Materiały źródłowe

• #1 Acute Compartment Syndrome – StatPearls – NCBI Bookshelf

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

  Acute compartment syndrome can occur with any condition that restricts the intracompartmental space or increases the fluid volume in the intracompartmental space. Acute compartment syndrome can occur without any precipitating trauma but typically occurs after a long bone fracture, with tibial fractures being the most common cause of the condition, followed by distal radius fractures. Seventy-five percent of cases of acute compartment syndrome are associated with fractures. After fractures, the most common cause of acute compartment syndrome is soft tissue injuries. Other causes of acute compartment syndrome include burns, vascular injuries, crush injuries, drug overdoses, reperfusion injuries, thrombosis, bleeding disorders, infections, improperly placed casts or splints, tight circumferential bandages, penetrating trauma, intense athletic activity, and poor positioning during surgery. […] In children, supracondylar fractures of the humerus and both ulnar and radial forearm fractures are associated with compartment syndrome.

• #1 Our knowledge of orthopaedics. Your best health.

  https://orthoinfo.aaos.org/en/diseases–conditions/compartment-syndrome/

  Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells. […] Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Rarely, it develops after a relatively minor injury. […] Conditions that may bring on acute compartment syndrome include: A fracture. A badly bruised muscle. This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg by another player’s helmet. It can also happen after overly vigorous exercise that causes muscle tissue to break down (rhabdomyolysis). Reestablished blood flow after blocked circulation. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. A blood vessel can also be blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. The development of compartment syndrome in this manner usually occurs in people whose brain function is impaired. This can happen after severe intoxication with alcohol or other drugs. Crush injuries. Anabolic steroid use. Taking steroids is a possible factor in compartment syndrome. Constricting bandages. Casts and tight bandages may lead to compartment syndrome. If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. If you have a cast, contact your doctor immediately. […] Chronic compartment syndrome causes pain or cramping during exercise. This pain goes away when activity stops. It most often occurs in the leg.

• #1 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. […] Long bone fracture — Fractures account for approximately 75 percent of cases of ACS. Risk increases with comminuted fractures. The tibia is involved most often, with ACS developing in approximately 1 to 10 percent of such fractures. […] Risk associated with fracture treatment — Both closed and open fracture treatment can increase compartment pressure and the risk for ACS.

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

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

  Compartment syndrome happens when an injury or repeated stress causes swelling and bleeding inside a muscle compartment. If the pressure builds too much, your muscles press against the fascia that holds them in place. […] Severe injuries are the most common cause of acute compartment syndrome, including: car accidents, falling from a high place (like off a roof or ladder), bone fractures (broken bones), crushing injuries (when something heavy falls on you), severe muscle contusions, sports injuries, complications after surgery, complications from wearing a cast or splint that’s too tight, and prolonged pressure on an arm or leg after not moving for several hours at a time. […] Chronic (exertional) compartment syndrome usually builds up over time. Frequent, intense exercise is the most common cause. Doing the same kind of workout or training can put repeated stress on the same muscles and cause a pressure build-up. Some common causes include: running, biking, swimming, and weightlifting.

• #1

  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. […] Etiology includes trauma such as fractures (69% of cases), crush injuries, contusions, and gunshot wounds. […] Other causes include tight casts, dressings, or external wrappings, extravasation of IV infusion, burns, postischemic swelling, bleeding disorders, and arterial injury. […] The cascade of events includes local trauma and soft tissue destruction, bleeding and edema, increased interstitial pressure, vascular occlusion (decreased venous outflow relative to arterial inflow), and myoneural ischemia. […] Risk factors include diaphyseal fractures and young age (highest prevalence in 12-19 year olds).

• #1 Acute compartment syndrome of the extremities – UpToDate

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

  Trauma without fracture — Other forms of trauma not involving a fracture can predispose a patient to ACS. Possible causes include: forceful direct trauma to a tissue compartment (eg, crush injury), severe thermal burns, constrictive bandages, splints, or casts (usually circumferential), penetrating trauma, high-pressure injection, injury to vascular structures, animal bites and stings. […] Nontraumatic causes — Nontraumatic causes of ACS occur less frequently but may stem from a wide range of conditions or events: hematologic: ischemia-reperfusion injury, thrombosis, bleeding disorders, vascular disease, spontaneous hemorrhage; anticoagulation; nephrotic syndrome (or other conditions that decrease serum osmolarity); toxic: animal envenomations and bites; injection of recreational drugs; intravenous fluids: extravasation of fluid; massive fluid resuscitation (eg, severe thermal burns, sepsis); prolonged limb compression (eg, following severe drug or alcohol intoxication; poor positioning during surgery); revascularization procedures or treatments (eg, extremity bypass surgery, embolectomy, thrombolysis); group A streptococcus infections of muscle; systemic inflammatory response.

• #1 Compartment syndrome: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/318581

  Compartment syndrome happens when pressure in the muscles builds to dangerous levels and decreases blood flow to the affected area. […] There are two kinds of compartment syndrome. Acute compartment syndrome tends to be caused by a severe injury. […] The other type is chronic compartment syndrome, which is not a medical emergency. […] Acute compartment syndrome is usually caused by a severe injury, such as a car accident or a broken bone. […] One possible cause is when blood flow is restored after blocked circulation. […] Other possible causes include: fracture, badly bruised muscle, crush injuries, anabolic steroid use, casts or bandages that are too tight, burns. […] Chronic compartment syndrome is characterized by pain and swelling and is usually caused by exercise. […] Repetitive motion activities are more likely to cause chronic compartment syndrome, they include: running, cycling, swimming, elliptical training.

• #1 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.

• #1 Chronic exertional compartment syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-exertional-compartment-syndrome/symptoms-causes/syc-20350830

  Chronic exertional compartment syndrome is an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes disability in the affected muscles of the legs or arms. […] The cause of chronic exertional compartment syndrome isn’t completely understood. When you exercise, your muscles expand in volume. If you have chronic exertional compartment syndrome, the tissue that encases the affected muscle (fascia) doesn’t expand with the muscle, causing pressure and pain in a compartment of the affected limb. […] Some experts suggest that how you move while exercising might have a role in causing chronic exertional compartment syndrome. Other causes might include having muscles that enlarge excessively during exercise, having an especially inflexible fascia surrounding the affected muscle compartment or having high pressure within your veins.

• #1 Chronic Compartment Syndrome | Kingsley Physio | More than your local Physio

  https://kingsleyphysio.com/common-conditions/chronic-compartment-syndrome/

  There are 2 broad mechanisms by which chronic compartment syndrome is thought to be caused: The relative increase in tightness and reduction in elasticity of the surrounding fascial tissue. […] Reduced or poor autonomic control of venous blood return. […] A third, less substantiated theory, suggests that low-grade lumbar dysfunction (often with negligible or absent lumbar symptoms) may impair reflexive inhibition of antagonistic muscle action during the loading response and terminal stance phases of the gait/running cycle. […] The mechanical aggravators of CCS may include: Abnormal foot biomechanics (such as flat or pronated feet). […] Tightness in the posterior calf muscles (gastrocnemius and/or soleus). […] Sub-optimal or imbalanced exercise schedules. […] Weak hip stabilizers. […] Poor footwear.

