Materiały źródłowe

• #1 Pathophysiology of Compartment Syndrome – Compartment Syndrome – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553903/

  The pathophysiology behind acute compartment syndrome is generally ignored by treating physicians. Pressure and subjective signs like pain have been used as surrogate measures of pathology progression in the affected compartment. Due to incomplete understanding of local and systemic physiological changes that occur with increasing pressure in the compartment, both surgical and nonoperative procedures have not been optimized. A recognized progression of the pathological changes has been elicited. Local necrosis, fluctuating pressure gradients and reperfusion injury all play a part in the condition. Ongoing physiological cascades then progress to overall muscle death, nerve injury, and systemic manifestations that are reversible or treatable in some cases. […] Pathophysiology stems from pressure-related changes in the affected muscle.

• #2 Acute Compartment Syndrome – StatPearls – NCBI Bookshelf

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

  Acute compartment syndrome occurs due to decreased intracompartmental space or increased intracompartmental fluid volume because the surrounding fascia is inherently non-compliant. As the compartment pressure increases, hemodynamics are impaired. There is normally an equilibrium between venous outflow and arterial inflow. When there is an increase in compartmental pressure, there is a reduction in venous outflow. This causes venous pressure and, thus, venous capillary pressure to increase. If the intracompartmental pressure becomes higher than arterial pressure, a decrease in arterial inflow will also occur. The reduction of venous outflow and arterial inflow result in decreased oxygenation of tissues causing ischemia. If the deficit of oxygenation becomes high enough, irreversible necrosis may occur. […] The normal pressure within a compartment is less than 10 mmHg. If the intracompartmental pressure reaches 30 mmHg or greater, acute compartment syndrome is present. However, a single normal ICP reading does not exclude acute compartment syndrome. ICP should be monitored serially or continuously.

• #3 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. […] 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. […] In acute compartment syndrome, unless the pressure is relieved quickly, permanent disability and tissue death may result. This does not usually happen in chronic (exertional) compartment syndrome.

• #4 Acute Compartment Syndrome – StatPearls – NCBI Bookshelf

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

  Acute compartment syndrome occurs due to decreased intracompartmental space or increased intracompartmental fluid volume because the surrounding fascia is inherently non-compliant. As the compartment pressure increases, hemodynamics are impaired. There is normally an equilibrium between venous outflow and arterial inflow. When there is an increase in compartmental pressure, there is a reduction in venous outflow. This causes venous pressure and, thus, venous capillary pressure to increase. If the intracompartmental pressure becomes higher than arterial pressure, a decrease in arterial inflow will also occur. The reduction of venous outflow and arterial inflow result in decreased oxygenation of tissues causing ischemia. If the deficit of oxygenation becomes high enough, irreversible necrosis may occur. […] The normal pressure within a compartment is less than 10 mmHg. If the intracompartmental pressure reaches 30 mmHg or greater, acute compartment syndrome is present. However, a single normal ICP reading does not exclude acute compartment syndrome. ICP should be monitored serially or continuously.

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

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

  Acute compartment syndrome occurs when there is increased pressure within a closed osteofascial compartment, resulting in impaired local circulation. […] Acute compartment syndrome occurs due to decreased intracompartmental space or increased intracompartmental fluid volume because the surrounding fascia is inherently non-compliant. As the compartment pressure increases, hemodynamics are impaired. There is normally an equilibrium between venous outflow and arterial inflow. When there is an increase in compartmental pressure, there is a reduction in venous outflow. This causes venous pressure and, thus, venous capillary pressure to increase. If the intracompartmental pressure becomes higher than arterial pressure, a decrease in arterial inflow will also occur. The reduction of venous outflow and arterial inflow result in decreased oxygenation of tissues causing ischemia. If the deficit of oxygenation becomes high enough, irreversible necrosis may occur. […] The normal pressure within a compartment is less than 10 mmHg. If the intracompartmental pressure reaches 30 mmHg or greater, acute compartment syndrome is present. However, a single normal ICP reading does not exclude acute compartment syndrome. ICP should be monitored serially or continuously.

• #6 Acute Compartment Syndrome – StatPearls – NCBI Bookshelf

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

  Acute compartment syndrome occurs due to decreased intracompartmental space or increased intracompartmental fluid volume because the surrounding fascia is inherently non-compliant. As the compartment pressure increases, hemodynamics are impaired. There is normally an equilibrium between venous outflow and arterial inflow. When there is an increase in compartmental pressure, there is a reduction in venous outflow. This causes venous pressure and, thus, venous capillary pressure to increase. If the intracompartmental pressure becomes higher than arterial pressure, a decrease in arterial inflow will also occur. The reduction of venous outflow and arterial inflow result in decreased oxygenation of tissues causing ischemia. If the deficit of oxygenation becomes high enough, irreversible necrosis may occur. […] The normal pressure within a compartment is less than 10 mmHg. If the intracompartmental pressure reaches 30 mmHg or greater, acute compartment syndrome is present. However, a single normal ICP reading does not exclude acute compartment syndrome. ICP should be monitored serially or continuously.

• #7 Acute Compartment Syndrome – StatPearls – NCBI Bookshelf

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

  Acute compartment syndrome occurs due to decreased intracompartmental space or increased intracompartmental fluid volume because the surrounding fascia is inherently non-compliant. As the compartment pressure increases, hemodynamics are impaired. There is normally an equilibrium between venous outflow and arterial inflow. When there is an increase in compartmental pressure, there is a reduction in venous outflow. This causes venous pressure and, thus, venous capillary pressure to increase. If the intracompartmental pressure becomes higher than arterial pressure, a decrease in arterial inflow will also occur. The reduction of venous outflow and arterial inflow result in decreased oxygenation of tissues causing ischemia. If the deficit of oxygenation becomes high enough, irreversible necrosis may occur. […] The normal pressure within a compartment is less than 10 mmHg. If the intracompartmental pressure reaches 30 mmHg or greater, acute compartment syndrome is present. However, a single normal ICP reading does not exclude acute compartment syndrome. ICP should be monitored serially or continuously.

• #8 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  The most widely accepted hypothesis for the pathophysiology of acute extremity compartment syndrome is the arteriovenous pressure gradient theory. The increased compartment pressure restricts local tissue perfusion by reducing the arteriovenous pressure gradient (reduced arterial pressure, increased venous pressure) and, if prolonged, will result in cellular anoxia leading to damage to nerve and muscle tissues. […] A vicious cycle ensues, in which capillary flow deteriorates owing to an increase in compartment pressure, which further reduces tissue perfusion, enhancing blood vessel permeability and further increasing internal pressure. […] Compartment pressures capable of compromising perfusion develop when they rise to within 10 to 30 mmHg of diastolic pressure; muscle oxygenation decreases as tissue pressure approaches mean arterial pressure.

