Materiały źródłowe

• #1 Acute Compartment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK448124/

  The incidence of acute compartment syndrome is estimated to be 7.3 per 100,000 in males and 0.7 per 100,000 in females, with the majority of cases occurring after trauma. Tibial shaft fracture is the most common cause of acute compartment syndrome, is associated with a 1 to 10 percent incidence of acute compartment syndrome. […] Acute compartment syndrome occurs more commonly in males younger than 35, which may be due to a larger relative intracompartmental muscle mass and increased likelihood of being involved in high-energy trauma. […] Patients with bleeding diathesis, such as hemophilia, are at greater risk for acute compartment syndrome. Cases of acute compartment syndrome have been reported without acute precipitating trauma in pediatric leukemia. […] Patients who develop acute compartment syndrome without any fracture are at a higher risk of developing complications and delayed treatment.

• #2 Acute Compartment Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/19772

  The incidence of acute compartment syndrome is estimated to be 7.3 per 100,000 in males and 0.7 per 100,000 in females, with the majority of cases occurring after trauma. […] Acute compartment syndrome occurs more commonly in males younger than 35, which may be due to a larger relative intracompartmental muscle mass and increased likelihood of being involved in high-energy trauma. […] Patients with bleeding diathesis, such as hemophilia, are at greater risk for acute compartment syndrome. […] Cases of acute compartment syndrome have been reported without acute precipitating trauma in pediatric leukemia. […] Patients who develop acute compartment syndrome without any fracture are at a higher risk of developing complications and delayed treatment.

• #3 Compartment Syndrome: Symptoms and Treatment | Doctor

  https://patient.info/doctor/compartment-syndrome-pro

  The incidence of acute compartment syndrome is estimated to be 7.3 per 100,000 in males and 0.7 per 100,000 in females. Most cases occur after trauma. The most common cause is tibial shaft fracture. […] Acute compartment syndrome most commonly occurs in males younger than 35, probably due to larger relative intracompartmental muscle mass and increased likelihood of being involved in high-energy trauma. […] Chronic exertional compartment syndrome has an incidence of 33% in active patients with exercise-induced leg pain. […] A study of a military population reported an annual incidence of 0.49 per 1,000 at-risk person-years. […] The condition has a peak prevalence of 20-25 years. […] Most at risk are those who exercise with repetitive motions or activity.

• #4 59.08 Epidemiology and One-Year Sequelae of Acute Compartment Syndrome – Academic Surgical Congress Abstracts Archive

  https://www.asc-abstracts.org/abs2016/59-08-epidemiology-and-one-year-sequelae-of-acute-compartment-syndrome/

  Acute compartment syndrome (CS) is an important diagnosis for general, vascular, orthopedic, and trauma surgeons. However, only single center studies have previously described the epidemiology of CS; and the long-term outcomes for these patients have yet to be reported. In this study, we sought to describe the epidemiology of CS and the rate of subsequent limb loss using a comprehensive statewide inpatient database. […] There were 6,471 CS cases 1,294 per year, or an annual incidence of 3.5 per 100,000 population. […] CS is an infrequent but potentially devastating diagnosis that can lead to limb loss. There are significant long-term sequelae with the majority of amputations becoming necessary after discharge from hospital.

• #5 Epidemiological Analysis of Traumatic Compartment Syndromes in Germany

  https://www.mdpi.com/2077-0383/13/6/1678

  Our study uncovered clear trends and demographic features regarding compartment syndrome (CS) following trauma. Predominantly, cases were observed in the lower leg (44.4%), with a notable proportion occurring in the upper extremities (10.5%). These data are consistent with the literature. Notably, McQueen et al. demonstrated that fractures are the primary cause of CS at a rate of 69%, with the most prevalent location being the diaphysis of the tibia, followed by the distal radius as the second most common site. […] Our research examined 13,305 cases of traumatic compartment syndromes that were treated concurrently with osteosynthetic procedures, recorded in Germany from 2015 to 2022. Data from the German Statistical Office indicate that the country’s average population during this period was approximately 83,053,327. This translates to an incidence rate of 2 per 100,000 individuals for traumatic compartment syndrome. With this incidence, the compartment syndrome following trauma represents a rare clinical entity that needs more attention.

• #5 Epidemiological Analysis of Traumatic Compartment Syndromes in Germany

  https://www.mdpi.com/2077-0383/13/6/1678

  During the period from 2015 to 2022, we reviewed a total of 13,305 cases of traumatic compartment syndromes. Of these, 61% manifested in the lower extremities and 11% in the upper extremities. A significant portion of cases lacked precise localization classification (25.2%). Most traumatic compartment syndromes occurred in males (4092 cases in females vs. 9213 in males), resulting in a female to male ratio 1:2.3. The distribution of males and females within younger and older patients was equal in the group “foot”. For all other localizations (unspecified, lower leg, hip and thigh, upper extremities), the male to female ratio decreased significantly in patients above 40 years of age. […] Throughout the analyzed period, all traumatic compartment syndromes exhibited a significant decline in cases per year, amounting to a reduction of 43.87 cases annually. A classification based on the sex also shows a significant decline of 36.04 cases per year for males and a not significant decline of 7.83 cases per year for females. The subgroup analysis further confirms a yearly decrease in the incidence of compartment syndrome following osteosynthesis. Notably, a significant yearly decrease was observed in all male patient groups, with a reduction of 23.68 cases in males under 40 and 12.36 cases in males over 40. Among females under 40, the data also indicate a significant yearly decrease, with 5.75 fewer cases. However, for females over 40, the yearly reduction was not statistically significant, showing only a modest decrease of 2.08 cases.