• #1 Compartment Syndrome: Causes, Diagnosis, Symptoms, and Treatments

  https://www.webmd.com/pain-management/compartment-syndrome-causes-treatments

  Taking anabolic steroids can also contribute to developing compartment syndrome. […] Abdominal compartment syndrome almost always develops after a severe injury or surgery, or during critical illness. […] Some conditions associated with abdominal compartment syndrome include trauma, especially when it results in shock, abdominal surgery, particularly liver transplant, burns, sepsis, severe ascites, or abdominal bleeding, and pelvic fracture. […] Exertional compartment syndrome can happen after extremely vigorous exercise, especially eccentric movements.

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

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

  Compartment syndrome is a self-perpetuating cascade of events. […] Common causes of compartment syndrome include fractures, severe contusions or crush injuries, reperfusion injury after vascular injury and repair. […] Rare causes include snakebites, burns, severe exertion, illicit drug overdose (of heroin or cocaine), casts, tight bandages, and other rigid circumferential devices that limit swelling and thus increase compartment pressure. […] Prolonged pressure on a muscle during coma may cause rhabdomyolysis.

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

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

  Acute compartment syndrome occurs when the tissue pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischemia. It typically occurs subsequent to a traumatic event, most commonly a fracture. […] The cycle of events leading to acute compartment syndrome begins when the tissue pressure exceeds the venous pressure and impairs blood outflow. Lack of oxygenated blood and accumulation of waste products result in pain and decreased peripheral sensation secondary to nerve irritation. […] The literature is somewhat confusing because of the interchangeable use of the terms acute, subacute, chronic, and recurrent compartment syndrome; crush syndrome; and Volkmann ischemic contracture. Crush syndrome is distinct from compartment syndrome; it is defined as a severe systemic manifestation (eg, rhabdomyolysis) of trauma and ischemia involving soft tissues, principally skeletal muscle, as a result of prolonged, severe crushing. Crush syndrome trauma or rhabdomyolysis may also lead to acute compartment syndrome.

• #1

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

  The most common cause is a fracture […] Soft tissue injury […] Circumferential burns […] Crush injuries […] Constrictive dressing (e.g., splints, casts, or poor surgical positioning) […] Penetrating wounds […] blood flow is blocked when the tissue pressure exceeds the perfusion pressure within a fixed-volume compartment […] this results in a lack of oxygen and the accumulation of waste products, causing pain and decreased peripheral sensation […] irreversible tissue damage occurs between 6-8 hours after onset […] after a period of ischemia, tissue reperfusion generates toxic reactive oxygen species and other inflammatory mediators that cause increased capillary permeability and interstitial edema […] increased edema leads to rising compartment pressures, which can cause compartment syndrome […] limb ischemia-reperfusion injury.

• #1 Compartment Syndrome Causes, Symptoms, Diagnosis & Treatment

  https://www.medicinenet.com/compartment_syndrome/article.htm

  Compartment syndrome describes increased pressure within a muscle compartment of the arm or leg. […] Compartment syndrome is a condition that occurs when an injury causes generalized painful swelling and increased pressure within a compartment to the point that blood cannot supply the muscles and nerves with oxygen and nutrients. […] Muscles are contained in compartments covered by thick fibrous bands of tissue or fascia. Because of injury, pressure can increase within the compartment to swelling (fluid accumulation) or bleeding. […] If the pressure within the compartment increases (usually greater than about 30 -45mmHg; or within 30 mm of the diastolic blood pressure) most individuals develop compartment syndrome. […] When these high compartment pressures are present, blood cannot circulate to the muscles and nerves to supply them with oxygen and nutrients.

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

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

  The incidence of compartment syndrome depends on the patient population studied and the etiology of the syndrome. In a study by Qvarfordt and colleagues, 14% of patients with leg pain were noted to have anterior compartment syndrome; compartment syndrome was seen in 1-9% of leg fractures. […] Compartment syndrome may affect any compartment, including the hand, forearm, upper arm, abdomen, buttock, and entire lower extremity. Almost any injury can cause this syndrome, including injury resulting from vigorous exercise. […] Any internal or external event that increases pressure within a compartment can cause compartment syndrome. Thus, increased fluid content or decreased compartment size can lead to the condition. […] Increased fluid content can be caused by the following: Intensive muscle use (eg, tetany, vigorous exercise, seizures); Everyday exercise activities (eg, stationary bicycle use, horseback riding); Burns; Envenomation; Decreased serum osmolarity (eg, nephrotic syndrome); Hemorrhage (particularly from a large vessel injury); Postischemic swelling; Drug/alcohol abuse and coma; Rhabdomyolysis; Gastrocnemius or peroneus muscle tear (lower extremity); Ruptured Baker cyst; Influenza myositis; Autoimmune vasculitis; Androgen abuse/muscle hypertrophy; Deep venous thrombosis.

• #1 Acute Compartment Syndrome of the Limbs: Current Concepts and Management

  https://openorthopaedicsjournal.com/VOLUME/6/PAGE/535/FULLTEXT/

  The causes of ACS either increase the volume of the contents of a compartment or reduce the capacity/volume of the compartment sheath (Box 1) […] Causes of a decrease in compartment size include tight dressings, bandages or casts. In some cases, lying on a limb for prolonged periods has been implicated. It is therefore important for clinicians to be particularly alert in patients who have had periods of prolonged unconsciousness, such as drug users. Several papers have also reported the occurrence of ACS after operations, which require unnatural positioning of the patient such as some gynaecological conditions requiring the lithotomy position. Patients with circumferential burns to the limbs are also at risk of ACS if they develop an inelastic eschar which prevents tissue expansion during swelling. In such patients, an escharotomy may be initially indicated.

• #1 Compartment Syndrome Causes, Symptoms, Diagnosis & Treatment

  https://www.medicinenet.com/compartment_syndrome/article.htm

  As the muscle cells lose their blood and oxygen supply, they begin to die. […] If the condition is not recognized and treated, the whole muscle can die, scar down, and contract. […] Similarly, nerve cells that are damaged may fail to cause numbness and weakness in the structures beyond the injury site. […] Acute compartment syndrome occurs as a complication of an injury. […] Often it is due to a fracture of the radius or ulna in the forearm or the tibia and fibula in the lower leg that causes significant bleeding in one or more of the compartments. […] Compartment syndrome may be a complication of bandages or casts that are applied too tightly or due to swelling that occurs after casting. […] Other abrupt causes of compartment syndrome include burns, snake bites and other envenomation, and anabolic steroid use. […] Chronic compartment syndrome occurs because of excessive exercise, where repetitive motion and muscle use cause localized swelling and irritation. […] Symptoms resolve with rest and very rarely progress to an acute limb-threatening situation.

