Compartment Syndrome

Compartment Syndrome is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Elevated tissue pressure in closed spaces that compromises blood flow through capillaries
  • Normal tissue pressure is <10 mm Hg.
  • Capillary blood flow in a compartment is compromised at pressures >20 mm Hg.
  • Muscles and nerves can develop ischemic necrosis at pressures >30 mm Hg.
  • When distal pulses are diminished on exam, muscle necrosis is probably present.
  • The 4 compartments of the leg are most frequently involved, but compartment syndrome can occur in the arm, forearm, hand, foot, shoulder, buttocks, and thigh.

Etiology

  • Decreased compartment size: Circumferential cast, burn eschar, or military antishock trousers (MAST)
  • Increased compartment contents: Compression of the compartment from edema or hematoma caused by direct trauma, fracture, overexertion of muscles, contrast extravasation, injection of recreational drugs, postischemic time, or limb compression during prolonged recumbency

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