• #9 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  The most widely accepted hypothesis for the pathophysiology of acute extremity compartment syndrome is the arteriovenous pressure gradient theory. The increased compartment pressure restricts local tissue perfusion by reducing the arteriovenous pressure gradient (reduced arterial pressure, increased venous pressure) and, if prolonged, will result in cellular anoxia leading to damage to nerve and muscle tissues. […] A vicious cycle ensues, in which capillary flow deteriorates owing to an increase in compartment pressure, which further reduces tissue perfusion, enhancing blood vessel permeability and further increasing internal pressure. […] Compartment pressures capable of compromising perfusion develop when they rise to within 10 to 30 mmHg of diastolic pressure; muscle oxygenation decreases as tissue pressure approaches mean arterial pressure.

• #10 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  The most widely accepted hypothesis for the pathophysiology of acute extremity compartment syndrome is the arteriovenous pressure gradient theory. The increased compartment pressure restricts local tissue perfusion by reducing the arteriovenous pressure gradient (reduced arterial pressure, increased venous pressure) and, if prolonged, will result in cellular anoxia leading to damage to nerve and muscle tissues. […] A vicious cycle ensues, in which capillary flow deteriorates owing to an increase in compartment pressure, which further reduces tissue perfusion, enhancing blood vessel permeability and further increasing internal pressure. […] Compartment pressures capable of compromising perfusion develop when they rise to within 10 to 30 mmHg of diastolic pressure; muscle oxygenation decreases as tissue pressure approaches mean arterial pressure.

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

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

  Compartment syndrome is increased tissue pressure within a closed fascial space, resulting in tissue ischemia. The earliest symptom is pain out of proportion to the severity of injury. Diagnosis is clinical and usually confirmed by measuring compartment pressure. Treatment is fasciotomy. […] Compartment syndrome is a self-perpetuating cascade of events. It begins with the tissue edema that normally occurs after injury (eg, because of soft-tissue swelling or a hematoma). If edema develops within a closed fascial compartment, typically in the anterior or posterior compartments of the leg, there is little room for tissue expansion, so interstitial (compartment) pressure increases. As compartment pressure exceeds the normal capillary pressure of approximately 8 mm Hg, cellular perfusion slows and may ultimately stop.

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

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

  Compartment syndrome is increased tissue pressure within a closed fascial space, resulting in tissue ischemia. The earliest symptom is pain out of proportion to the severity of injury. Diagnosis is clinical and usually confirmed by measuring compartment pressure. Treatment is fasciotomy. […] Compartment syndrome is a self-perpetuating cascade of events. It begins with the tissue edema that normally occurs after injury (eg, because of soft-tissue swelling or a hematoma). If edema develops within a closed fascial compartment, typically in the anterior or posterior compartments of the leg, there is little room for tissue expansion, so interstitial (compartment) pressure increases. As compartment pressure exceeds the normal capillary pressure of approximately 8 mm Hg, cellular perfusion slows and may ultimately stop.

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

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

  Compartment syndrome results primarily from increased intracompartmental pressure. The mechanism involved in the development of increased pressure depends on the precipitating event. […] Two distinct types of compartment syndrome have been recognized. The first type is associated with trauma to the affected compartment, as seen in fractures or muscle injuries. The second form, called exertional compartment syndrome, is associated with repetitive loading or microtrauma related to physical activity. […] Tissue perfusion is proportional to the difference between the capillary perfusion pressure (CPP) and the interstitial fluid pressure, which is stated by the following formula: LBF = (PA – PV)/R. […] When fluid is introduced into a fixed-volume compartment, tissue pressure increases and venous pressure rises. When the interstitial pressure exceeds the CPP (a narrowed arteriovenous [AV] perfusion gradient), capillary collapse and muscle and tissue ischemia occur.

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

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

  Skeletal muscle responds to ischemia by releasing histaminelike substances that increase vascular permeability. Plasma leaks out of the capillaries, and relative blood sludging in the small capillaries occurs, worsening the ischemia. […] One milliosmole (mOsm) is estimated to exert a pressure of 19.5 mm Hg; therefore, a relatively small increase in osmotically active particles in a closed compartment attracts sufficient fluid to cause a further rise in intramuscular pressure. […] When tissue blood flow is diminished further, muscle ischemia and subsequent cell edema worsen. This vicious cycle of worsening tissue perfusion continues to propagate. […] However, compartment tamponade occurs as arterial blood flow is occluded. […] The transmural pressure at which blood flow ceases depends on adrenergic tone as well as the interstitial pressure; the pressure at which this occurs is still under debate.

• #15 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

• #16 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

• #17 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  The increase in tissue swelling worsens the hypoxic state and creates an ongoing positive feedback. […] As the cascade of elevated pressure then compromises the microcirculation with decreased oxygen and nutrient delivery, tissue anoxia with eventual myonecrosis then proceeds. […] In fact, systemic changes have been reported as remote changes in liver and kidney function. […] The ongoing changes at the cellular level represent early pressure-induced reversible ACS. […] The vacillating flow-no-flow scenario at the muscle level either causes limited local cellular death and changes or progresses through to complete ACS and more apparent clinical changes. […] Continued physiological changes later in the disease can be tracked by other markers in combination with pressure.

• #18 Pathophysiology of Compartment Syndrome – Compartment Syndrome – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553903/

  As the cascade of elevated pressure then compromises the microcirculation with decreased oxygen and nutrient delivery, tissue anoxia with eventual myonecrosis then proceeds. […] Reperfusion injury is tissue damage caused when blood supply returns to the compartment contents after a period of ischemia. […] Elevated compartment pressure results in a shift of perfusion toward intermittently perfused and non-perfused capillaries, leading to low flow ischemic muscle areas. […] The metabolic demands of the tissue cannot be met, resulting in the production of reactive oxygen species and other inflammatory intermediaries. […] The reperfusion injury would not only persist throughout the duration of the ACS, but would be further intensified by surgical treatment that allows restoration of normal blood flow into the capillary bed. […] Continued physiological changes later in the disease can be tracked by other markers in combination with pressure.

• #19 Pathophysiology of Compartment Syndrome – Compartment Syndrome – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553903/

  As the cascade of elevated pressure then compromises the microcirculation with decreased oxygen and nutrient delivery, tissue anoxia with eventual myonecrosis then proceeds. […] Reperfusion injury is tissue damage caused when blood supply returns to the compartment contents after a period of ischemia. […] Elevated compartment pressure results in a shift of perfusion toward intermittently perfused and non-perfused capillaries, leading to low flow ischemic muscle areas. […] The metabolic demands of the tissue cannot be met, resulting in the production of reactive oxygen species and other inflammatory intermediaries. […] The reperfusion injury would not only persist throughout the duration of the ACS, but would be further intensified by surgical treatment that allows restoration of normal blood flow into the capillary bed. […] Continued physiological changes later in the disease can be tracked by other markers in combination with pressure.

• #20 Pathophysiology of Compartment Syndrome – Compartment Syndrome – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553903/

  As the cascade of elevated pressure then compromises the microcirculation with decreased oxygen and nutrient delivery, tissue anoxia with eventual myonecrosis then proceeds. […] Reperfusion injury is tissue damage caused when blood supply returns to the compartment contents after a period of ischemia. […] Elevated compartment pressure results in a shift of perfusion toward intermittently perfused and non-perfused capillaries, leading to low flow ischemic muscle areas. […] The metabolic demands of the tissue cannot be met, resulting in the production of reactive oxygen species and other inflammatory intermediaries. […] The reperfusion injury would not only persist throughout the duration of the ACS, but would be further intensified by surgical treatment that allows restoration of normal blood flow into the capillary bed. […] Continued physiological changes later in the disease can be tracked by other markers in combination with pressure.