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

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

  Fractures or gunshot wounds may be the source of hemorrhage underlying compartment syndrome. Upper extremity fractures most frequently associated with compartment syndrome are supracondylar fractures of the humerus, but cases have also been reported in conjunction with fractures of the radial or ulnar diaphysis, fractures of the surgical neck of the humerus, and Colles fractures. […] Although trauma is the most common etiology, compartment syndrome has been shown to occur in neonates from intrauterine malposition or strangulation of the extremity by the umbilical cord. […] A study by Shadgan et al indicated that in adult patients with tibial diaphyseal fractures, younger age is a risk factor for acute compartment syndrome. […] In contrast, in a retrospective study by Robertson et al of pediatric patients with supracondylar humerus fractures, regression analysis indicated that compartment syndrome is more likely to occur in patients who are older or male, as well as in those who exhibit a floating elbow fracture pattern or have neurovascular injury.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4110398/

  Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. […] The commonest cause of all ACSs are tibial shaft fractures with a range from 2-9%. […] Any internal or external event that increases intra-compartmental pressure can cause a compartment syndrome. […] The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] Poor patient positioning in unconscious patients for long periods of time can also contribute to the aetiology of ACS.

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

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

  Another pediatric study, a literature review by Mortensen et al, indicated that in children, risk factors for the development of acute compartment syndrome include open radius/ulna fractures, high-energy trauma, humerus fractures sustained concurrently with forearm fractures, open tibia fractures, and male gender. […] A literature review by Mortensen et al involving adult patients indicated that risk factors for acute compartment syndrome include age 18-64 years, male gender, gunshot wound with fracture and vascular injury, combined forefoot and midfoot injury, an Injury Severity Score (ISS) of 0-9 compared with an ISS of greater than 9, Orthopaedic Trauma Association (OTA)/AO Foundation (AO) type C fracture, vascular injury, and high-energy trauma. […] A study by Bouklouch et al of over 200,000 patients with tibial fractures indicated that, regarding fracture location, proximal and midshaft tibial fractures increase the risk of acute compartment syndrome by the greatest amount. […] A study by Allmon et al of radiographic predictors of compartment syndrome in patients with tibial fractures found that each 10% increase in the ratio of fracture length to tibial length increased the odds of compartment syndrome by 1.67.

• #1 Compartment Syndrome: Causes, Types, and Symptoms

  https://www.healthline.com/health/compartment-syndrome

  Compartment syndrome can develop when theres bleeding or swelling within a compartment. This can cause pressure to build up inside the compartment, which can prevent blood flow. […] Acute compartment syndrome typically occurs after you experience a major injury. In rare cases, it can also develop after a minor injury. […] Chronic (exertional) compartment syndrome occurs most frequently in people under 40, but you can develop it at any age. […] The link between exercise and chronic compartment syndrome isnt fully understood. […] Acute compartment syndrome requires immediate medical attention to relieve pressure. Permanent damage to your muscles and nerves can develop within hours. […] Surgery is the only treatment option for this type of compartment syndrome. […] If these methods dont work, you may need surgery. Surgery is generally more effective than nonsurgical methods for treating chronic compartment syndrome.

• #1 Diagnosing Compartment Syndrome | NYU Langone Health

  https://nyulangone.org/conditions/compartment-syndrome/diagnosis

  Chronic compartment syndrome is not immediately dangerous, but it can become a more serious problem if not eventually addressed. Athletes who use anabolic steroids are at increased risk, because muscles may grow quickly and push against the surrounding fascia, increasing the pressure inside the muscle compartment.

• #1 Compartment Syndrome: Symptoms and Treatment | Doctor

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

  Compartment syndrome is caused by an increased pressure within a closed anatomical space, which compromises the circulation and function of the tissues within that space. This may result in temporary or permanent damage to muscles and nerves. […] Acute compartment syndrome is most often caused by trauma, which may be relatively minor. Intense exercise can also cause acute compartment syndrome. […] Chronic compartment syndrome is usually caused by exercise and presents with recurrent pain and disability, which subside when the cause (usually running) is stopped but return when the activity is resumed. […] Causes include fractures – especially fractures of the forearm and lower leg that have been internally fixed or infected, crush injury, burns, infection, prolonged limb compression, vascular ischaemia-reperfusion injury, haemorrhage, phlegmasia caerulea dolens, iatrogenic factors such as intramuscular injections, and muscle hypertrophy in athletes. […] The most common cause is tibial shaft fracture. […] Chronic exertional compartment syndrome has an incidence of 33% in active patients with exercise-induced leg pain. […] Excessive training increases the risk.

• #1 Compartment Syndrome – Clinical Features – Emergency Management – TeachMeSurgery

  https://teachmesurgery.com/orthopaedic/principles/compartment-syndrome/

  Compartment syndrome is defined as a critical pressure increase within a confined compartmental space. Any fascial compartment can be affected, however the most common sites affected are in the leg, thigh, forearm, foot, hand and buttock. […] Compartment syndrome typically occurs following high-energy trauma, crush injuries, or fractures that cause vascular injury. Other causes include iatrogenic vascular injury, tight casts or splints, deep vein thrombosis, and post-reperfusion swelling. […] As the intra-compartmental pressure reaches the diastolic blood pressure, the arterial inflow will be compromised, and the leg will become ischaemic. […] Compartment syndrome is most common in the lower limbs, typically following traumatic injury or fractures.

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

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

  Lower extremity compartment syndrome is a devastating complication if not rapidly diagnosed and properly managed. […] Causes of compartment syndrome are varied. Trauma is the most likely precipitating factor, with fracture of the extremity leading the greatest number of cases of compartment syndrome. […] Among trauma patients, the incidence of compartment syndrome varies with mechanism. In the largest single center review, Branco et al evaluated trauma patients who developed compartment syndrome for both mechanism and type of injury. Gunshot wound, followed by stab wound, motorcycle crash, and pedestrian struck by automobile are the most likely mechanisms to lead to compartment syndrome. […] Exertion and drug overdose leading to prolonged pressure on an extremity are also well-documented causes of compartment syndrome. […] Additionally, compartment syndrome can develop in the non-injured extremity from a large systemic inflammatory response and capillary leak. […] Although rare, group A streptococcal infections that are associated with exotoxin release, and tissue swelling can also trigger compartment syndrome.

• #1 Compartment syndrome: challenges and solutions | ORR

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

  The risk of 0.25% with distal radius fracture, increases to 15% with ipsilateral distal radius and elbow injury, as reported by Hwang et al. […] Compartment syndrome is caused by the increase in pressure within the fibro-osseous space, which causes decreased tissue perfusion. […] The rise in intracompartmental pressure causes collapse of the venules, as they lack musculature. […] This could possibly result in closure of arterioles, which also contributes to decreased local perfusion. […] Harvey et al in their review article, described damaged tissue itself rather than bleeding or collection of fluid, as a factor contributing to the increase in an intracompartmental volume. […] They also found inflammation to play a major role based on the newer studies. […] Compartment syndrome is a surgical emergency. […] ACS is a serious clinical condition and every care must be taken to treat this condition as soon as possible.

• #1 Acute compartment syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/acute-compartment-syndrome/

  Most commonly caused by fractures of the wrist, forearm, or distal arm. […] Hand compartment syndrome: Etiologies include trauma, high-pressure injection, and IV infiltration. […] Foot compartment syndrome: Etiologies include crush injuries, falls from height, and high-velocity accidents. […] Gluteal compartment syndrome: Etiologies include pelvic trauma and prolonged immobilization during surgery.