• #5 Epidemiological Analysis of Traumatic Compartment Syndromes in Germany

  https://www.mdpi.com/2077-0383/13/6/1678

  Epidemiological Analysis of Traumatic Compartment Syndromes in Germany […] Background: Traumatic compartment syndrome is a critical condition that can lead to severe, lifelong disability. Methods: This retrospective study analyzed hospital billing data from 2015 to 2022, provided by the Federal Statistical Office of Germany, to examine the demographics and trends of traumatic compartment syndrome in Germany. The analysis included cases coded with ICD-10 codes T79.60 to T79.69 and any therapeutic OPS code starting with 5–79, focusing on diagnosis year, gender, ICD-10 code, and patient age. Results: The results showed that out of 13,305 cases, the majority were in the lower leg (44.4%), with males having a significantly higher incidence than females (2.3:1 ratio). A bimodal age distribution was observed, with peaks at 22–23 and 55 years. A notable annual decline of 43.87 cases in compartment syndrome was observed, with significant decreases across different genders and age groups, particularly in males under 40 (23.68 cases per year) and in the “foot” and “lower leg” categories (16.67 and 32.87 cases per year, respectively). Conclusions: The study highlights a declining trend in traumatic CS cases in Germany, with distinct demographic patterns. Through these findings, hospitals can adjust their therapeutic regimens, and it could increase awareness among healthcare professionals about this disease.

• #5 Epidemiological Analysis of Traumatic Compartment Syndromes in Germany

  https://www.mdpi.com/2077-0383/13/6/1678

  Compartment syndrome (CS) is a severe and potentially limb-threatening medical condition, most commonly arising following traumatic injuries. The causes of CS can be divided into traumatic and non-traumatic. Epidemiological studies have well established that fractures are the most common cause of traumatic compartment syndromes, accounting for about 69–75% of all cases. Nevertheless, traumatic CS can also be triggered by other diverse factors, including soft tissue injuries, vascular injuries, penetrating trauma, or severe thermal burns. […] To date, there is a lack of literature detailing the prevalence of traumatic CS. Furthermore, research has not been conducted to identify which anatomical regions are most affected by CS. Moreover, a significant gap exists in the literature concerning comprehensive analyses encompassing trends and demographic characteristics associated with traumatic CS with simultaneous osteosyntheses in Germany. Our research aimed to fill this gap by examining cases of traumatic compartment syndrome that were treated concurrently with osteosynthetic procedures. The objective of our study was to investigate the demographics and overall trends in Germany.

• #6 Compartment syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Compartment_syndrome

  In a case series of 164 people with acute compartment syndrome, 69% had an associated fracture. The article’s authors found that the yearly rate of acute compartment syndrome is 1 to 7.3 cases per 100,000 people. It varies greatly by age and gender in trauma. Men are ten times more likely than women to get ACS. The mean age for ACS is 30 in men and 44 in women. People under 35 may get ACS more often. This is likely because they have more muscle mass. The anterior compartment of the leg is where ACS usually happens.

• #7 Epidemiology and Demographics compartment syndrome – wikidoc

  https://www.wikidoc.org/index.php/Epidemiology_and_Demographics_compartment_syndrome

  Compartment syndrome is a painful problem known as the increased intracompartmental pressure (ICP) within a closed osteofascial compartment. […] CS usually develops after severe (such as fractures or crush injury), minor, or even iatrogenic has injuries, and it related mortality rate is almost 50%. […] Usually the leg and forearm are the most common affected sites, but it can also involves the arm, hand, foot, and buttock. […] Male are almost 10 times more likely to suffer than female with the mean age of involvement of 30 years and 44 years, respectively. […] Meanwhile, the closed tibial shaft fracture as the most common cause of CS comprised almost 30% of all cases of CS; and blunt and crushed soft tissue limb trauma while radius ulna shaft fractures are responsible for 25% and 20% of cases, respectively. […] Also, foot injuries in road traffic accidents account for 6% of CS cases, while this incidence is less common in lower leg injuries. […] the prevalence of Abdominal CS ranged from 0.0% to 36.4% and the related mortality rated ranged from 0.0% to 100.0%.

• #8 The Dreaded Acute Compartment Syndrome – emDocs

  https://www.emdocs.net/the-dreaded-acute-compartment-syndrome/

  A surgical emergency, acute compartment syndrome (ACS) is the result of excessive pressure within a fascial compartment, leading to decreased perfusion. Incidence varies but is close to 0.7-7.3 cases per 100,000 people. Failure to treat ACS can cause long-term neurovascular deficits, and ACS is associated with significant medicolegal risk. In fact, 23% of medicolegal cases are due to misdiagnosis, and 32% of cases are due to delay to definitive treatment. […] ACS is most common in patients < 35 years of age. These patients have increased risk of high-energy injuries, stronger fascia, and greater muscle bulk. Males are 10x more likely to experience ACS compared to females. [...] Overall, signs and symptoms can suggest the diagnosis, but they are not definitive. Combining factors is better. A combination of pain with rest, pain with passive stretch, paralysis, and paresthesias increases sensitivity to 93%.

