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Acute Compartment Syndrome

(ACS; Compartment Syndrome, Acute; Volkmann’s Ischemia)

Definition

Sheets of connective tissue called fascia are located under the skin of the arms and legs. These wrap around groups of muscles, nerves, and blood vessels to create a unit called a compartment. When pressure builds up in these enclosed spaces, it is redirected into the compartment. When pressure reaches a certain point, it disrupts blood flow. Blood vessels may fail and tissue dies. Acute compartment syndrome (ACS) can affect the arms, hands, legs, feet, and buttocks.
Compartment Syndrome in Lower Leg
Compartment Syndrome
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Causes

Common causes include:

Risk Factors

Factors that may increase your chance of ACS include:

Symptoms

ACS may cause:
Symptoms can develop within 30 minutes-2 hours. In other cases, it may take days.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids will be tested. This can be done with blood tests.
Imaging tests to evaluate bodily structures may include:
The pressure inside your compartments will be measured. This can be done with:

Treatment

ACS is a medical emergency. Call for emergency medical services right away. Damage can result in serious injury or even death.
Surgery to relieve pressure, called fasciotomy, must be done right away to prevent permanent damage. The doctor makes a long cut into the fascia to open the envelope of tissue and relieve pressure.

Prevention

ACS is difficult to prevent because there are many causes. But there are some steps you can take to reduce your risk of injury, such as:

RESOURCES

National Institutes of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov

Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Foundation http://www.canorth.org

Canadian Physiotherapy Association http://www.physiotherapy.ca

References

Basic metabolic panel. American Association for Clinical Chemistry Lab Tests Online website. Available at: http://labtestsonline.org/understanding/analytes/bmp/tab/glance. Updated September 6, 2012. Accessed November 25, 2013.

Cascio B, Wilckens J, et al. Documentation of acute compartment syndrome at an academic health-care center. J Bone Joint Surg. 2005;87:346-350.

Compartment syndrome. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00204. Updated October 2009. Accessed November 25, 2013.

Compartment syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 20, 2013. Accessed November 25, 2013.

Complete blood count. American Association for Clinical Chemistry Lab Tests Online website. Available at: http://labtestsonline.org/understanding/analytes/cbc/test.htm. Updated June 25, 2012. Accessed October 24, 2012.

Comprehensive metabolic panel. American Association for Clinical Chemistry Lab Tests Online website. Available at: http://labtestsonline.org/understanding/analytes/cmp/tab/glance. Updated September 6, 2012. Accessed November 25, 2013.

Erdos J, Dlaska C, et al. Acute compartment syndrome in children: a case series in 24 patients and review of the literature. Int Orthop. 2011 Apr;35(4):569-575.

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