• #1 Idiopathic spontaneous compartment syndrome of the right lower limb: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-02683-y

  Acutely painful lower limb is a common presentation to the emergency department, and acute compartment syndrome is an important differential diagnosis to consider given the correct predisposing history and clinical presentation. However, idiopathic spontaneous compartment syndrome is an uncommon occurrence. […] Acute compartment syndrome occurs secondary to crush injuries or fractures resulting in increased interstitial pressure within a closed osteofascial compartment. This leads to impaired venous circulation, resulting in fluid extravasation and edema. The raised pressure causes impaired lymphatic drainage and subsequently affects arterial supply, causing tissue ischemia. […] However, in the absence of any obvious risk factors, idiopathic spontaneous acute compartment syndrome is a rarely reported phenomenon and may pose a diagnostic challenge.

• #1 Idiopathic spontaneous compartment syndrome of the right lower limb: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-02683-y

  Spontaneous acute compartment syndrome is an uncommon phenomenon and is rarely documented in the literature. […] Our patient had no obvious risk factors, intrinsic or acquired, that predisposed him to developing acute compartment syndrome, making his situation an idiopathic spontaneous compartment syndrome. This is a very uncommon phenomenon, rarely reported in the medical literature, with only a few case reports to date. […] Acute compartment syndrome is an important surgical emergency which should not be missed.

• #1

  https://journals.lww.com/md-journal/fulltext/2018/07270/acute_compartment_syndrome_of_the_leg_due_to.51.aspx

  Acute compartment syndrome is a highly aggressive condition, which needs rapid diagnosis and surgical emergency. Most cases are caused by trauma, fractures, surgeries, or vascular injury, while other causes are easily misdiagnosed. […] Infection secondary to insect bites with infectious cellulitis and myositis is a rarely known cause of compartment syndrome. […] Compartment syndrome occurs when intracompartmental pressure is increased, leading to tissue ischemia and function disorder of the involved muscle, nerve, and vascular. Commonly, compartment syndrome occurs after high-energy trauma, especially crush injury. Other causes include burns, animal bites, bleeding disorders, and tight circumferential dressings. […] Given the severe consequences of compartment syndrome, fasciotomy as well as early diagnosis is critical to improve the clinical outcome of patients.

• #1

  https://journals.lww.com/md-journal/fulltext/2018/07270/acute_compartment_syndrome_of_the_leg_due_to.51.aspx

  Compartment syndrome is a rare, but serious, complication of infection due to insect bites. The diagnosis should be based on the clinical examinations, medical history, and clinical course. Prompt fasciotomy, repeat and thorough debridement, and appropriate antibiotic therapy are the most effective methods to prevent amputation and morbid consequences.

• #1 Compartment syndrome causes systemic inflammation in a rat | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.98B8.36325

  Compartment syndrome results from increased intra-compartmental pressure (ICP) causing local tissue ischaemia and cell death, but the systemic effects are not well described. […] Compartment syndrome can be accompanied by severe systemic inflammation and end organ damage. This study provides evidence of the relationship between compartment syndrome in a limb and systemic inflammation and dysfunction in a remote organ.

• #1 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. […] Causes: Fracture […] Bleeding into compartment (i.e. vascular injury) […] External compression (i.e. cast, crush injury) […] Iatrogenic (infiltration of IV infusion, surgical complication). […] Three general etiologies: Increased compartment contents (bleeding, infiltrated infusion) […] Decreased compartment volume […] External pressure.

• #1 Compartment syndrome

  https://www.nhs.uk/conditions/compartment-syndrome/

  Compartment syndrome is an increase in pressure inside a muscle, which restricts blood flow and causes pain. If compartment syndrome happens suddenly, you’ll need surgery as soon as possible to relieve the pressure in the muscle. […] If the GP thinks you may have compartment syndrome, you may be referred to a specialist for tests. […] Treatment for compartment syndrome depends on whether it happens suddenly or comes on gradually. […] If compartment syndrome happens suddenly, you’ll need surgery as soon as possible to relieve the pressure in the muscle. […] Sometimes, skin may need to be removed from another part of the body and used to cover the wound. This is known as a skin graft. […] If your symptoms do not improve after trying these things, surgery may be an option. The operation is similar to the one used to treat acute compartment syndrome.

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

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

  Acute compartment syndrome occurs when the tissue pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischemia. It typically occurs subsequent to a traumatic event, most commonly a fracture. […] The cycle of events leading to acute compartment syndrome begins when the tissue pressure exceeds the venous pressure and impairs blood outflow. Lack of oxygenated blood and accumulation of waste products result in pain and decreased peripheral sensation secondary to nerve irritation. […] The literature is somewhat confusing because of the interchangeable use of the terms acute, subacute, chronic, and recurrent compartment syndrome; crush syndrome; and Volkmann ischemic contracture. Crush syndrome is distinct from compartment syndrome; it is defined as a severe systemic manifestation (eg, rhabdomyolysis) of trauma and ischemia involving soft tissues, principally skeletal muscle, as a result of prolonged, severe crushing. Crush syndrome trauma or rhabdomyolysis may also lead to acute compartment syndrome.

• #2 Compartment Syndrome: Causes, Diagnosis, Symptoms, and Treatments

  https://www.webmd.com/pain-management/compartment-syndrome-causes-treatments

  Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body. The condition usually results from bleeding or swelling after an injury. The dangerously high pressure in compartment syndrome slows the flow of blood, oxygen, and nutrients to and from the affected tissues. It can be an emergency, requiring surgery to prevent permanent injury. […] Acute compartment syndrome is the most common type of compartment syndrome. About three-quarters of the time, acute compartment syndrome is caused by a broken leg or arm. […] Acute compartment syndrome can occur after you have some kind of trauma, such as crush injuries, burns, an overly tight bandaging, prolonged compression of a limb during a period of unconsciousness, surgery to blood vessels of an arm or leg, blood clot in the blood vessel of an arm or leg, severe muscle sprain or bruise, or broken bone.

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

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

  The incidence of compartment syndrome depends on the patient population studied and the etiology of the syndrome. In a study by Qvarfordt and colleagues, 14% of patients with leg pain were noted to have anterior compartment syndrome; compartment syndrome was seen in 1-9% of leg fractures. […] Compartment syndrome may affect any compartment, including the hand, forearm, upper arm, abdomen, buttock, and entire lower extremity. Almost any injury can cause this syndrome, including injury resulting from vigorous exercise. […] Any internal or external event that increases pressure within a compartment can cause compartment syndrome. Thus, increased fluid content or decreased compartment size can lead to the condition. […] Increased fluid content can be caused by the following: Intensive muscle use (eg, tetany, vigorous exercise, seizures); Everyday exercise activities (eg, stationary bicycle use, horseback riding); Burns; Envenomation; Decreased serum osmolarity (eg, nephrotic syndrome); Hemorrhage (particularly from a large vessel injury); Postischemic swelling; Drug/alcohol abuse and coma; Rhabdomyolysis; Gastrocnemius or peroneus muscle tear (lower extremity); Ruptured Baker cyst; Influenza myositis; Autoimmune vasculitis; Androgen abuse/muscle hypertrophy; Deep venous thrombosis.