• #9 Acute compartment syndrome of the extremities – UpToDate

  https://www.uptodate.com/contents/acute-compartment-syndrome-of-the-extremities

  Acute compartment syndrome (ACS) most often develops soon after significant trauma, particularly involving long bone fractures. […] However, ACS may also occur following minor trauma or from nontraumatic causes. In brief, any condition that decreases the volume capacity of a compartment or increases the volume of fluid within a compartment raises intracompartmental pressure and places the patient at risk for developing compartment syndrome. Common sites include the leg and forearm. […] ACS is seen more often in patients under 35 years of age. Young males appear to have the highest incidence, particularly after fractures of the tibial diaphysis, tibial plateau, and distal radius. […] Long bone fracture — Fractures account for approximately 75 percent of cases of ACS. Risk increases with comminuted fractures.

• #10 Compartment syndrome in the extremities

  https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=110700

  Acute compartment syndrome (ACS) most commonly develops soon after significant trauma, mainly when long bone fractures occur; however, it can be seen from non-traumatic causes. It may be due to intrinsic factors (e.g., swelling, hemorrhage) or extrinsic or post-injury factors that restrict the ability of the fascial envelope to expand. It is more common in the lower extremity than in the upper extremity. The calf is the most common site affected in the lower extremity, and the forearm is the most common site in the upper extremity. Fasciotomies are less frequently needed in the upper extremities, accounting for approximately 20% of all extremity fasciotomies. ACS is most commonly seen in young men 35 years with the highest incidence, particularly after tibial diaphysis and distal radius fractures.

• #11

  https://www.orthobullets.com/trauma/1001/leg-compartment-syndrome

  Leg Compartment Syndrome is a devastating lower extremity condition where the osseofascial compartment pressure rises to a level that decreases perfusion to the leg and may lead to irreversible muscle and neurovascular damage. […] Epidemiology: compartment syndrome may occur anywhere that skeletal muscle is surrounded by fascia, but most commonly leg, forearm, hand, foot, thigh, buttock, shoulder, and paraspinous muscles. […] young age (highest prevalence in 12-19 year olds) is a risk factor for compartment syndrome.

• #12 Acute Compartment Syndrome

  https://www.abdn.ac.uk/medical/elf/courses/view/146779/acute-compartment-syndrome/1/page5

  Acute compartment syndrome: […] Most commonly occurs in the lower leg […] Followed by the forearm / thigh […] Rarely, abdominal and gluteal compartment syndrome occurs.

• #13 Acute Compartment Syndrome: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/307668-overview

  The anterior distal lower extremity is the most common studied site of compartment syndrome. Tibial fracture is the most common precipitating event, accounting for 2-12% of all compartment syndrome cases, according to the literature. In a retrospective study by McQueen and Court-Brown in 164 patients with diagnosed compartment syndrome, 69% of cases were associated with a fracture, and half of those involved the tibia. In the study, compartment syndrome was diagnosed more often in men than in women. This finding likely represents selection bias, however, because most patients with traumatic injuries are male. […] In a 10-year study, McQueen et al studied 850 patients and concluded that continuous intracompartmental pressure monitoring should be considered following tibial diaphyseal fracture because these patients are at risk for acute compartment syndrome.

• #13 Acute Compartment Syndrome: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/307668-overview

  The incidence of acute compartment syndrome varies depending on the inciting event. DeLee and Stiehl found that 6% of patients with open tibial fractures developed compartment syndrome, compared with only 1.2% of patients with closed tibial fractures. […] The reported incidence of compartment syndrome may underestimate the true incidence because the syndrome may go undetected in severely traumatized patients. […] In the aforementioned study by Robertson et al of pediatric patients with supracondylar humerus fractures, acute traumatic compartment syndrome developed in approximately 2-3 fractures per 1000. […] The frequency of compartment syndrome is much higher in patients who have an associated vascular injury. Feliciano et al reported that 19% of patients with vascular injury required fasciotomy; an incidence of 30% has also been suggested, but this figure is not well documented and is most likely an estimate. The true incidence of cases associated with vascular trauma may not be known because many vascular surgeons perform a prophylactic fasciotomy at the time of the vascular repair in high-risk patients.

• #14 Compartment syndrome in the extremities

  https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=110700

  Several studies showed that fractures are the most common cause of ACS, accounting for about 69-75% of cases. Multiple other etiologies can cause ACS; among all, trauma is the most frequent, particularly long bone fractures, where the tibia is most frequently affected, and approximately 1-10% of fractures develop ACS. Fractures of the forearm are the second most affected bones in the upper extremities. Other traumatic causes of CS include penetrating extremity trauma with vascular (arterial, venous) injury, intra-compartmental hemorrhage, contusions, and crush or burn injuries. Non-traumatic causes include prolonged external compression, animal bites and stings, coagulopathies, tight casts, and postischemic edema. All these causes are presented below. […] Any condition that decreases the capacity of a compartment or increases the volume of fluid within a compartment increases intra-compartmental pressure and puts the patient at risk for developing compartment syndrome. Common sites include the leg and forearm; however, it can also occur in the foot, thigh, and gluteal region.

