Wheeless' Textbook of Orthopaedics compartment syndrome is elevation of interstitial pressure in closed fascial compartment that results in microvascular compromise; - as duration & magnitude of interstitial pressure increase, myoneural function is impaired & necrosis of soft tissues eventually develops;

Compartment Syndromes Highly Reputable

BMJ editorial BMJ 2002;325:557-558 Acute limb compartment syndrome is a surgical emergency characterised by raised pressure in an unyielding osteofascial compartment. Sustained elevation of tissue pressure reduces capillary perfusion below a level necessary for tissue viability, and irreversible muscle and nerve damage may occur within hours. Causes include trauma, revascularisation procedures, burns, and exercise. Regardless of the cause, the increased intracompartmental pressure must be promptly decompressed by surgical fasciotomy. Missed diagnosis and late decompression are associated with significant morbidity due to irreversible ischaemic necrosis of the muscles and nerves in the compartment. Increased awareness of the syndrome and the advent of measurements of intracompartmental pressure have raised the possibility of early diagnosis and treatment. Recent publications have, however, highlighted some of the problems associated with measurements of intracompartmental pressure. 1 2 Furthermore, late or poorly performed fasciotomies may contribute to morbidity

Wheeless Textbook of Orthopaedics. Notes on:
Anterior Compartment Syndrome:
Posterior Compartment Syndrome
Lateral Compartment Syndrome
Non Operative Treatment
Indications for Surgery
Technique: (chronic anterior compartment syndrome)

Medscape Journal Scan April 2004 Review of articles on missed diagnosis of compartment syndrome

compartment syndrome following tibia fractures are most common in closed frx (upto 20% of frx) but may also occur following open frx; - cast immobilization may increase pressure; - it remains unclear whether IM nailing will increase or decrease compartment pressures, but on occassion the surgeon may find a significant decrease in pressure measurements following nailing; - references: - Compartment syndrome in open tibial fractures. - Compartment syndrome after intramedullary nailing of the tibia. - compartment pressures measurements: - most common finding is isolated elevation in the deep posterior compartment followed by isolated elevation in the anterior compartment; - be sure to measure pressure in the deep posterior compartment as well as anterior & superficial compartments; - associated factors: - cast immobilization may increase pressure; - intramedullary nailing: - it remains unclear whether IM nailing will increase or decrease compartment pressures, but on occassion the surgeon may find a significant decrease in pressure measurements following nailing; - compartment pressures measurements: - most common finding is isolated elevation in the deep posterior compartment followed by isolated elevation in the anterior compartment; - be sure to measure pressure in the deep posterior compartment as well as anterior & superficial compartments; - compartment pressure measurements should be taken as close to the frx site as possible (since these will give the highest readings); - peak compartment pressures will be located within 5 cm of frx; - measurements away from the frx site may underestimate compartment pressure; - sterile technique is a must when compartments are measured, otherwise the frx hematoma may become infected;

SOA - Orthopaedic Care.net Textbook The purpose of this chapter is to provide an overview of acute upper extremity compartment syndrome. It will review the causes, the pathophysiology, the diagnosis, and the treatment of this condition. Some discussion of chronic compartment syndrome is also presented.

Compartmental Syndromes
A compartmental syndrome is a condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space. This condition is a cause of major loss of function, limb and even life. It can result from trauma, prolonged recumbancy (in surgery or resulting from drugs or alcohol), or physical activity. It is common enough to affect thousands of individuals each year, yet rare enough that each physician may encounter it only once or twice during his or her career.

Documentation of acute compartment syndrome at an academic health-care center JBJS 2005 70% had inadequate documentation

Exertional Compartment Syndrome of the Leg: Steps for Expedient Return to Activity Peter Edwards, MD; Mark S. Myerson, MD THE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 4 - APRIL 96 In Brief: The pain and swelling associated with exertional compartment syndrome is caused by raised intracompartmental pressures possibly induced by muscle swelling or increased osmotic pressure. Although either the acute or chronic form of exertional compartment syndrome may occur, chronic is more common. Patients typically experience pain and swelling and may also have sensory deficits or paresthesias, and motor loss or weakness. Diagnosis is confirmed by intracompartmental pressure measurements before and after exercise. Although activity modification may alleviate symptoms, fasciotomy may be required.

eMedicine 2005 Compartment syndrome (CS) is a limb-threatening and life-threatening condition observed when perfusion pressure falls below tissue pressure in a closed anatomic space. The current body of knowledge unequivocally reflects that untreated CS leads to tissue necrosis, permanent functional impairment, and, if severe, renal failure and death.

Lower extremity compartment syndrome When to suspect acute or chronic pressure buildup Randall Swain, MD; David Ross, MD VOL 105 / NO 3 / MARCH 1999 / POSTGRADUATE MEDICINE CME learning objectives To recognize both acute and chronic compartment syndromes in the sports setting To understand the differential diagnosis of lower leg pain in athletes To learn the workup and treatment of potential compartment syndrome cases