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

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

  Fractures or gunshot wounds may be the source of hemorrhage underlying compartment syndrome. Upper extremity fractures most frequently associated with compartment syndrome are supracondylar fractures of the humerus, but cases have also been reported in conjunction with fractures of the radial or ulnar diaphysis, fractures of the surgical neck of the humerus, and Colles fractures. […] Although trauma is the most common etiology, compartment syndrome has been shown to occur in neonates from intrauterine malposition or strangulation of the extremity by the umbilical cord. […] A study by Shadgan et al indicated that in adult patients with tibial diaphyseal fractures, younger age is a risk factor for acute compartment syndrome. […] In contrast, in a retrospective study by Robertson et al of pediatric patients with supracondylar humerus fractures, regression analysis indicated that compartment syndrome is more likely to occur in patients who are older or male, as well as in those who exhibit a floating elbow fracture pattern or have neurovascular injury.

• #2 Our knowledge of orthopaedics. Your best health.

  https://orthoinfo.aaos.org/en/diseases–conditions/compartment-syndrome

  Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells. […] Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Rarely, it develops after a relatively minor injury. […] Conditions that may bring on acute compartment syndrome include: A fracture. A badly bruised muscle. This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg by another player’s helmet. It can also happen after overly vigorous exercise that causes muscle tissue to break down (rhabdomyolysis). Reestablished blood flow after blocked circulation. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. A blood vessel can also be blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. The development of compartment syndrome in this manner usually occurs in people whose brain function is impaired. This can happen after severe intoxication with alcohol or other drugs. Crush injuries. Anabolic steroid use. Taking steroids is a possible factor in compartment syndrome. Constricting bandages. Casts and tight bandages may lead to compartment syndrome. If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. If you have a cast, contact your doctor immediately.

• #2 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. […] Causes: Fracture […] Bleeding into compartment (i.e. vascular injury) […] External compression (i.e. cast, crush injury) […] Iatrogenic (infiltration of IV infusion, surgical complication). […] Three general etiologies: Increased compartment contents (bleeding, infiltrated infusion) […] Decreased compartment volume […] External pressure.

• #2 Acute Compartment Syndrome of the Limbs: Current Concepts and Management

  https://openorthopaedicsjournal.com/VOLUME/6/PAGE/535/FULLTEXT/

  Injuries to soft tissue are another important cause of ACS responsible for as much as 23% of cases in some series. Crush injuries without fractures occur when continuous external compressive forces are applied to a compartment, resulting in traumatic muscle breakdown (rhabdomyolysis). Once tissue necrosis occurs, inflammation ensues. One of the cardinal features of inflammation, tumour, is soft tissue swelling which results in a rise in ICP. […] The aetiology of ACS can also be iatrogenic. It is known that trans-radial angiography and intervention can result in compartment syndrome if the radial artery perforates and bleeds. However, there has been a reported case where ACS after trans-radial intervention was not due to bleeding or hematoma formation. It was thought to be due to either arterial spasm induced by the radial sheath or catheter resulted in ischemia of the forearm muscles.

• #2 Compartment syndrome – Wikipedia

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

  Acute compartment syndrome (ACS) is a medical emergency. It can develop after traumatic injuries, like car accidents, gunshot wounds, fractures, or intense sports. Examples include a severe crush injury or an open or closed fracture of an extremity. Rarely, ACS can develop after a minor injury or another medical issue. It can also affect the thigh, buttock, hand, abdomen, and foot. The most common cause of acute compartment syndrome is a fractured bone, usually the tibia. Leg compartment syndrome occurs in 1% to 10% of tibial fractures. It is strongly linked to tibial diaphysis fractures and other tibial injuries. Direct injury to blood vessels can reduce blood flow to soft tissues, causing compartment syndrome. Compartment syndrome can also be caused by: […] Patients on anticoagulant therapy, or those with blood disorders such as hemophilia or leukemia are at higher risk of developing compartment syndrome.

• #2 Chronic exertional compartment syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-exertional-compartment-syndrome/symptoms-causes/syc-20350830

  Chronic exertional compartment syndrome is an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes disability in the affected muscles of the legs or arms. […] The cause of chronic exertional compartment syndrome isn’t completely understood. When you exercise, your muscles expand in volume. If you have chronic exertional compartment syndrome, the tissue that encases the affected muscle (fascia) doesn’t expand with the muscle, causing pressure and pain in a compartment of the affected limb. […] Some experts suggest that how you move while exercising might have a role in causing chronic exertional compartment syndrome. Other causes might include having muscles that enlarge excessively during exercise, having an especially inflexible fascia surrounding the affected muscle compartment or having high pressure within your veins.

• #2 Our knowledge of orthopaedics. Your best health.

  https://orthoinfo.aaos.org/en/diseases–conditions/compartment-syndrome

  The pain and swelling of chronic compartment syndrome is caused by exercise. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop chronic compartment syndrome. This is usually relieved by discontinuing the exercise, and is usually not dangerous.

• #2 Compartment syndrome | nidirect

  https://www.nidirect.gov.uk/conditions/compartment-syndrome

  Compartment syndrome can be caused by: […] a broken bone or a crush injury this is the most common cause […] a plaster cast or tight bandage being applied to a limb before it has stopped swelling […] burns, which can cause the skin to become scarred and tight […] surgery to repair a damaged or blocked blood vessel (once blood is able to flow back into a muscle, it can lead to swelling). […] Chronic compartment syndrome usually occurs in young people who do regular repetitive exercise, such as running or cycling. […] The exact cause is unknown. […] One theory is that it’s caused by temporary swelling of the muscles during exercise affecting the blood supply to a whole group of muscles.

• #2 Chronic Compartment Syndrome | Kingsley Physio | More than your local Physio

  https://kingsleyphysio.com/common-conditions/chronic-compartment-syndrome/

  There are 2 broad mechanisms by which chronic compartment syndrome is thought to be caused: The relative increase in tightness and reduction in elasticity of the surrounding fascial tissue. […] Reduced or poor autonomic control of venous blood return. […] A third, less substantiated theory, suggests that low-grade lumbar dysfunction (often with negligible or absent lumbar symptoms) may impair reflexive inhibition of antagonistic muscle action during the loading response and terminal stance phases of the gait/running cycle. […] The mechanical aggravators of CCS may include: Abnormal foot biomechanics (such as flat or pronated feet). […] Tightness in the posterior calf muscles (gastrocnemius and/or soleus). […] Sub-optimal or imbalanced exercise schedules. […] Weak hip stabilizers. […] Poor footwear.

• #2 UNDERSTANDING COMPARTMENT SYNDROME: CAUSES AND TREATMENT | Mya Care

  https://myacare.com/blog/understanding-compartment-syndrome-causes-and-treatment

  Minor injuries, such as shin splints or tendonitis, can lead to the syndrome if not treated promptly. It is critical to seek medical attention for any injury, no matter how minor it may seem. […] Abdominal compartment syndrome is a rare form. Trauma, surgery, or medical conditions like pancreatitis or liver failure can lead to this type.

