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Acute Compartment Syndrome

  • Cynthia M. Johnson, MA
Publication Type:


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.

Compartment Syndrome in Lower Leg.

Compartment Syndromehttp://services.epnet.com/getimage.aspx?imageiid=77677767si55550628_105433_1.jpgsi55550628_105433_1.jpgNULLjpgCompartment SyndromeNULL\\hgfiler01a\intellect\images\si55550628_105433_1.jpgNULL67NULL2008-12-24261400Copyright © Nucleus Medical Media, Inc.


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.


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
  • Tonometer
  • 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
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.