• #21 Pathophysiology of Compartment Syndrome – Compartment Syndrome – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553903/

  As the cascade of elevated pressure then compromises the microcirculation with decreased oxygen and nutrient delivery, tissue anoxia with eventual myonecrosis then proceeds. […] Reperfusion injury is tissue damage caused when blood supply returns to the compartment contents after a period of ischemia. […] Elevated compartment pressure results in a shift of perfusion toward intermittently perfused and non-perfused capillaries, leading to low flow ischemic muscle areas. […] The metabolic demands of the tissue cannot be met, resulting in the production of reactive oxygen species and other inflammatory intermediaries. […] The reperfusion injury would not only persist throughout the duration of the ACS, but would be further intensified by surgical treatment that allows restoration of normal blood flow into the capillary bed. […] Continued physiological changes later in the disease can be tracked by other markers in combination with pressure.

• #22 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  Nerve conduction disturbances emerge when the difference between the compartment and diastolic pressure becomes less than 30 mmHg or compartment pressure becomes greater than 30 mmHg. […] If this occurs, patients may perceive altered sensation at the affected site and exhibit decreased performance in the two-point discrimination test. […] If the compartment pressure continues to rise beyond this point, nerve conduction eventually ceases and motor paralysis will occur. […] Further progression of ischemia results in cell death and myocytolysis. The degree of muscle damage depends on the duration of extremity ischemia and the metabolic rate of the tissue, though damage typically becomes irreversible after four to eight hours. […] Ultimately, long-term ischemia may lead to liquefactive necrosis of the muscles within the compartment.

• #23 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  Nerve conduction disturbances emerge when the difference between the compartment and diastolic pressure becomes less than 30 mmHg or compartment pressure becomes greater than 30 mmHg. […] If this occurs, patients may perceive altered sensation at the affected site and exhibit decreased performance in the two-point discrimination test. […] If the compartment pressure continues to rise beyond this point, nerve conduction eventually ceases and motor paralysis will occur. […] Further progression of ischemia results in cell death and myocytolysis. The degree of muscle damage depends on the duration of extremity ischemia and the metabolic rate of the tissue, though damage typically becomes irreversible after four to eight hours. […] Ultimately, long-term ischemia may lead to liquefactive necrosis of the muscles within the compartment.

• #24 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  Nerve conduction disturbances emerge when the difference between the compartment and diastolic pressure becomes less than 30 mmHg or compartment pressure becomes greater than 30 mmHg. […] If this occurs, patients may perceive altered sensation at the affected site and exhibit decreased performance in the two-point discrimination test. […] If the compartment pressure continues to rise beyond this point, nerve conduction eventually ceases and motor paralysis will occur. […] Further progression of ischemia results in cell death and myocytolysis. The degree of muscle damage depends on the duration of extremity ischemia and the metabolic rate of the tissue, though damage typically becomes irreversible after four to eight hours. […] Ultimately, long-term ischemia may lead to liquefactive necrosis of the muscles within the compartment.

• #25 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  Nerve conduction disturbances emerge when the difference between the compartment and diastolic pressure becomes less than 30 mmHg or compartment pressure becomes greater than 30 mmHg. […] If this occurs, patients may perceive altered sensation at the affected site and exhibit decreased performance in the two-point discrimination test. […] If the compartment pressure continues to rise beyond this point, nerve conduction eventually ceases and motor paralysis will occur. […] Further progression of ischemia results in cell death and myocytolysis. The degree of muscle damage depends on the duration of extremity ischemia and the metabolic rate of the tissue, though damage typically becomes irreversible after four to eight hours. […] Ultimately, long-term ischemia may lead to liquefactive necrosis of the muscles within the compartment.

• #26 Compartment Syndrome | Concise Medical Knowledge

  https://www.lecturio.com/concepts/compartment-syndrome/

  Compartment syndrome is a condition that occurs when increased pressure in a closed muscle compartment exceeds the pressure to perfuse the compartment, resulting in muscle and nerve ischemia. […] Muscle groups are divided into compartments, which are reinforced by fascial membranes. […] Compartment pressure venous outflow obstruction (venous pressure) arteriolar collapse (arterial pressure) decreased tissue perfusion cellular anoxia damage to nerve and muscle tissues. […] Factors affecting injury: Pressure: Normal pressure within a compartment: generally 08 mm Hg. […] Pressures tolerated without damage: up to 20 mm Hg. […] Duration: Prolonged exposure at elevated pressures results in cell death. […] Reversible muscle injury: 4 hours. […] Irreversible muscle injury: 8 hours. […] Nerve conduction loss: 2 hours. […] Neuropraxia: 4 hours. […] Irreversible nerve injury: 8 hours. […] Can affect any compartment of the body.

• #27 Compartment Syndrome | Concise Medical Knowledge

  https://www.lecturio.com/concepts/compartment-syndrome/

  Compartment syndrome is a condition that occurs when increased pressure in a closed muscle compartment exceeds the pressure to perfuse the compartment, resulting in muscle and nerve ischemia. […] Muscle groups are divided into compartments, which are reinforced by fascial membranes. […] Compartment pressure venous outflow obstruction (venous pressure) arteriolar collapse (arterial pressure) decreased tissue perfusion cellular anoxia damage to nerve and muscle tissues. […] Factors affecting injury: Pressure: Normal pressure within a compartment: generally 08 mm Hg. […] Pressures tolerated without damage: up to 20 mm Hg. […] Duration: Prolonged exposure at elevated pressures results in cell death. […] Reversible muscle injury: 4 hours. […] Irreversible muscle injury: 8 hours. […] Nerve conduction loss: 2 hours. […] Neuropraxia: 4 hours. […] Irreversible nerve injury: 8 hours. […] Can affect any compartment of the body.

• #28

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

  Compartment syndrome occurs when the pressure within a closed osteo-fascial muscle compartment rises above a critical level. This critical level is the tissue pressure which collapses the capillary bed and prevents low-pressure blood flow through the capillaries and into the venous drainage. Normal tissue pressure is 0-10 mm Hg. The capillary filling pressure is essentially diastolic arterial pressure. When tissue pressure approaches the diastolic pressure, capillary blood flow ceases. A number of studies have shown that if diastolic arterial pressure is not more than 30 mm Hg above tissue pressure, compartmental capillary blood flow is significantly obstructed and severe hypoxia occurs in muscle and nerve tissue. […] The critical measurement is muscle perfusion pressure (MPP), the difference between diastolic blood pressure (dBP) and measured intramuscular tissue pressure. (MPP has also been called „Delta P”, to indicate the difference between diastolic blood pressure and intramuscular pressure.) This difference in pressure reflects tissue perfusion far more reliably than the absolute intramuscular pressure. […] Muscle tolerates short periods of hypoxia, but after a few hours, progressive necrosis begins. […] An arterial injury may cause compartmental tissue ischemia. After blood flow is restored, capillaries leak and ischemic muscle swells. Reperfusion injury is another cause of compartment syndrome.