• #2 Compartment syndrome – Diagnosis & treatment | Hirslanden

  https://www.hirslanden.ch/en/corporate/disease-patterns/compartment-syndrome.html

  Compartment syndrome is a medical emergency caused by increased pressure in a muscle compartment. […] The most common causes of compartment syndrome are soft tissue injuries caused by bone fractures or severe blows to the muscles. […] In rare cases, compartment syndrome can also be caused by extreme overexertion of the muscle in athletes, e.g. during marathons or intensive bodybuilding. […] Abdominal compartment syndrome affects the abdomen and is caused by increased pressure in the abdominal cavity. This can be caused by bleeding, swelling or fluid accumulation after injuries or surgery, and also requires immediate medical treatment.

• #2 Understanding Compartment Syndrome: What is it and How to Recover – Orthopedic & Sports Medicine

  https://orthosportsmed.com/understanding-compartment-syndrome-what-is-it-and-how-to-recover/

  Compartment syndrome describes increased pressure within a muscle compartment of the arm or leg. It is most often due to injury, such as fracture, that causes bleeding in a muscle, which then causes increased pressure in the muscle. This pressure increase causes nerve damage due to decreased blood supply. […] Compartment syndrome may occur acutely due to swelling that arises from injury, or it may be chronic because of exertion such as exercise. […] Because of injury, pressure can increase within the compartment to swelling (fluid accumulation) or bleeding. In non-contracting muscle, the compartment pressure is normally about 0-15 mmHg of pressure. If the pressure within the compartment increases (usually greater than about 30 -45mmHg; or are within 30 mm of the diastolic blood pressure) most individuals develop compartment syndrome.

• #2 Acute compartment syndrome of the extremities – UpToDate

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

  Trauma without fracture — Other forms of trauma not involving a fracture can predispose a patient to ACS. Possible causes include: forceful direct trauma to a tissue compartment (eg, crush injury), severe thermal burns, constrictive bandages, splints, or casts (usually circumferential), penetrating trauma, high-pressure injection, injury to vascular structures, animal bites and stings. […] Nontraumatic causes — Nontraumatic causes of ACS occur less frequently but may stem from a wide range of conditions or events: hematologic: ischemia-reperfusion injury, thrombosis, bleeding disorders, vascular disease, spontaneous hemorrhage; anticoagulation; nephrotic syndrome (or other conditions that decrease serum osmolarity); toxic: animal envenomations and bites; injection of recreational drugs; intravenous fluids: extravasation of fluid; massive fluid resuscitation (eg, severe thermal burns, sepsis); prolonged limb compression (eg, following severe drug or alcohol intoxication; poor positioning during surgery); revascularization procedures or treatments (eg, extremity bypass surgery, embolectomy, thrombolysis); group A streptococcus infections of muscle; systemic inflammatory response.

• #2 Compartment Syndrome | Lower Limb Surgery

  https://www.lowerlimbsurgery.com/compartment-syndrome

  The leg is divided into 4 main compartments separated by a thick, ligament-like tissue called fascia. […] When there is swelling within a compartment, the fascia does not stretch. The swelling within the compartment leads to increased pressure within the compartment. This increased pressure eventually stops blood flow in the veins and arteries and leads to the injury of muscles and nerves by direct pressure and loss of blood supply. This is called compartment syndrome. […] Compartment syndrome occurs most commonly in the legs, forearms, hands, feet, thighs, and buttocks. […] Increased contents within the compartment, such as with swelling or bleeding, or decreased volume capacity of the compartment, such as with a cast around the leg.

• #2

  https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/further-reading/compartment-syndrome

  Compartment syndrome occurs most commonly after high-energy limb injuries. […] Muscle compartment syndrome is a relatively common occurrence in the osteo-fascial compartments of the lower leg. […] Crushing injuries are at high risk of compartment syndrome. […] Certain other insults, such as burns, or prolonged compression (as may occur in a comatose, unprotected patient), may also cause muscle swelling and precipitate the syndrome. […] A further cause can be edema from abnormal capillary permeability caused by reperfusion after prolonged ischemia. […] Tight bandages, splints, or casts can also elevate compartmental pressure and contribute to development of compartment syndrome.

• #2

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

  The most common cause is a fracture […] Soft tissue injury […] Circumferential burns […] Crush injuries […] Constrictive dressing (e.g., splints, casts, or poor surgical positioning) […] Penetrating wounds […] blood flow is blocked when the tissue pressure exceeds the perfusion pressure within a fixed-volume compartment […] this results in a lack of oxygen and the accumulation of waste products, causing pain and decreased peripheral sensation […] irreversible tissue damage occurs between 6-8 hours after onset […] after a period of ischemia, tissue reperfusion generates toxic reactive oxygen species and other inflammatory mediators that cause increased capillary permeability and interstitial edema […] increased edema leads to rising compartment pressures, which can cause compartment syndrome […] limb ischemia-reperfusion injury.

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

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

  Another pediatric study, a literature review by Mortensen et al, indicated that in children, risk factors for the development of acute compartment syndrome include open radius/ulna fractures, high-energy trauma, humerus fractures sustained concurrently with forearm fractures, open tibia fractures, and male gender. […] A literature review by Mortensen et al involving adult patients indicated that risk factors for acute compartment syndrome include age 18-64 years, male gender, gunshot wound with fracture and vascular injury, combined forefoot and midfoot injury, an Injury Severity Score (ISS) of 0-9 compared with an ISS of greater than 9, Orthopaedic Trauma Association (OTA)/AO Foundation (AO) type C fracture, vascular injury, and high-energy trauma. […] A study by Bouklouch et al of over 200,000 patients with tibial fractures indicated that, regarding fracture location, proximal and midshaft tibial fractures increase the risk of acute compartment syndrome by the greatest amount. […] A study by Allmon et al of radiographic predictors of compartment syndrome in patients with tibial fractures found that each 10% increase in the ratio of fracture length to tibial length increased the odds of compartment syndrome by 1.67.

• #2 Compartment syndrome: challenges and solutions | ORR

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

  Compartment syndrome can be caused by a number of factors. These can be broadly classified as factors causing increased volume within a closed space, or those that restrict the compartment from expanding. The former include bleeding (eg, due to fractures, coagulopathy), extravasation of intravenous or interosseous infusion, edema or accumulation of purulent material. Constrictive dressing, casting, inadvertent use of tourniquet, and burns prevent expansion of the fibro-osseous space causing compartment syndrome. […] Compartment syndrome after vascular injury is a result of ischemia and reperfusion injury. […] A list of factors that can cause compartment syndrome is shown in Table 1. […] High energy injuries and polytrauma increase the risk of ACS. […] Amongst fractures, most commonly observed were of the tibial diaphysis (36%) and distal radius in 9.8%.

