Compartmentsyndrome Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;

# Overview

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CS is a medical emergency requiring immediate surgical treatment known as a fasciotomy to allow the pressure to return to normal.

# Treatment

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Immediate management of suspected CS include[1][2][3][4][5][6][7]:

Any dressing, splint, cast, or other restrictive covering should be removed and relieving all external pressure on the compartment should be considered as a primary step. The limb should neither be elevated nor placed in a dependent position. Placing the limb level with the heart is helpful to avoid reductions in arterial inflow and increases in compartment pressures from dependent swelling, both of which can exacerbate limb ischemia. Supplementary oxygen, Analgesics, and intravenous isotonic saline (Hypotension reduces perfusion, exacerbating tissue injury) should be provided. Fasciotomy to fully decompress all involved compartments is the definitive treatment for CSin the great majority of cases. Delayed fasciotomy increase morbidity, including the need for amputation.

# References

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1. ↑ Mars M, Hadley GP (July 1998). "Raised intracompartmental pressure and compartment syndromes". Injury. 29 (6): 403–11. PMID 9813693.
2. ↑ Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S (April 2010). "Compartment syndrome of the lower leg and foot". Clin. Orthop. Relat. Res. 468 (4): 940–50. doi:10.1007/s11999-009-0891-x. PMC 2835588. PMID 19472025.
3. ↑ McDonald S, Bearcroft P (June 2010). "Compartment syndromes". Semin Musculoskelet Radiol. 14 (2): 236–44. doi:10.1055/s-0030-1253164. PMID 20486031.
4. ↑ Johnston-Walker E, Hardcastle J (2011). "Neurovascular assessment in the critically ill patient". Nurs Crit Care. 16 (4): 170–7. doi:10.1111/j.1478-5153.2011.00431.x. PMID 21651657.
5. ↑ Suzuki T, Moirmura N, Kawai K, Sugiyama M (January 2005). "Arterial injury associated with acute compartment syndrome of the thigh following blunt trauma". Injury. 36 (1): 151–9. doi:10.1016/j.injury.2004.03.022. PMID 15589934.
6. ↑ Alexander W, Low N, Pratt G (January 2018). "Acute lumbar paraspinal compartment syndrome: a systematic review". ANZ J Surg. doi:10.1111/ans.14342. PMID 29316189.
7. ↑ Thati S, Carlson C, Maskill JD, Anderson JG, Bohay DR (June 2008). "Tibial compartment syndrome and the cavovarus foot". Foot Ankle Clin. 13 (2): 275–305, vii. doi:10.1016/j.fcl.2008.02.001. PMID 18457774.