Compartment Syndrome

Posted by e-Medical PPT Wednesday, October 20, 2010
Compartment syndrome is the compression of nerves, blood vessels, and muscle inside a closed space within the body. This leads to tissue death from lack of oxygenation; the blood vessels being compressed by the raised pressure within the compartment. Compartment syndrome most often involves the forearm and lower leg. It can be divided into acute, subacute, and chronic compartment syndrome.
There are classically 5 "Ps" associated with compartment syndrome — pain out of proportion to what is expected, paresthesia, pallor, paralysis and pulselessness.
Compartment syndrome is a clinical diagnosis. However, it can be tested for by gauging the pressure within the muscle compartments. If the pressure is sufficiently high, a fasciotomy will be required to relieve the pressure. Various recommendations of the intracompartmental pressure are used with some sources quoting more than 30 mmHg as an indication for fasciotomy while others suggest  less than 30 mmHg difference between intracompartmental pressure and diastolic blood pressure.
Failure to relieve the pressure can result in necrosis of tissue in that compartment, since capillary perfusion will fall leading to increasing hypoxia of those tissues. This can cause Volkmann's contracture in affected limbs.If left untreated, acute compartment syndrome can lead to more severe conditions including rhabdomyolysis and kidney failure potentially leading to death.

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