• #2 Compartment Syndrome: Medical Causes, Symptoms and Surgical Outcomes – Nova Science Publishers

  https://novapublishers.com/shop/compartment-syndrome-medical-causes-symptoms-and-surgical-outcomes/

  There are various underlying causes which initiate the sequence of events resulting in compartment syndrome including fractures, bleeding, tightly applied casts or extrinsic compressions devices, burns or vigorous exercise. […] Anesthesia may influence the development of CS through the use of regional anesthesia, optimum blood pressure control and oxygen delivery, and tailored analgesia in the peri-operative period. […] Chapter 6 focuses on Paraspinal Compartment Syndrome (PSCS), resulting in the “Bourdon tube effect.” […] The last chapter, Chapter 8, reviews orbital compartment syndrome (OCS), a rare but treatable ophthalmic surgical emergency, caused most often by a retrobulbar hematoma, facial trauma being the most frequent etiological factor.

• #2 Compartment Syndrome: Symptoms and Treatment | Doctor

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

  Compartment syndrome is caused by an increased pressure within a closed anatomical space, which compromises the circulation and function of the tissues within that space. This may result in temporary or permanent damage to muscles and nerves. […] Acute compartment syndrome is most often caused by trauma, which may be relatively minor. Intense exercise can also cause acute compartment syndrome. […] Chronic compartment syndrome is usually caused by exercise and presents with recurrent pain and disability, which subside when the cause (usually running) is stopped but return when the activity is resumed. […] Causes include fractures – especially fractures of the forearm and lower leg that have been internally fixed or infected, crush injury, burns, infection, prolonged limb compression, vascular ischaemia-reperfusion injury, haemorrhage, phlegmasia caerulea dolens, iatrogenic factors such as intramuscular injections, and muscle hypertrophy in athletes. […] The most common cause is tibial shaft fracture. […] Chronic exertional compartment syndrome has an incidence of 33% in active patients with exercise-induced leg pain. […] Excessive training increases the risk.

• #2 Compartment Syndrome | Treatment, Prevention & Management

  https://stretchcoach.com/articles/compartment-syndrome/?srsltid=AfmBOoqthbaLJOMdn3Tc8m7grOizPOq5RkQBxmOjYgXpJHOsJXC-eDMq

  Compartment syndrome is a condition that develops when the pressure inside the fascia surrounding the muscles and bones increases without relief. […] The condition may develop acutely, from an injury or other cause of immediate swelling, or chronically, because of overuse or other chronic swelling. […] Acute compartment syndrome is caused by trauma to the structures in the compartment. Any of the following may be a cause: Fracture to the bone. Tearing of the muscle. Crush injury. Blood flow blockage; due to injury or clots. Post-surgical swelling or bleeding. Anabolic steroid use. Extreme increase in activity level; increases mileage or speed workouts too quickly. […] Chronic compartment syndrome results from repetitive trauma and overuse. The following are potential causes: Running; especially on hard surfaces or a change of surface. Use of braces, wrapping or taping that is too tight. Muscle hypertrophy due to exercise without the accompanying fascia expansion. Repetitive stress that results in intra-compartment pressure not returning to normal during rest.

• #2 Acute compartment syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/acute-compartment-syndrome/

  Acute compartment syndrome (ACS) is caused by tissue ischemia due to increased pressure within a fascial compartment. […] Diagnosis of ACS is based on clinical findings and confirmed by measurement of intracompartmental pressures. […] Causes of external compression include trauma-related causes such as burn eschars, constrictive bandage/cast applied before the limb has stopped swelling, hematoma and edema from long bone fractures, and hemorrhage into muscle compartment. […] Non-trauma-related causes include prolonged poor positioning of limbs and increased capillary permeability due to shock. […] Because shock leads to reduced peripheral circulation, patients with polytrauma are at a high risk of compartment syndrome with muscle ischemia. […] Etiology of acute compartment syndrome usually includes trauma to the anterior compartment of the leg, such as tibial fracture.

• #2 Acute compartment syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/acute-compartment-syndrome/

  Most commonly caused by fractures of the wrist, forearm, or distal arm. […] Hand compartment syndrome: Etiologies include trauma, high-pressure injection, and IV infiltration. […] Foot compartment syndrome: Etiologies include crush injuries, falls from height, and high-velocity accidents. […] Gluteal compartment syndrome: Etiologies include pelvic trauma and prolonged immobilization during surgery.

• #2 Compartment Syndrome: Causes, Diagnosis, Symptoms, and Treatments

  https://www.webmd.com/pain-management/compartment-syndrome-causes-treatments

  Taking anabolic steroids can also contribute to developing compartment syndrome. […] Abdominal compartment syndrome almost always develops after a severe injury or surgery, or during critical illness. […] Some conditions associated with abdominal compartment syndrome include trauma, especially when it results in shock, abdominal surgery, particularly liver transplant, burns, sepsis, severe ascites, or abdominal bleeding, and pelvic fracture. […] Exertional compartment syndrome can happen after extremely vigorous exercise, especially eccentric movements.

• #2 Idiopathic spontaneous compartment syndrome of the right lower limb: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-02683-y

  Spontaneous acute compartment syndrome is an uncommon phenomenon and is rarely documented in the literature. […] Our patient had no obvious risk factors, intrinsic or acquired, that predisposed him to developing acute compartment syndrome, making his situation an idiopathic spontaneous compartment syndrome. This is a very uncommon phenomenon, rarely reported in the medical literature, with only a few case reports to date. […] Acute compartment syndrome is an important surgical emergency which should not be missed.

• #2

  https://journals.lww.com/md-journal/fulltext/2018/07270/acute_compartment_syndrome_of_the_leg_due_to.51.aspx

  Compartment syndrome is a rare, but serious, complication of infection due to insect bites. The diagnosis should be based on the clinical examinations, medical history, and clinical course. Prompt fasciotomy, repeat and thorough debridement, and appropriate antibiotic therapy are the most effective methods to prevent amputation and morbid consequences.

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

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

  Lower extremity compartment syndrome is a devastating complication if not rapidly diagnosed and properly managed. […] Causes of compartment syndrome are varied. Trauma is the most likely precipitating factor, with fracture of the extremity leading the greatest number of cases of compartment syndrome. […] Among trauma patients, the incidence of compartment syndrome varies with mechanism. In the largest single center review, Branco et al evaluated trauma patients who developed compartment syndrome for both mechanism and type of injury. Gunshot wound, followed by stab wound, motorcycle crash, and pedestrian struck by automobile are the most likely mechanisms to lead to compartment syndrome. […] Exertion and drug overdose leading to prolonged pressure on an extremity are also well-documented causes of compartment syndrome. […] Additionally, compartment syndrome can develop in the non-injured extremity from a large systemic inflammatory response and capillary leak. […] Although rare, group A streptococcal infections that are associated with exotoxin release, and tissue swelling can also trigger compartment syndrome.

• #2 Acute Compartment Syndrome Clinical Presentation: History, Physical Examination

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

  Anticoagulation therapy and bleeding disorders (eg, hemophilia) significantly increase the likelihood of compartment syndrome. Remember to ask if patients are anticoagulated for any reason. Compartment syndrome requiring fasciotomy has been observed after simple venipuncture in an anticoagulated patient. […] Vigorous exertion may lead to compartment syndrome. Compartment syndrome has been found in soldiers and athletes without any trauma. This can be acute or chronic, with acute compartment pressures as high as those found in severe trauma. If compartment syndrome is suspected, check intracompartmental pressure, even in the absence of any trauma history.