• #15 Lower Limb Exertional Compartment Syndrome | PM&R KnowledgeNow

  https://now.aapmr.org/lower-limb-exertional-compartment-syndrome/

  The incidence of LLECS in the general population is unknown, although some estimate that it accounts for 14-27% of previously undiagnosed exercise-induced leg pain. In fact, this may be under-appreciated secondary to poor awareness among medical providers and the public, as illustrated by an average of 22 months from symptom onset to treatment. A vast majority (87%) of patients with LLECS participate in sports, with running accounting for 69%. […] LLECS has a median age of onset of 20 years old, and the prevalence decreases with age, though it has been suggested that there is an underdiagnosed population within older adults, plateauing around age 50. Bilateral lower extremity involvement occurs in 85-95% of cases with a predilection for the anterior and deep compartments. The presence of unilateral symptoms is associated with prior trauma and vasculopathy. Risk factors include jumping, cutting, and skating sports. Location of LLECS can be sport or activity-dependent. The deep posterior compartment is more often affected in soccer players, while the anterior compartment is associated with speed skating and non-sports activities.

• #16 Compartment syndrome: challenges and solutions | ORR

  https://www.dovepress.com/compartment-syndrome-solutions-and-challenges-peer-reviewed-fulltext-article-ORR

  Compartment syndrome is defined as increased pressure within a fibro-osseous space resulting in decreased tissue perfusion to structures within that space. […] High energy injuries and polytrauma increase the risk of ACS. McQueen et al, reported fractures were most often implicated in compartment syndrome, in as much as 69%, as compared to 23.2% attributed to soft tissue injuries without fractures. […] In a systematic review by Ojike et al, it was found that 89 patients had thigh compartment syndrome, most commonly seen after blunt trauma (90%). […] Another systematic review of 39 cases of foot compartment syndrome reported crush injury to be the most common cause. […] In the adult forearm, distal radius fractures were found to be the most prevalent cause of compartment syndrome. […] In a review of the National Pediatric Trauma Registry, it was noted that in 131 children, 74% of ACS was attributed to forearm fractures and only 15% due to supracondylar fractures.

• #17 Compartment Syndrome: What It Is, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/15315-compartment-syndrome

  Experts estimate that fewer than 10 in every 100,000 people in the U.S. experience acute compartment syndrome each year. However, its much more common in people who have some types of bone fractures (broken bones). For example, studies estimate that around 10% of people who break their tibia (shin bone) develop compartment syndrome. […] Anyone can develop acute compartment syndrome because it happens after sudden injuries. […] Athletes and people with physically demanding jobs are more likely to overtrain or overwork their muscles and develop chronic compartment syndrome. […] Compartment syndrome can cause serious complications. […] Acute compartment syndrome can be fatal if its not treated right away.

• #18 Compartment Syndrome – Core EM

  https://coreem.net/core/compartment-syndrome/

  Increased pressure within a closed space that compromises circulation and, thus, function of the tissues (i.e. muscle, nerve, bone) within the space. Sequelae include neurological deficit, Volkmanns contracture, limb amputation and crush syndrome. […] Most commonly seen after a traumatic injury to an extremity […] Can occur in the absence of fracture […] Occur in 1-10% of tibial fractures (Elliott 2003) […] 75% of traumatic compartment syndrome accounted for by long-bone fractures (Carter 2013) […] Most common sites: lower leg, upper leg, forearm, gluteal/thigh and hand.

• #19 Acute Compartment Syndrome | MDedge

  https://ma1.mdedge.com/content/acute-compartment-syndrome

  Acute compartment syndromeelevation of interstitial pressure in closed fascial compartmentaffects 10 times as many men as women, at an average age of 32 years old and with an annual incidence of 7.3 per 100,000 men and 0.7 per 100,000 for women.1 McQueen et al1 found that the most common cause of acute compartment syndrome was fracture (69%), followed by soft tissue injury (23%). Younger patients are more likely to develop acute compartment syndrome from trauma because they typically have larger muscle beds with more tissue to become edematous compared to the older, hypotrophic muscles of elderly patients. […] Compartment syndrome is the end result of many different injury patterns. While fracture is the number one cause of compartment syndrome, many types of soft tissue injuries can also lead to compartment syndrome. Nonfracture etiologies of compartment syndrome are relatively uncommon, and as such can lead to a delay in diagnosis.

• #20 Identifying key risk factors for acute compartment syndrome in tibial diaphysis fracture patients | Scientific Reports

  https://www.nature.com/articles/s41598-024-59669-1

  The objective of this study is to explore the associations between the development of ACS in patients with tibial diaphyseal fractures and a variety of demographic factors, comorbidities, and notably, admission laboratory assessments, which may serve as potential predictors for the onset of ACS. […] Our research has successfully pinpointed gender, crush injuries, LDH levels, and white blood cell (WBC) count as crucial risk factors for the development of ACS in patients experiencing tibial diaphysis fractures. […] In this study, logistic regression analysis revealed significant associations between tibial diaphysis fractures and the development of ACS in male patients. […] Elevated WBC counts, elevated LDH levels, and a history of crush injury were also found to be significantly associated with the development of ACS.

