Compartment syndrome describes the state of increased pressure in a closed tissue space that impairs blood flow to that space. In turn, the lack of perfusion leads to hypoxia and damage to the muscles and nerves in the space or passing through it.
Compartment syndrome is often caused by trauma, such as a tibia fracture, but can be seen after vascular surgery (a so-called reperfusion injury). Compartment syndrome can also be caused by tight casts, or by infiltration of an intravenous line. Avoiding complications from compartment syndrome requires timely diagnosis and expeditious treatment. The diagnosis can be made on the basic clinical signs and symptoms (especially increasing pain as lactate – the product of anaerobic metabolism – builds up). Diagnosis can be confirmed with measurement of the pressure inside the compartment, but diagnosis can be made on clinical grounds alone in high-risk patients to expedite treatment. Definitive treatment is surgical with urgent fasciotomy: cutting the fascia that surrounds the compartment, thereby relieving the pressure.
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