Acute Compartment Syndrome
(ACS; Compartment Syndrome, Acute; Volkmann’s Ischemia)
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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Some causes are:
- A broken bone or crush injury (most common)
- A badly bruised muscle
- 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
This problem is more common in people under age 35. It is also more common in people who have had a tibial shaft fracture.
ACS may cause:
- Severe pain, especially with movement
- Tingling or burning
- A muscle that feels tight or full
- Numbness or problems moving
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
- Near-infrared spectroscopy
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.
There are no known guidelines to prevent this health problem.
- 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.
- Mark D. Arredondo, MD
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