• #29

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

  Compartment syndrome occurs when the pressure within a closed osteo-fascial muscle compartment rises above a critical level. This critical level is the tissue pressure which collapses the capillary bed and prevents low-pressure blood flow through the capillaries and into the venous drainage. Normal tissue pressure is 0-10 mm Hg. The capillary filling pressure is essentially diastolic arterial pressure. When tissue pressure approaches the diastolic pressure, capillary blood flow ceases. A number of studies have shown that if diastolic arterial pressure is not more than 30 mm Hg above tissue pressure, compartmental capillary blood flow is significantly obstructed and severe hypoxia occurs in muscle and nerve tissue. […] The critical measurement is muscle perfusion pressure (MPP), the difference between diastolic blood pressure (dBP) and measured intramuscular tissue pressure. (MPP has also been called „Delta P”, to indicate the difference between diastolic blood pressure and intramuscular pressure.) This difference in pressure reflects tissue perfusion far more reliably than the absolute intramuscular pressure. […] Muscle tolerates short periods of hypoxia, but after a few hours, progressive necrosis begins. […] An arterial injury may cause compartmental tissue ischemia. After blood flow is restored, capillaries leak and ischemic muscle swells. Reperfusion injury is another cause of compartment syndrome.

• #30

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

  Compartment syndrome occurs when the pressure within a closed osteo-fascial muscle compartment rises above a critical level. This critical level is the tissue pressure which collapses the capillary bed and prevents low-pressure blood flow through the capillaries and into the venous drainage. Normal tissue pressure is 0-10 mm Hg. The capillary filling pressure is essentially diastolic arterial pressure. When tissue pressure approaches the diastolic pressure, capillary blood flow ceases. A number of studies have shown that if diastolic arterial pressure is not more than 30 mm Hg above tissue pressure, compartmental capillary blood flow is significantly obstructed and severe hypoxia occurs in muscle and nerve tissue. […] The critical measurement is muscle perfusion pressure (MPP), the difference between diastolic blood pressure (dBP) and measured intramuscular tissue pressure. (MPP has also been called „Delta P”, to indicate the difference between diastolic blood pressure and intramuscular pressure.) This difference in pressure reflects tissue perfusion far more reliably than the absolute intramuscular pressure. […] Muscle tolerates short periods of hypoxia, but after a few hours, progressive necrosis begins. […] An arterial injury may cause compartmental tissue ischemia. After blood flow is restored, capillaries leak and ischemic muscle swells. Reperfusion injury is another cause of compartment syndrome.

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

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

  The pressure difference or delta pressure is the diastolic blood pressure minus intra-compartmental pressure. […] McQueen and Court-Brown prospectively studied 116 patients with diaphyseal tibial fractures and concluded a threshold delta pressure for decompression of 30 mmHg led to no missed cases, unnecessary fasciotomies or significant complications of ACS. […] Delayed fasciotomy after 8-10 hours is associated with significantly increased risks which may outweigh any potential benefit.

• #32 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

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

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

  Skeletal muscle responds to ischemia by releasing histaminelike substances that increase vascular permeability. Plasma leaks out of the capillaries, and relative blood sludging in the small capillaries occurs, worsening the ischemia. […] One milliosmole (mOsm) is estimated to exert a pressure of 19.5 mm Hg; therefore, a relatively small increase in osmotically active particles in a closed compartment attracts sufficient fluid to cause a further rise in intramuscular pressure. […] When tissue blood flow is diminished further, muscle ischemia and subsequent cell edema worsen. This vicious cycle of worsening tissue perfusion continues to propagate. […] However, compartment tamponade occurs as arterial blood flow is occluded. […] The transmural pressure at which blood flow ceases depends on adrenergic tone as well as the interstitial pressure; the pressure at which this occurs is still under debate.

• #34 Pathophysiology compartment syndrome – wikidoc

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

  Whenever in a fixed-volume compartment the fluid occurs then tissue pressure increases and venous pressure rises. When the interstitial pressure exceeds the CPP (a narrowed arteriovenous [AV] perfusion gradient), capillary collapse and muscle and tissue ischemia occur. […] Skeletal muscle responds to ischemia by releasing histaminelike substances that increase vascular permeability. Plasma leaks out of the capillaries, and relative blood sludging in the small capillaries occurs, worsening the ischemia. The myocytes begin to lyse, and the myofibrillar proteins decompose into osmotically active particles that attract water from arterial blood.

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

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

  Skeletal muscle responds to ischemia by releasing histaminelike substances that increase vascular permeability. Plasma leaks out of the capillaries, and relative blood sludging in the small capillaries occurs, worsening the ischemia. […] One milliosmole (mOsm) is estimated to exert a pressure of 19.5 mm Hg; therefore, a relatively small increase in osmotically active particles in a closed compartment attracts sufficient fluid to cause a further rise in intramuscular pressure. […] When tissue blood flow is diminished further, muscle ischemia and subsequent cell edema worsen. This vicious cycle of worsening tissue perfusion continues to propagate. […] However, compartment tamponade occurs as arterial blood flow is occluded. […] The transmural pressure at which blood flow ceases depends on adrenergic tone as well as the interstitial pressure; the pressure at which this occurs is still under debate.

• #36 Pathophysiology of Compartment Syndrome

  https://ir.lib.uwo.ca/etd/2053/

  Acute limb compartment syndrome (CS), a potentially devastating complication of musculoskeletal trauma, is characterized by increased pressure within a closed osseofascial compartment, resulting in muscle-threatening and ultimately limb-threatening ischemia. […] Despite a large body of literature dedicated to understanding the pathophysiology of CS, the mechanisms of CS-induced tissue damage are rather poorly understood. The established view is that increasing compartmental pressure compromises microcirculatory perfusion, restricting oxygen and nutrient delivery to vital tissues, resulting in cellular anoxia and severe tissue necrosis. However, unlike complete ischemia, CS causes myonecrosis in the face of patent vessels. […] A severe acute inflammatory component was detected in CS; the role of inflammation in muscle damage in compartment syndrome is unknown. This study provides evidence of the relationship between limb compartment syndrome, systemic inflammation and remote organ dysfunction, presumably through the release of pro-inflammatory cytokines (primarily TNF-).

• #37 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  The increase in tissue swelling worsens the hypoxic state and creates an ongoing positive feedback. […] As the cascade of elevated pressure then compromises the microcirculation with decreased oxygen and nutrient delivery, tissue anoxia with eventual myonecrosis then proceeds. […] In fact, systemic changes have been reported as remote changes in liver and kidney function. […] The ongoing changes at the cellular level represent early pressure-induced reversible ACS. […] The vacillating flow-no-flow scenario at the muscle level either causes limited local cellular death and changes or progresses through to complete ACS and more apparent clinical changes. […] Continued physiological changes later in the disease can be tracked by other markers in combination with pressure.