• #20 Identifying key risk factors for acute compartment syndrome in tibial diaphysis fracture patients | Scientific Reports

  https://www.nature.com/articles/s41598-024-59669-1

  Acute compartment syndrome (ACS) is a severe orthopedic issue that, if left untreated, can result in lasting nerve and muscle damage or even necessitate amputation. […] The leading causes of diaphyseal fractures are falls on the same level, sports-related activities, and road traffic accidents. […] It is worth noting that tibial diaphyseal fractures stand as the leading cause of ACS, with an estimated 36% of ACS cases being attributed to these specific fractures. […] Acute compartment syndrome (ACS) in the lower leg poses a significant threat to limb integrity and demands immediate surgical intervention. […] Numerous prior studies have pinpointed various risk factors associated with the development of ACS in patients with tibial fractures, including younger age, male gender, individuals without a history of hypertension, high-energy injuries, absence of hypertension, and the presence of fibular fractures.

• #20 Identifying key risk factors for acute compartment syndrome in tibial diaphysis fracture patients | Scientific Reports

  https://www.nature.com/articles/s41598-024-59669-1

  Our study has shown that male patients, elevated WBC counts, increased LDH levels, and a history of crush injury were independent predictors of ACS in patients with tibial diaphysis fractures. […] The cut-off values for LDH and WBC to predict ACS are 266.26 U/L and 11.7109 cells per liter, respectively.

• #21

  https://step2.medbullets.com/orthopedics/120558/compartment-syndrome

  Clinical definition a painful emergency condition that occurs when the tissue pressure inside an anatomical compartment, bound by fascia, exceeds the perfusion pressure, resulting in ischemia and necrosis […] Epidemiology Location lower extremity upper extremity leg forearm hand foot thigh […] Risk factors trauma anticoagulation therapy bleeding disorders […] The most common cause is a fracture tibia fracture […] Compartment pressure measurement indication to confirm the diagnosis if clinicians are unable to elicit the symptoms or history […] most cases are clinically diagnosed or guided by pressure measurement absolute ICP 30 mm Hg […] pressure (diastolic blood pressure – ICP) 30 mmHg normal ICP is 0 mm Hg […] Management approach management is focused on early decompression […] observation and conservative management is appropriate only if ICPs are not high […] indications ICP 30 mm Hg (with lower threshold for compartment syndrome of the hand) prolonged duration of compartment syndrome 8 hours […] Higher chance of regaining function of the affected limb if a fasciotomy is performed within 12 hours.

• #22 1. Acute Extremity Compartment Syndrome (CS) and the Role of Fasciotomy in Extremity War Wounds

  https://tccc.org.ua/en/guide/acute-extremity-compartment-syndrome-and-the-role-of-fasciotomy-cpg

  CS is a common, controversial, and disabling problem in extremity war injuries. Seven to 11% of civilian tibia fractures result in compartment syndrome. A similar incidence can be expected in cases of fractures from non-battle injuries in deployed areas. In contrast, combat injuries often involve a higher overall trauma burden; extreme transfusion requirements; extensive soft tissue injuries; associated arterial injuries; multi-level limb trauma; and occur in remote locations. This results in fifteen percent of all military orthopaedic trauma casualties requiring at least one prophylactic or therapeutic fasciotomy. […] Recent research indicates proper detection of Compartment Syndrome (CS) is lifesaving and delay in diagnosis can be lethal. The operational definition of CS is a clinical syndrome wherein high pressure within a myofascial space reduces perfusion and decreases tissue viability.

• #22 1. Acute Extremity Compartment Syndrome (CS) and the Role of Fasciotomy in Extremity War Wounds

  https://tccc.org.ua/en/guide/acute-extremity-compartment-syndrome-and-the-role-of-fasciotomy-cpg

  Compartment syndrome can lead to significant morbidity and mortality. Surveys indicate surgeons with more training and experience, are more willing to perform fasciotomy. […] The most common compartment syndrome is in the anterior leg. About 45% of all compartment syndromes are caused by tibia fracture. Open fractures, even with traumatic fasciotomy, have higher CS rates than closed fractures because they are more severe, with more swelling and more often injured arteries. […] In one study, burns sustained in combat have been associated with an increased fasciotomy rate. […] CS requires immediate operative intervention. Once intra-compartmental pressure reaches a critical threshold, only surgical treatment can interrupt the cascade of events leading to ischemia and tissue necrosis. […] Delayed or incomplete compartment release has been associated with increased mortality and need for amputation in military casualties.

• #22 1. Acute Extremity Compartment Syndrome (CS) and the Role of Fasciotomy in Extremity War Wounds

  https://tccc.org.ua/en/guide/acute-extremity-compartment-syndrome-and-the-role-of-fasciotomy-cpg

  The decision to proceed with prophylactic fasciotomy is based on the pattern of extremity injury, the patients physiological profile, and operational considerations. […] Occasionally, casualties present with a compartment syndrome of prolonged duration ( 12 hours) due to delayed evacuation. This situation is associated with markedly increased risk of complications, including death and infection. […] Therefore, compartment syndromes with greater than 12 hours of warm ischemia with nonviable muscle should not routinely undergo fasciotomy. […] Incomplete fasciotomy is associated with worse outcomes; fortunately, improved surgical education has been shown to decrease the rate of fasciotomy requiring revision.

