Acute Compartment Syndrome
Condition
(ACS; Compartment Syndrome, Acute; Volkmann’s Ischemia)
Definition
Acute compartment syndrome (ACS) is bleeding or swelling in an enclosed bundle of muscles. It can block blood flow and lead to tissue death. ACS needs care right away.
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Causes
Some causes are:
- A broken bone or crush injury (most common)
- A badly bruised muscle
- Burns
- Past surgery to repair a damaged or blocked blood vessel
- Problems that block blood flow to the limbs, such as a tight cast or bandage
Risk Factors
This problem is more common in people under age 35. It is also more common in people who have had a tibial shaft fracture.
Symptoms
ACS may cause:
- Severe pain, especially with movement
- Tingling or burning
- A muscle that feels tight or full
- Numbness or problems moving
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
Blood tests will be done.
Images may be taken. This can be done with x-rays.
The pressure inside the muscle bundle will be measured. This can be done with:
- Slit catheter
- Tonometer
- Near-infrared spectroscopy
Treatment
ACS can be deadly. Treatment is needed right away to ease pressure. This is done with a fasciotomy. This surgery makes a cut in the tissue to ease swelling and pressure in the muscle bundle.
Prevention
There are no known guidelines to prevent this health problem.
National Institutes of Arthritis and Musculoskeletal and Skin Diseases
Ortho Info—American Academy of Orthopaedic Surgeons
CANADIAN RESOURCES:
Canadian Orthopaedic Foundation
Canadian Physiotherapy Association
National Institutes of Arthritis and Musculoskeletal and Skin Diseases
Ortho Info—American Academy of Orthopaedic Surgeons
CANADIAN RESOURCES:
Canadian Orthopaedic Foundation
Canadian Physiotherapy Association
References
- Acute compartment syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/acute-compartment-syndrome-emergency-management.
- Compartment syndrome. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/compartment-syndrome.
- Long B, Koyfman A, et al. Evaluation and management of acute compartment syndrome in the emergency department. J Emerg Med. 2019;56(4):386-397.
Contributors
- Mark D. Arredondo, MD
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