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

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

  Continuous compartment pressure monitoring has been suggested as an alternative to spot compartment pressure checks. […] The traditional treatment for lower extremity compartment syndrome is a two-incision, four-compartment fasciotomy and has been well described in the literature. […] A missed compartment is a critical technical error as irreversible muscle and nerve may damage occur. […] Rhabdomyolysis may result from the muscle necrosis secondary to compartment syndrome, with ischemic cellular contents spilling into the circulation. […] Loss of limb is, arguably, the most devastating complication of compartment syndrome. The reported amputation rate after compartment syndrome is 5.7% to 12.9%. […] Vigilance is key when evaluating and treating patients with lower extremity compartment syndrome. The classic signs of compartment syndrome, the 6 Ps can be deceiving. If there is any concern for compartment syndrome, especially when a patient has pain out of proportion to an injured extremity, compartment pressures should be checked immediately.

• #39 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome/print

  Any pathologic process that results in increased pressure within a muscular compartment exceeding the perfusion pressure of the tissue has the potential to cause extremity compartment syndrome. Most cases of acute extremity compartment syndrome are associated with trauma and/or vascular disorders, but a variety of other conditions can lead to increased compartment pressure and extremity compartment syndrome. […] The pathophysiology, classification, and etiologies of acute extremity compartment syndrome are reviewed here. […] Multiple explanations for the complex pathophysiology of acute extremity compartment syndrome exist. In all cases, the final common pathway is cellular anoxia. Any etiology that increases the fluid volume within a muscle compartment, or restrains the external expansion of the compartment, will increase the internal pressure of the compartment because of the relatively nondistensible fascia that encloses the muscles.

• #40 CEUFast – Compartment Syndrome

  https://ceufast.com/course/compartment-syndrome

  Subsequent necrosis of muscle and loss of capillary wall integrity will lead to transudation, exudation, and the development of massive edema within the compartment. Rhabdomyolysis then occurs. […] Significant fluid loss into damaged tissues leads to hypovolemia and metabolic acidosis. […] The syndrome may develop as quickly as within the first 30 minutes to 1-2 hours post trauma. […] If it is allowed to last for more than 6 hours, neuromuscular damage becomes irreversible. […] There are three categories of etiology: 1. Decreased compartment size can be caused by restrictive dressings, splints or casts, excessive traction, or premature closure of fascia. 2. Increased compartment content can be caused by a fracture that causes bleeding or from a vascular injury, burns, infiltrated IV infusion, swollen or inflamed bowel, or snakebites. 3. Externally applied C can be caused from restrictive dressings, prolonged compression from lying on a limb or crushing injuries of soft tissue.

• #41 CEUFast – Compartment Syndrome

  https://ceufast.com/course/compartment-syndrome

  Subsequent necrosis of muscle and loss of capillary wall integrity will lead to transudation, exudation, and the development of massive edema within the compartment. Rhabdomyolysis then occurs. […] Significant fluid loss into damaged tissues leads to hypovolemia and metabolic acidosis. […] The syndrome may develop as quickly as within the first 30 minutes to 1-2 hours post trauma. […] If it is allowed to last for more than 6 hours, neuromuscular damage becomes irreversible. […] There are three categories of etiology: 1. Decreased compartment size can be caused by restrictive dressings, splints or casts, excessive traction, or premature closure of fascia. 2. Increased compartment content can be caused by a fracture that causes bleeding or from a vascular injury, burns, infiltrated IV infusion, swollen or inflamed bowel, or snakebites. 3. Externally applied C can be caused from restrictive dressings, prolonged compression from lying on a limb or crushing injuries of soft tissue.

• #42

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

  Furthermore, the most important thing to treat ACS was comprehension to the true injury mechanism, but a systemic classification about traumatic mechanism in most literature was not clear. […] In patients with fracture, the structure in compartment was actually not disturbed which is different from crushing injury. In patients with crushing, cellular death or cell membrane lysis releases osmotically active cellular contents into the interstitial space, causing further accumulation of fluid and further increase in intracompartment pressure. […] The obvious differences of pressure increase among fracture, and crushing injury was that the former can be released though some mechanism surrounding intact fascia.

• #43

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

  Furthermore, the most important thing to treat ACS was comprehension to the true injury mechanism, but a systemic classification about traumatic mechanism in most literature was not clear. […] In patients with fracture, the structure in compartment was actually not disturbed which is different from crushing injury. In patients with crushing, cellular death or cell membrane lysis releases osmotically active cellular contents into the interstitial space, causing further accumulation of fluid and further increase in intracompartment pressure. […] The obvious differences of pressure increase among fracture, and crushing injury was that the former can be released though some mechanism surrounding intact fascia.

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

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

  However, in general, compartmental pressures higher than 30 mm Hg require surgical intervention. If such high compartmental pressures are left untreated, within 6-10 hours, muscle infarction, tissue necrosis, and nerve injury occur. […] The mechanism of compartment syndrome following vascular trauma may differ slightly from the above scenario because most cases occur with reperfusion. […] Muscle has considerable ability to regenerate by forming new muscle cells. Therefore, it is extremely important to decompress ischemic muscle as early as possible. Compartment pressures return to normal after a fasciotomy.

• #45

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

  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

• #46

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

  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

• #47

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

  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

• #48 Pathophysiology and Management of Limb Compartment Syndromes | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-43683-4_20

  The pathophysiology of acute extremity compartment syndrome involves external compression or internal expansion within the compartment leading to increased tissue pressure, reduced capillary blood flow, tissue hypoxia and necrosis. […] Acute limb compartment syndrome in vascular surgery is mostly related to ischemia-reperfusion injury associated with acute ischemia or vascular trauma. […] When fasciotomy is performed within 6 h of onset, the majority of extremities return to normal function but later fasciotomy is associated with significant complications including neuromuscular dysfunction and amputation.

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

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

  Compartment syndrome results primarily from increased intracompartmental pressure. The mechanism involved in the development of increased pressure depends on the precipitating event. […] Two distinct types of compartment syndrome have been recognized. The first type is associated with trauma to the affected compartment, as seen in fractures or muscle injuries. The second form, called exertional compartment syndrome, is associated with repetitive loading or microtrauma related to physical activity. […] Tissue perfusion is proportional to the difference between the capillary perfusion pressure (CPP) and the interstitial fluid pressure, which is stated by the following formula: LBF = (PA – PV)/R. […] When fluid is introduced into a fixed-volume compartment, tissue pressure increases and venous pressure rises. When the interstitial pressure exceeds the CPP (a narrowed arteriovenous [AV] perfusion gradient), capillary collapse and muscle and tissue ischemia occur.

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

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

  Compartment syndrome results primarily from increased intracompartmental pressure. The mechanism involved in the development of increased pressure depends on the precipitating event. […] Two distinct types of compartment syndrome have been recognized. The first type is associated with trauma to the affected compartment, as seen in fractures or muscle injuries. The second form, called exertional compartment syndrome, is associated with repetitive loading or microtrauma related to physical activity. […] Tissue perfusion is proportional to the difference between the capillary perfusion pressure (CPP) and the interstitial fluid pressure, which is stated by the following formula: LBF = (PA – PV)/R. […] When fluid is introduced into a fixed-volume compartment, tissue pressure increases and venous pressure rises. When the interstitial pressure exceeds the CPP (a narrowed arteriovenous [AV] perfusion gradient), capillary collapse and muscle and tissue ischemia occur.