• #23 Chronic exertional compartment syndrome – UpToDate

  https://www.uptodate.com/contents/chronic-exertional-compartment-syndrome

  Chronic exertional compartment syndrome (CECS) is a condition that typically affects young endurance athletes, especially those who run extensively. Like acute compartment syndrome (ACS), it is thought to result from increased pressure within a muscle compartment. CECS occurs primarily in the lower leg, although it has been reported in the forearm and elsewhere. […] The pathophysiology of CECS is not completely understood. One theory is that tissue ischemia in CECS stems from a noncompliant fascial compartment that cannot accommodate the expansion of muscle volume that occurs with exercise. Simply put, „stiff” fascia does not allow for the increased blood flow that exercising muscle requires. As pressure increases and local tissue perfusion becomes compromised, metabolic demands cannot be met and ischemic symptoms develop. Several studies have demonstrated decreased blood flow and oxygenation in the legs of symptomatic patients with CECS. […] The role of thicker or stiffer fascia is supported by some studies but refuted by others. However, neither macroscopic nor microscopic assessment of fascial thickness or stiffness has been shown to be a useful predictor of success following fasciotomy.

• #24 Chronic Exertional Compartment Syndrome in ­Athletes: A narrative Review – SEMS-journal

  https://sems-journal.ch/8207

  Chronic exertional compartment syndrome (CECS) of the lower leg accounts for up to 75% of sports-related chronic leg pain in endurance athletes. […] Athletes that participate in endurance sports, particularly long distance running, soccer, and ballet or squash are primarily at risk of developing CECS.

• #25 The Pathophysiology, Diagnosis and Current Management of Acute Compartment Syndrome

  https://openorthopaedicsjournal.com/VOLUME/8/PAGE/185/

  Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. […] The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] Compartment pressure monitoring may aid in the diagnosis, with a delta pressure of 30 mmHg or below suggestive of ACS. […] A delay of more than six hours is associated with irreversible myoneural damage and timing is crucial. […] Delayed fasciotomy after 8-10 hours is associated with significantly increased risks which may outweigh any potential benefit.

• #26 The Dreaded Acute Compartment Syndrome – emDocs

  https://www.emdocs.net/the-dreaded-acute-compartment-syndrome/

  Delayed diagnosis results in poor outcomes including infection, muscle necrosis, rhabdomyolysis, renal failure, muscle contractures, neurologic injury, chronic pain, fracture, amputation, and death. Missed diagnosis is associated with clinician inexperience, patient sedation, polytrauma, soft tissue injury, and reliance on signs and symptoms alone. […] The most important point is to consider ACS. Once you suspect ACS, consult orthopedic or general surgery, remove any constrictive dressings, and avoid a dependent position of the extremity (try your best to keep the extremity at the level of the heart). Removing external compressive devices alone can reduce pressures by 65-85%. […] Another important point is that outcomes improve with rapid diagnosis and decompression. Rapid fasciotomy is correlated with improved outcomes, including muscle and nerve injury and death.

• #27 Acute compartment syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/acute-compartment-syndrome?lang=us

  Acute compartment syndrome is more common in those under 35 years of age. It is ten times more common in males and most commonly seen following tibial shaft fractures. […] Acute compartment syndrome is diagnosed based on clinical findings and the measurement of compartmental pressures.

• #28 Compartment Syndrome • LITFL • Trauma Library

  https://litfl.com/compartment-syndrome/

  Epidemiology […] Trauma (fractures 69%, crush injuries, burns, contusions, gunshot wounds) External compression (tight casts dressings) Bleeding disorders Reperfusion injury (tourniquets, surgical thrombectomy) Extravasation of IV fluids Arterial injury Snake bite Anabolic steroid use. […] […] […] Have a high index of suspicion in: Tibial shaft fractures (CS occurs in up to 9%) Pain not relieved with 0.2mg/kg iv morphine bolus The obtunded patient (inebriated, comatose, sedated, polytrauma, paralysed). […] […] […] After 8 hours of established CS, severe muscle necrosis and permanent nerve injury will have occurred, performing a dermofasciotomy has increased risk of infection, amputation (twice as likely) and death (three times as likely) and is unlikely to avoid severe muscle contracture.

• #29

  https://link.springer.com/article/10.1007/s00068-007-7151-0

  Due to an insult that causes a pressure elevation in the compartment, which is the limited space surrounded by the unyielding bone and fascia, the circulation is compromised resulting in muscular and neural ischemia and eventually tissue necrosis. […] The diagnosis of the compartment syndrome has always been based on the clinical symptoms, however, multiple studies suggested that clinical examination alone is insufficient and may result in delayed diagnosis, delayed treatment and serious sequelae. […] To avoid delayed diagnosis and treatment the use of compartment pressure monitoring has been advised. […] There is, however, no consensus about the indications for the compartment pressure monitoring, or about the threshold pressure that should be used for dermatofasciotomy.

• #30 Compartment Syndrome – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/fractures/compartment-syndrome

  Compartment syndrome is mainly a disorder of the extremities and is most common in the lower leg and the forearm. However, compartment syndrome can also occur in other locations (eg, upper arm, abdomen, buttock). […] Diagnosis of compartment syndrome must be made and treatment started before pallor or pulselessness develops, indicating necrosis. […] Compartment syndrome is confirmed if compartmental pressure is more than approximately 30 mm Hg or within approximately 30 mm Hg of diastolic blood pressure (BP). […] Measure compartment pressure to confirm the diagnosis; a finding of more than approximately 30 mm Hg or within approximately 30 mm Hg of diastolic BP confirms it. […] Unless the disorder resolves rapidly after initial treatment, fasciotomy must be done as soon as possible.

