Back متلازمة الحيز Arabic Síndrome compartimental Catalan Kompartmentsyndrom German Síndrome compartimental Spanish Konpartimentuen sindromea Basque سندرم کمپارتمان Persian Syndrome de loge French תסמונת המדור HE Միջփակեղային համախտանիշ Armenian Sindroma kompartemen ID

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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