• #51 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. […] Compartment syndrome may be a complication of bandages or casts that are applied too tightly or due to swelling that occurs after casting. […] Chronic compartment syndrome occurs because of excessive exercise, where repetitive motion and muscle use cause localized swelling and irritation. […] The treatment for acute compartment syndrome is surgery (fasciotomy). The surgeon (either an orthopedic or general surgeon) will perform a fasciotomy, an operation where the thick, fibrous bands that line the muscles are filleted open, allowing the muscles to swell and relieve the pressure within the compartment.

• #52 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.

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

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

  The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] The principles of fasciotomy include: Adequate and extensile incision, Complete release of all involved compartment, Preservation of vital structure, Thorough debridement, Skin coverage at a later date (7-10 days). […] The normal intra-compartmental pressure of healthy muscle is roughly 10 mmHg. […] Initial studies showed absolute intra-compartmental pressure values of 30 mmHg, 45 mmHg and 50 mmHg as the critical threshold above which circulation is compromised. […] Whitesides et al. subsequently introduced the concept that the threshold at which irreversible damage was done is variable and dependent on the perfusion pressure. […] This takes into account the variability of the patients blood pressure maintaining (or not) adequate tissue perfusion.

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

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

  The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] The principles of fasciotomy include: Adequate and extensile incision, Complete release of all involved compartment, Preservation of vital structure, Thorough debridement, Skin coverage at a later date (7-10 days). […] The normal intra-compartmental pressure of healthy muscle is roughly 10 mmHg. […] Initial studies showed absolute intra-compartmental pressure values of 30 mmHg, 45 mmHg and 50 mmHg as the critical threshold above which circulation is compromised. […] Whitesides et al. subsequently introduced the concept that the threshold at which irreversible damage was done is variable and dependent on the perfusion pressure. […] This takes into account the variability of the patients blood pressure maintaining (or not) adequate tissue perfusion.

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

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

  Resultant tissue ischemia further worsens edema in a vicious circle. […] 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). […] Once the process triggering compartment syndrome begins, compartment syndrome tends to increase in severity. […] 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.

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

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

  The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] The principles of fasciotomy include: Adequate and extensile incision, Complete release of all involved compartment, Preservation of vital structure, Thorough debridement, Skin coverage at a later date (7-10 days). […] The normal intra-compartmental pressure of healthy muscle is roughly 10 mmHg. […] Initial studies showed absolute intra-compartmental pressure values of 30 mmHg, 45 mmHg and 50 mmHg as the critical threshold above which circulation is compromised. […] Whitesides et al. subsequently introduced the concept that the threshold at which irreversible damage was done is variable and dependent on the perfusion pressure. […] This takes into account the variability of the patients blood pressure maintaining (or not) adequate tissue perfusion.

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

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

  The incidence is thought to be 3.1 per 100000 population, with males ten times more commonly affected than females. […] The principles of fasciotomy include: Adequate and extensile incision, Complete release of all involved compartment, Preservation of vital structure, Thorough debridement, Skin coverage at a later date (7-10 days). […] The normal intra-compartmental pressure of healthy muscle is roughly 10 mmHg. […] Initial studies showed absolute intra-compartmental pressure values of 30 mmHg, 45 mmHg and 50 mmHg as the critical threshold above which circulation is compromised. […] Whitesides et al. subsequently introduced the concept that the threshold at which irreversible damage was done is variable and dependent on the perfusion pressure. […] This takes into account the variability of the patients blood pressure maintaining (or not) adequate tissue perfusion.

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

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

  The pressure difference or delta pressure is the diastolic blood pressure minus intra-compartmental pressure. […] McQueen and Court-Brown prospectively studied 116 patients with diaphyseal tibial fractures and concluded a threshold delta pressure for decompression of 30 mmHg led to no missed cases, unnecessary fasciotomies or significant complications of ACS. […] Delayed fasciotomy after 8-10 hours is associated with significantly increased risks which may outweigh any potential benefit.

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

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

  The pressure difference or delta pressure is the diastolic blood pressure minus intra-compartmental pressure. […] McQueen and Court-Brown prospectively studied 116 patients with diaphyseal tibial fractures and concluded a threshold delta pressure for decompression of 30 mmHg led to no missed cases, unnecessary fasciotomies or significant complications of ACS. […] Delayed fasciotomy after 8-10 hours is associated with significantly increased risks which may outweigh any potential benefit.

• #60 Compartment Syndrome – Core EM

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

  Increased compartment pressure – increased venous pressure – compromised local circulation and hypoxia […] Three general etiologies: Increased compartment contents (bleeding, infiltrated infusion), Decreased compartment volume, External pressure […] Tissue threshold for ischemia: Muscle 4 hours, Nerve 8 hours, Fat 12 hours, Skin 24 hours, Bone 72-96 hours […] Optimal therapeutic approach is immediate fasciotomy in the operating room. Delay of surgical intervention can result in irreversible muscle damage, nerve death and bone infarction […] Indications: Clinical signs of acute compartment syndrome, Absolute compartment pressure 30 mm Hg, Perfusion pressure 30 mm Hg.

• #61 Compartment Syndrome – Core EM

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

  Increased compartment pressure – increased venous pressure – compromised local circulation and hypoxia […] Three general etiologies: Increased compartment contents (bleeding, infiltrated infusion), Decreased compartment volume, External pressure […] Tissue threshold for ischemia: Muscle 4 hours, Nerve 8 hours, Fat 12 hours, Skin 24 hours, Bone 72-96 hours […] Optimal therapeutic approach is immediate fasciotomy in the operating room. Delay of surgical intervention can result in irreversible muscle damage, nerve death and bone infarction […] Indications: Clinical signs of acute compartment syndrome, Absolute compartment pressure 30 mm Hg, Perfusion pressure 30 mm Hg.

• #62 Compartment syndrome – Wikipedia

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

  Compartment syndrome is a serious medical condition in which increased pressure within a body compartment compromises blood flow and tissue function, potentially leading to permanent damage if not promptly treated. There are two types: acute and chronic. Acute compartment syndrome can lead to a loss of the affected limb due to tissue death. […] ACS is defined as a critical pressure increase within a confined compartmental space causing a decline in the perfusion pressure to the tissue within that compartment. A normal human body needs a pressure gradient for blood flow. It must go from the higher-pressure arterial system to the lower-pressure venous system. This causes blood to back up. Excess fluid leaks from the capillaries into the spaces between the soft tissue’s cells. This swells the extracellular space and raises the pressure in the compartment. The swelling of the soft tissues around the blood vessels compresses the blood and lymphatic vessels. This causes more fluid to enter the extracellular spaces, leading to further compression. The pressure keeps rising due to the non-compliant fascia in the compartment. This cycle can cause tissue ischemia, a lack of oxygen, and necrosis, or tissue death. Paresthesia, or tingling, can start as early as 30 minutes after tissue ischemia begins. Permanent damage can occur 12 hours after the injury starts.