• #31 Compartment Syndrome | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/compartment-syndrome

  Compartment syndrome may occur in any area where the skeletal muscle is surrounded by a layer of fascia. It occurs most commonly in the leg, forearm, hand, and foot. […] Identifying high-risk patients and prompt diagnosis and treatment are critical. […] Compartment syndrome remains a clinical diagnosis. Clinicians should monitor high-risk patients and closely monitor their analgesic use. Compartment measurements should be interpreted with caution, as the cut off values may be different in children than adults. The literature fails to support treatment of compartment syndrome based solely on compartment pressure measurements.

• #32

  https://journals.lww.com/jorthotrauma/fulltext/9900/clinical_trial_of_a_new_continuous_compartment.492.aspx

  To evaluate a new compartment pressure monitor reporting continuous pressures and its contribution to Acute Compartment Syndrome (ACS) diagnosis. […] The MEMS-based device reliably enabled continuous compartment pressure monitoring in all the study institutions. Further examination of continuous trends and accompanying perfusion pressure could allow surgeons the clinical adjunct to diagnose ACS many hours earlier than clinical signs alone.

• #33 Lower extremity compartment syndrome | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/2/1/e000094

  Lower extremity compartment syndrome is not uncommon and has the potential to cause devastating morbidity for patients and a high-risk medical-legal environment for physicians. Rapid diagnosis and prompt, accurate treatment lead to the best outcomes. […] No comprehensive accounting of the prevalence of acute lower extremity compartment syndrome has been published. In part, this is secondary to the many different causes and descriptions of the disease process. It has been estimated that the average annual incidence is 0.7 per 100000 women and 7.3 per 100000 men. […] A missed diagnosis of compartment syndrome is important because of direct morbidity to the patient and because it creates a high-risk medical-legal environment for the provider. […] The most prominent risk factor for an indemnity payment was a delay of more than 8hours from the onset of the disease. […] The protocol included physical examination and compartment pressures, when indicated, every 4hours for the first 48hours. Their study showed a high rate of acute lower extremity compartment syndrome, 20%, in the patient population that underwent screening.

• #34 Abdominal compartment syndrome – EMCrit Project

  https://emcrit.org/ibcc/abdominal-compartment-syndrome/

  abdominal compartment syndrome is common […] The incidence of abdominal compartment syndrome varies, between ~2-8%. […] This often represents a complication from over-resuscitation of septic shock or pancreatitis. […] Surgical ICU: higher rates than medical ICU.

• #35 Abdominal compartment syndrome: Current concepts and management | Revista de Gastroenterología de México

  https://www.revistagastroenterologiamexico.org/en-abdominal-compartment-syndrome-current-concepts-articulo-S2255534X20300736

  Abdominal compartment syndrome occurs when 2 or more anatomic compartments have a sustained intra-abdominal pressure 20mmHg, associated with organ failure. Incidence is 2% and prevalence varies from 0% to 36.4%. […] According to a 2014 Scandinavian study, there was a 39% incidence of IAH and a 2% incidence of ACS. Incidence of ACS in intensive care units (ICUs) was reported to vary from 0.5% to 58.8% and to reach 14% in patients with a history of trauma. […] The prevalence of ACS varied from 0% to 36.4% in patients with visceral damage, and from 0.9% to 36.4% in patients that underwent laparotomy for abdominal trauma. […] ACS-associated mortality is high, with 2 recent articles reporting a mortality rate of 47.1% and 53.1%, respectively.

• #36

  https://journals.lww.com/md-journal/fulltext/2019/07050/acute_compartment_syndrome__cause,_diagnosis,_and.62.aspx

  Acute compartment syndrome (ACS) is defined as a clinical entity originated from trauma or other conditions that cause bleeding, edema, or that compromises perfusion in limbs. The incidence rate of ACS was reported 30.4% especially in shaft and proximal regions of tibia. […] To prevent serious complications induced by ACS, fasciotomy should be done before irreversible tissue necrosis occurs, thus there is a strong clinic bias toward doing fasciotomy empirically or prophylactically in patients who are considered to be at high risk and/or who have concerning clinical findings. […] The diagnosis of compartment syndrome is always controversial and is based on clinical assessment and pressure measurement in compartment. […] The overtreatment based on intracompartmental pressure measurements alone was still existed in a sizeable number of patients, and not all hospitals have the technical equipment to do this. […] The ACS is considered as an orthopedic emergency which can lead to limb and life-threatening outcome if there is delay in diagnosis and treatment.

• #37 Acute Compartment Syndrome | MDedge

  https://ma1.mdedge.com/content/acute-compartment-syndrome

  Almost 70% of all cases of compartment syndrome are due to fracture.1 Fractures of the tibia, distal radius, and ulna are the most common injuries that lead to acute compartment syndrome. Interestingly, acute compartment syndrome is caused by an equal distribution of high-energy and low-energy mechanisms of injuries.1 Because the increase in compartment pressure is highest at the fracture site,9 it is imperative to measure pressures at the site of the fracture. […] Delay in the diagnosis of acute compartment syndrome has become an increasing source of medicolegal liability. In a 2004 review by Bhattacharyya and Vrahas34 of 23 years of claims from a medical malpractice insurer, only 19 claims were made for compartment syndrome. In this series, the following four risk factors were associated with an unsuccessful defense: (1) a linear association between the number of documented cardinal signs of compartment syndrome and an indemnity payment; (2) delays in fasciotomy; (3) poor communication with the patient and nursing staff; (4) and failure to intervene after documentation of an abnormal physical finding. All of the above were associated with a negative legal outcome.

