RESEARCH ARTICLE


Acute Compartment Syndrome of the Limbs: Current Concepts and Management



Nigel Tapiwa Mabvuure 1, Marco Malahias 2, Sandip Hindocha*, 3, Wasim Khan 4, Ali Juma 5
1 Brighton and Sussex Medical School, Brighton, BN25XL, UK
2 Department of Plastic Surgery, Good Hope Hospital, Rectory road, West Midlands B75 7RR, UK
3 Department of Plastic Surgery, Whiston Hospital, Warrington Road, L355DR, UK
4 University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA74LP, UK
5 Department of Plastic Surgery, Countess of Chester Hospital, Liverpool Road, Chester, CH21UL, UK


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© Mabvuure et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Plastic Surgery, Whiston Hospital, Warrington Road, L355DR, UK; Tel: 01244366265; Fax: 01244366265; E-mail: hindocha2001@yahoo.com


Abstract

Acute compartment syndrome (ACS) of the limb refers to a constellation of symptoms, which occur following a rise in the pressure inside a limb muscle compartment. A failure or delay in recognising ACS almost invariably results in adverse outcomes for patients. Unrecognised ACS can leave patients with nonviable limbs requiring amputation and can also be life–threatening. Several clinical features indicate ACS. Where diagnosis is unclear there are several techniques for measuring intracompartmental pressure described in this review. As early diagnosis and fasciotomy are known to be the best determinants of good outcomes, it is important that surgeons are aware of the features that make this diagnosis likely. This clinical review discusses current knowledge on the relevant clinical anatomy, aetiology, pathophysiology, risk factors, clinical features, diagnostic procedures and management of an acute presentation of compartment syndrome.

Keywords: Acute compartment syndrome, fasciotomy, intracompartmental pressure, myofascial compartment, pathophysiology, review.