• #63 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

• #64 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

• #65 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

• #66 Pathophysiology of Compartment Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-22331-1_3

  In general, increased tissue pressure as low as 20 mm Hg affects tissue flow, and tissue circulation is decreased as the applied pressure is raised. […] The high susceptibility of capillaries to elevated external pressure indicated to the authors that there was a need for early fasciotomy to restore impaired circulation. […] Lack of effective circulation is the factor that perpetuates further physiological changes and propagates a full compartment syndrome. […] The combination of hypoxia, increase in oxidant stress, and development of hypoglycemia in the compartmental tissue causes cell edema due to a shutdown of the ATPase channels that maintain cellular osmotic balance. […] Early ACS microvascular dysfunction results in a decrease in capillary perfusion and an increase in cellular injury and was associated with a severe acute inflammatory component.

• #67 Acute Compartment Syndrome – OrthoPaedia

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

  Critical to an understanding of compartment syndrome is that capillaries are occluded by an increasing compartment pressure before arteries are occluded. Arteries may still flow, and distal pulses may still be palpable, even if capillary perfusion is blocked. […] An increase in intra-compartmental pressure leading to acute compartment syndrome may be seen in a variety of conditions. These associated conditions include fractures, internal bleeding, extensive damage of the muscles (rhabdomyolysis), infiltration of IV infusions, increased capillary permeability caused by trauma (including surgical procedures) or burns, and reperfusion after a prolonged period of ischemia. […] Acute compartment syndrome is a surgical emergency. Treatment requires surgical release of the fascia around the compartments to allow the contents to expand. This procedure is known as a fasciotomy. […] Failure to treat compartment syndrome can result in muscle ischemia or necrosis, resulting in muscle contractures, infection and/or loss of limb.

• #68 Acute Compartment Syndrome – OrthoPaedia

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

  Compartment syndrome describes the state of increased pressure in a closed tissue space that impairs blood flow to that space. In turn, the lack of perfusion leads to hypoxia and damage to the muscles and nerves in the space or passing through it. […] When there is bleeding or edema within a compartment, the pressure within the compartment increases, because the surrounding fascia does not stretch. The increased pressure impairs blood flow to the tissues. […] In the setting of decreased perfusion and resulting ischemia, the tissues within a compartment will switch from aerobic to anaerobic metabolism. This causes increased production of lactate (lactic acid). The increased level of lactate creates the burning pain characteristic of compartment syndrome. […] Ultimately, increased pressure and decreased perfusion leads to necrosis of the muscles and nerves within the compartment.

• #69 Acute Compartment Syndrome – OrthoPaedia

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

  Compartment syndrome describes the state of increased pressure in a closed tissue space that impairs blood flow to that space. In turn, the lack of perfusion leads to hypoxia and damage to the muscles and nerves in the space or passing through it. […] When there is bleeding or edema within a compartment, the pressure within the compartment increases, because the surrounding fascia does not stretch. The increased pressure impairs blood flow to the tissues. […] In the setting of decreased perfusion and resulting ischemia, the tissues within a compartment will switch from aerobic to anaerobic metabolism. This causes increased production of lactate (lactic acid). The increased level of lactate creates the burning pain characteristic of compartment syndrome. […] Ultimately, increased pressure and decreased perfusion leads to necrosis of the muscles and nerves within the compartment.

• #70 Acute Compartment Syndrome – OrthoPaedia

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

  Compartment syndrome describes the state of increased pressure in a closed tissue space that impairs blood flow to that space. In turn, the lack of perfusion leads to hypoxia and damage to the muscles and nerves in the space or passing through it. […] When there is bleeding or edema within a compartment, the pressure within the compartment increases, because the surrounding fascia does not stretch. The increased pressure impairs blood flow to the tissues. […] In the setting of decreased perfusion and resulting ischemia, the tissues within a compartment will switch from aerobic to anaerobic metabolism. This causes increased production of lactate (lactic acid). The increased level of lactate creates the burning pain characteristic of compartment syndrome. […] Ultimately, increased pressure and decreased perfusion leads to necrosis of the muscles and nerves within the compartment.

• #71 Review of Compartment Syndrome | IntechOpen

  https://www.intechopen.com/chapters/78511

  Histologically, there is central muscle necrosis with a surrounding zone of partial ischaemia and peripheral tissue oedema, often within areas of incomplete injury. […] Injury (the amount of muscle necrosis) is determined by duration of ischaemia, fibre type, the available residual blood flow and temperature at which ischaemia takes place. Increased collateral blood flow and decreased ischaemic temperature lead to less muscle necrosis. […] Longer time to diagnose and definitive treatment result in progressive skeletal muscle death and the degree of skeletal muscle injury correlate directly with the severity and duration of ischaemia.

• #72 Review of Compartment Syndrome | IntechOpen

  https://www.intechopen.com/chapters/78511

  Histologically, there is central muscle necrosis with a surrounding zone of partial ischaemia and peripheral tissue oedema, often within areas of incomplete injury. […] Injury (the amount of muscle necrosis) is determined by duration of ischaemia, fibre type, the available residual blood flow and temperature at which ischaemia takes place. Increased collateral blood flow and decreased ischaemic temperature lead to less muscle necrosis. […] Longer time to diagnose and definitive treatment result in progressive skeletal muscle death and the degree of skeletal muscle injury correlate directly with the severity and duration of ischaemia.

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

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

  However, in general, compartmental pressures higher than 30 mm Hg require surgical intervention. If such high compartmental pressures are left untreated, within 6-10 hours, muscle infarction, tissue necrosis, and nerve injury occur. […] The mechanism of compartment syndrome following vascular trauma may differ slightly from the above scenario because most cases occur with reperfusion. […] Muscle has considerable ability to regenerate by forming new muscle cells. Therefore, it is extremely important to decompress ischemic muscle as early as possible. Compartment pressures return to normal after a fasciotomy.

• #74 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  Nerve conduction disturbances emerge when the difference between the compartment and diastolic pressure becomes less than 30 mmHg or compartment pressure becomes greater than 30 mmHg. […] If this occurs, patients may perceive altered sensation at the affected site and exhibit decreased performance in the two-point discrimination test. […] If the compartment pressure continues to rise beyond this point, nerve conduction eventually ceases and motor paralysis will occur. […] Further progression of ischemia results in cell death and myocytolysis. The degree of muscle damage depends on the duration of extremity ischemia and the metabolic rate of the tissue, though damage typically becomes irreversible after four to eight hours. […] Ultimately, long-term ischemia may lead to liquefactive necrosis of the muscles within the compartment.

• #75 Pathophysiology of Compartment Syndrome : Wheeless’ Textbook of Orthopaedics

  https://www.wheelessonline.com/muscles-tendons/pathophysiology-of-compartment-syndrome/

  – occurs when pressure in a muscle compartment is pressure in the capillaries, which leads to progressive muscle ischemia and edema and left untreated can result in infarction of the compartment contents; […] – ischemia and necrosis of the muscles occur even though the arterial pressure is still high enough to produce pulses; […] – muscle and nerves can survive for upto 4 hours of ischemia w/o irreversible damage; […] – nerve kept ischemic for under 4 hours will show neuropraxic damage, whereas after 4 hours, nerves will show irreversible damage; […] – the development of a compartment syndrome depends not only on intra-compartment pressure but also depends on systemic blood pressure; […] – DBP – CP should be greater than 30.