• #3 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. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. […] The commonest cause of all ACSs are tibial shaft fractures with a range from 2-9%. […] Any internal or external event that increases intra-compartmental pressure can cause a compartment syndrome. […] The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] Poor patient positioning in unconscious patients for long periods of time can also contribute to the aetiology of ACS. […] The lack of a clear aetiology or conspicuous traumatic injury both contribute to a potential diagnostic difficulty in haemophiliacs. […] Any internal or external event that increases intra-compartmental pressure can cause a compartment syndrome.

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

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

  Another pediatric study, a literature review by Mortensen et al, indicated that in children, risk factors for the development of acute compartment syndrome include open radius/ulna fractures, high-energy trauma, humerus fractures sustained concurrently with forearm fractures, open tibia fractures, and male gender. […] A literature review by Mortensen et al involving adult patients indicated that risk factors for acute compartment syndrome include age 18-64 years, male gender, gunshot wound with fracture and vascular injury, combined forefoot and midfoot injury, an Injury Severity Score (ISS) of 0-9 compared with an ISS of greater than 9, Orthopaedic Trauma Association (OTA)/AO Foundation (AO) type C fracture, vascular injury, and high-energy trauma. […] A study by Bouklouch et al of over 200,000 patients with tibial fractures indicated that, regarding fracture location, proximal and midshaft tibial fractures increase the risk of acute compartment syndrome by the greatest amount. […] A study by Allmon et al of radiographic predictors of compartment syndrome in patients with tibial fractures found that each 10% increase in the ratio of fracture length to tibial length increased the odds of compartment syndrome by 1.67.

• #3 Compartment Syndrome: Causes, Diagnosis, Symptoms, and Treatments

  https://www.webmd.com/pain-management/compartment-syndrome-causes-treatments

  Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body. The condition usually results from bleeding or swelling after an injury. The dangerously high pressure in compartment syndrome slows the flow of blood, oxygen, and nutrients to and from the affected tissues. It can be an emergency, requiring surgery to prevent permanent injury. […] Acute compartment syndrome is the most common type of compartment syndrome. About three-quarters of the time, acute compartment syndrome is caused by a broken leg or arm. […] Acute compartment syndrome can occur after you have some kind of trauma, such as crush injuries, burns, an overly tight bandaging, prolonged compression of a limb during a period of unconsciousness, surgery to blood vessels of an arm or leg, blood clot in the blood vessel of an arm or leg, severe muscle sprain or bruise, or broken bone.

• #3 Acute Compartment Syndrome – OrthoPaedia

  https://www.orthopaedia.com/acute-compartment-syndrome/

  Acute compartment syndrome may be iatrogenic. For example, anticoagulants (leading to bleeding in the compartment) and constrictive dressings are possible physician-induced causes. […] Again, the conditions associated with compartment syndromes include fracture, gunshot wound, circumferential casts or dressing, extravasation of intravenous lines, burns, coagulopathy and arterial injury, or surgery.

• #3 Compartment Syndrome – Dr. Henry Backe

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

  Compartment syndrome develops when swelling or bleeding occurs within a compartment. Because the fascia does not stretch, this can cause increased pressure on the capillaries, nerves, and muscles in the compartment. Blood flow to muscle and nerve cells is disrupted. Without a steady supply of oxygen and nutrients, nerve and muscle cells can be damaged. […] Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Rarely, it develops after a relatively minor injury. […] Conditions that may bring on acute compartment syndrome include: A fracture. A badly bruised muscle. This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg with another players helmet. […] Reestablished blood flow after blocked circulation. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. A blood vessel can also be blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. The development of compartment syndrome in this manner usually occurs in people who are neurologically compromised. This can happen after severe intoxication with alcohol or other drugs.

• #3 Understanding Compartment Syndrome: What is it and How to Recover – Orthopedic & Sports Medicine

  https://orthosportsmed.com/understanding-compartment-syndrome-what-is-it-and-how-to-recover/

  Acute compartment syndrome occurs as a complication of an injury. Often it is due to a fracture of the radius or ulna in the forearm or the tibia and fibula in the lower leg that causes significant bleeding in one or more of the compartments. […] Other abrupt causes of compartment syndrome include burns, snake bites and other envenomation, and anabolic steroid use. Individuals taking anticoagulants have a higher risk for compartment syndrome after trauma due to bleeding that cannot clot normally. […] Chronic compartment syndrome occurs because of excessive exercise, where repetitive motion and muscle use cause localized swelling and irritation.

• #3 Compartment Syndrome Causes, Symptoms, Diagnosis & Treatment

  https://www.medicinenet.com/compartment_syndrome/article.htm

  Compartment syndrome describes increased pressure within a muscle compartment of the arm or leg. […] Compartment syndrome is a condition that occurs when an injury causes generalized painful swelling and increased pressure within a compartment to the point that blood cannot supply the muscles and nerves with oxygen and nutrients. […] Muscles are contained in compartments covered by thick fibrous bands of tissue or fascia. Because of injury, pressure can increase within the compartment to swelling (fluid accumulation) or bleeding. […] If the pressure within the compartment increases (usually greater than about 30 -45mmHg; or within 30 mm of the diastolic blood pressure) most individuals develop compartment syndrome. […] When these high compartment pressures are present, blood cannot circulate to the muscles and nerves to supply them with oxygen and nutrients.

• #3

  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. […] Etiology includes trauma such as fractures (69% of cases), crush injuries, contusions, and gunshot wounds. […] Other causes include tight casts, dressings, or external wrappings, extravasation of IV infusion, burns, postischemic swelling, bleeding disorders, and arterial injury. […] The cascade of events includes local trauma and soft tissue destruction, bleeding and edema, increased interstitial pressure, vascular occlusion (decreased venous outflow relative to arterial inflow), and myoneural ischemia. […] Risk factors include diaphyseal fractures and young age (highest prevalence in 12-19 year olds).

• #4 Acute compartment syndrome of the extremities – UpToDate

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

  Trauma without fracture — Other forms of trauma not involving a fracture can predispose a patient to ACS. Possible causes include: forceful direct trauma to a tissue compartment (eg, crush injury), severe thermal burns, constrictive bandages, splints, or casts (usually circumferential), penetrating trauma, high-pressure injection, injury to vascular structures, animal bites and stings. […] Nontraumatic causes — Nontraumatic causes of ACS occur less frequently but may stem from a wide range of conditions or events: hematologic: ischemia-reperfusion injury, thrombosis, bleeding disorders, vascular disease, spontaneous hemorrhage; anticoagulation; nephrotic syndrome (or other conditions that decrease serum osmolarity); toxic: animal envenomations and bites; injection of recreational drugs; intravenous fluids: extravasation of fluid; massive fluid resuscitation (eg, severe thermal burns, sepsis); prolonged limb compression (eg, following severe drug or alcohol intoxication; poor positioning during surgery); revascularization procedures or treatments (eg, extremity bypass surgery, embolectomy, thrombolysis); group A streptococcus infections of muscle; systemic inflammatory response.

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