Acute Compartment Syndrome

(ACS; Compartment Syndrome, Acute; Volkmann’s Ischemia)

How to Say It: com-PART-ment SIN-drome

Definition

Acute compartment syndrome (ACS) is bleeding or swelling in an enclosed bundle (compartment) of muscles. It can block blood flow and lead to tissue death. ACS needs care right away.

Compartment Syndrome in Lower Leg

Compartment Syndrome
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Causes

Some causes are:

  • A broken bone or crush injury (most common)
  • A badly bruised muscle
  • Burns
  • Prior 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 who are 35 and younger. 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 your symptoms and health history. 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 compartment 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 compartment.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

National Institutes of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org
Canadian Physiotherapy Association
http://www.physiotherapy.ca

References:

Acute compartment syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/acute-compartment-syndrome-emergency-management. Accessed February 15, 2021.
Compartment syndrome. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/compartment-syndrome. Accessed February 15, 2021.
Via AG, Oliva F, et al. Acute compartment syndrome. Muscles Ligaments Tendons J. 2015 Jan-Mar;5(1):18-22.
Last reviewed December 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 2/15/2021

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