• #38 Publications – MY01

  https://my01.io/publications/

  Acute compartment syndrome (ACS) is a well-recognized and common emergency. Undiagnosed ACS leads to muscle necrosis, limb contracture, intractable pain, and may even result in amputation. […] There remain gaps in knowledge regarding the pathophysiology, initial diagnosis, treatment, and outcome of acute compartment syndrome (ACS). Most reported clinical outcomes are from smaller studies of heterogeneous patients. For a disease associated with a financial burden to society that represents billions of dollars worldwide, the literature does not currently establish baseline diagnostic parameters and risk factors that may serve to predict treatment and outcomes. […] Compartment syndrome (CS) occurs in several clinical scenarios. Reperfusion injury and tissue swelling are common causes. This can occur after trauma but also is seen post-revascularization of extremities. CS is a difficult diagnosis to make in a timely fashion that avoids permanent tissue damage.

• #38 Publications – MY01

  https://my01.io/publications/

  Acute compartment syndrome (ACS) can occur in a variety of clinical scenarios. Reperfusion injury and tissue swelling are common causes across etiologies. Trauma is recognized as a common cause, but CS is also seen after limb alignment correction for extremities. CS is a difficult diagnosis to make in any scenario. Timely diagnosis is also difficult. Correct diagnosis is inexact, with many false positives and some false negatives being the normal outcome. […] Digital health principles are starting to be evident in medicine. Orthopaedic trauma surgery is also being impacted indirectly by all other improvements in the health ecosystem but also in particular efforts aimed at trauma surgery. Data acquisition is changing how evidence is gathered and utilized. Sensors are the pen and paper of the next wave of data acquisition. Sensors are gathering wide arrays of information to facilitate digital health relevance and adoption.

• #39 Compartment Syndrome – Market Insight, Epidemiology, and Market Forecast – 2034

  https://www.giiresearch.com/report/del1506677-compartment-syndrome-market-insight-epidemiology.html

  The Compartment Syndrome epidemiology division provide insights about historical and current Compartment Syndrome patient pool and forecasted trend for every seven major countries. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the DelveInsight report also provides the diagnosed patient pool and their trends along with assumptions undertaken. […] The disease epidemiology covered in the report provides historical as well as forecasted Compartment Syndrome epidemiology scenario in the 7MM covering the United States, EU5 countries (Germany, Spain, Italy, France, and the United Kingdom), and Japan from 2020 to 2034. […] The epidemiology segment also provides the Compartment Syndrome epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

• #40 Demographic Characteristics Among Patients With Chronic Exertional Compartment Syndrome of the Lower Leg in: Journal of Sport Rehabilitation Volume 29 Issue 8 (2020)

  https://journals.humankinetics.com/view/journals/jsr/29/8/article-p1214.xml

  Chronic exertional compartment syndrome (CECS) is a condition related with ischemia of the bodys tissue due to increases in intracompartmental pressures, which involves, among other symptoms, pain with exertion. […] Research is lacking on the type of patient most likely to experience CECS, highlighting the need for identification of common demographic characteristics among affected individuals. […] Current evidence has identified commonalities in sex, age, and sport participation as characteristics often present among individuals experiencing lower leg CECS. […] There is conflicting evidence regarding sex as a predictor for CECS. […] There is inconsistent evidence regarding the age of patients affected by CECS. […] Participation in sport has been commonly associated with the development of CECS. […] Minimal prospective evidence exists evaluating predictive factors for CECS. […] Future research should focus on additional prospective studies to further confirm common characteristics among those diagnosed with CECS as the current research is still controversial.

• #41 Incidence of acute compartment syndrome with routine use of regional anesthesia for long bone fractures: Key insights – NYSORA

  https://www.nysora.com/education-news/incidence-of-acute-compartment-syndrome-with-routine-use-of-regional-anesthesia-for-long-bone-fractures-key-insights/

  Overall incidence of ACS: Out of 26,537 patients with long bone fractures, 27 were confirmed to have ACS caused by long bone fractures, resulting in an incidence rate of 0.1% (1.017 per 1000 patients). […] The study challenges the traditional caution against using PNBs in patients at risk for ACS. With a well-structured protocol and multidisciplinary management, the routine use of regional anesthesia in trauma patients showed a low incidence of ACS. […] This study provides evidence that with careful patient selection, appropriate protocols, and vigilant monitoring, the routine use of regional anesthesia in trauma patients with long bone fractures can be safe, with a low risk of delaying the diagnosis of ACS. Future prospective studies are needed to further explore the relationship between regional anesthesia and ACS risk, potentially leading to updated guidelines and improved patient outcomes.

• #42

  https://www.banglajol.info/index.php/JAFMC/article/view/50835

  Acute compartment syndrome (ACS) is a serious and well known complication of limb trauma. This condition is an orthopaedic emergency and is associated with significant morbidity if not diagnosed promptly and treated effectively. […] A total of 320 patients met the inclusion criteria among them only 2.81% had ACS and male young adults were mostly affected. […] ACS of limb is not very common. Early clinical diagnosis in the absence of pressure monitoring equipment and emergency fasciotomies are recommended to salvage the limbs.

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