the original on 2017-07-29.
  8. ^ Guo J, Yin Y, Jin L, Zhang R, Hou Z, Zhang Y (2019-07-01). "Acute compartment syndrome: Cause, diagnosis, and new viewpoint". Medicine. 98 (27): e16260. doi:10.1097/MD.0000000000016260. PMC 6635163. PMID 31277147.
  9. ^ Cite error: The named reference Stat2020 was invoked but never defined (see the help page).
  10. ^ McQueen MM, Duckworth AD (October 2014). "The diagnosis of acute compartment syndrome: a review". European Journal of Trauma and Emergency Surgery. 40 (5): 521–8. doi:10.1007/s00068-014-0414-7. PMID 26814506. S2CID 38330727.
  11. ^ Cite error: The named reference Jen2017 was invoked but never defined (see the help page).
  12. ^ a b Bucholz RW (2012). Rockwood and Green's Fractures in Adults: Two Volumes Plus Integrated Content Website (Rockwood, Green, and Wilkins' Fractures). Lippincott Williams & Wilkins. p. 691. ISBN 978-1-4511-6144-1. Archived from the original on 2017-07-29.
  13. ^ Miller MD, Wiesel SW (2012). Operative Techniques in Sports Medicine Surgery. Lippincott Williams & Wilkins. p. 437. ISBN 978-1-4511-2490-3. Archived from the original on 2017-07-29.
  14. ^ Garner MR, Taylor SA, Gausden E, Lyden JP (July 2014). "Compartment syndrome: diagnosis, management, and unique concerns in the twenty-first century". HSS Journal. 10 (2): 143–52. doi:10.1007/s11420-014-9386-8. PMC 4071472. PMID 25050098.

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متلازمة الحيز Arabic Síndrome compartimental Catalan Kompartmentsyndrom German Síndrome compartimental Spanish Konpartimentuen sindromea EU سندرم کمپارتمان FA Syndrome de loge French תסמונת המדור HE Միջփակեղային համախտանիշ HY Sindroma kompartemen ID

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