• #76 Pathophysiology, classification, and causes of acute extremity compartment syndrome – UpToDate

  https://www.uptodate.com/contents/pathophysiology-classification-and-causes-of-acute-extremity-compartment-syndrome

  Nerve conduction disturbances emerge when the difference between the compartment and diastolic pressure becomes less than 30 mmHg or compartment pressure becomes greater than 30 mmHg. […] If this occurs, patients may perceive altered sensation at the affected site and exhibit decreased performance in the two-point discrimination test. […] If the compartment pressure continues to rise beyond this point, nerve conduction eventually ceases and motor paralysis will occur. […] Further progression of ischemia results in cell death and myocytolysis. The degree of muscle damage depends on the duration of extremity ischemia and the metabolic rate of the tissue, though damage typically becomes irreversible after four to eight hours. […] Ultimately, long-term ischemia may lead to liquefactive necrosis of the muscles within the compartment.

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

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

  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. […] Fascial compartments are closed and cannot be distended; consequently, any fluid that is deposited therein will cause an increase in the intra-compartmental pressure. […] As pressure increase, the veins will be compressed. This increases the hydrostatic pressure within them, causing fluid to move down its gradient and out of the veins in to the compartment. This increases the intra-compartmental pressure further. […] Next, the traversing nerves are compressed. This causes a sensory +/- motor deficit in the distal distribution. Paraesthesia is therefore a common symptom. […] As the intra-compartmental pressure reaches the diastolic blood pressure, the arterial inflow will be compromised, and the leg will become ischaemic.

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

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

  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. […] Fascial compartments are closed and cannot be distended; consequently, any fluid that is deposited therein will cause an increase in the intra-compartmental pressure. […] As pressure increase, the veins will be compressed. This increases the hydrostatic pressure within them, causing fluid to move down its gradient and out of the veins in to the compartment. This increases the intra-compartmental pressure further. […] Next, the traversing nerves are compressed. This causes a sensory +/- motor deficit in the distal distribution. Paraesthesia is therefore a common symptom. […] As the intra-compartmental pressure reaches the diastolic blood pressure, the arterial inflow will be compromised, and the leg will become ischaemic.

• #79 Compartment syndrome – Wikipedia

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

  Compartment syndrome is a serious medical condition in which increased pressure within a body compartment compromises blood flow and tissue function, potentially leading to permanent damage if not promptly treated. There are two types: acute and chronic. Acute compartment syndrome can lead to a loss of the affected limb due to tissue death. […] ACS is defined as a critical pressure increase within a confined compartmental space causing a decline in the perfusion pressure to the tissue within that compartment. A normal human body needs a pressure gradient for blood flow. It must go from the higher-pressure arterial system to the lower-pressure venous system. This causes blood to back up. Excess fluid leaks from the capillaries into the spaces between the soft tissue’s cells. This swells the extracellular space and raises the pressure in the compartment. The swelling of the soft tissues around the blood vessels compresses the blood and lymphatic vessels. This causes more fluid to enter the extracellular spaces, leading to further compression. The pressure keeps rising due to the non-compliant fascia in the compartment. This cycle can cause tissue ischemia, a lack of oxygen, and necrosis, or tissue death. Paresthesia, or tingling, can start as early as 30 minutes after tissue ischemia begins. Permanent damage can occur 12 hours after the injury starts.

• #80 Compartment syndrome – Wikipedia

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

  Compartment syndrome is a serious medical condition in which increased pressure within a body compartment compromises blood flow and tissue function, potentially leading to permanent damage if not promptly treated. There are two types: acute and chronic. Acute compartment syndrome can lead to a loss of the affected limb due to tissue death. […] ACS is defined as a critical pressure increase within a confined compartmental space causing a decline in the perfusion pressure to the tissue within that compartment. A normal human body needs a pressure gradient for blood flow. It must go from the higher-pressure arterial system to the lower-pressure venous system. This causes blood to back up. Excess fluid leaks from the capillaries into the spaces between the soft tissue’s cells. This swells the extracellular space and raises the pressure in the compartment. The swelling of the soft tissues around the blood vessels compresses the blood and lymphatic vessels. This causes more fluid to enter the extracellular spaces, leading to further compression. The pressure keeps rising due to the non-compliant fascia in the compartment. This cycle can cause tissue ischemia, a lack of oxygen, and necrosis, or tissue death. Paresthesia, or tingling, can start as early as 30 minutes after tissue ischemia begins. Permanent damage can occur 12 hours after the injury starts.

• #81 Compartment syndrome – Wikipedia

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

  Compartment syndrome is a serious medical condition in which increased pressure within a body compartment compromises blood flow and tissue function, potentially leading to permanent damage if not promptly treated. There are two types: acute and chronic. Acute compartment syndrome can lead to a loss of the affected limb due to tissue death. […] ACS is defined as a critical pressure increase within a confined compartmental space causing a decline in the perfusion pressure to the tissue within that compartment. A normal human body needs a pressure gradient for blood flow. It must go from the higher-pressure arterial system to the lower-pressure venous system. This causes blood to back up. Excess fluid leaks from the capillaries into the spaces between the soft tissue’s cells. This swells the extracellular space and raises the pressure in the compartment. The swelling of the soft tissues around the blood vessels compresses the blood and lymphatic vessels. This causes more fluid to enter the extracellular spaces, leading to further compression. The pressure keeps rising due to the non-compliant fascia in the compartment. This cycle can cause tissue ischemia, a lack of oxygen, and necrosis, or tissue death. Paresthesia, or tingling, can start as early as 30 minutes after tissue ischemia begins. Permanent damage can occur 12 hours after the injury starts.

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

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

  A delay in the diagnosis of acute compartment syndrome can have devastating consequences for the patient. Early suspicion of the disease should invoke an immediate response. […] The classic signs of acute compartment syndrome include the 6 Ps: pain, paresthesia, poikilothermia, pallor, paralysis, and pulselessness. Pain is usually the initial complaint and should trigger the workup of acute compartment syndrome. […] For both evaluable and non-evaluable patients, pressure measurement is invaluable in the diagnosis of compartment syndrome. […] Traditionally, an intramuscular compartment pressure of 30 mm Hg was used as a diagnostic threshold for diagnosing compartment syndrome, although the absolute pressure value has been debated. […] Tissue perfusion pressure, or delta pressure, which is calculated as diastolic blood pressure minus the compartment pressure, has been studied as an alternative trigger for compartment release.

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

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

  A delay in the diagnosis of acute compartment syndrome can have devastating consequences for the patient. Early suspicion of the disease should invoke an immediate response. […] The classic signs of acute compartment syndrome include the 6 Ps: pain, paresthesia, poikilothermia, pallor, paralysis, and pulselessness. Pain is usually the initial complaint and should trigger the workup of acute compartment syndrome. […] For both evaluable and non-evaluable patients, pressure measurement is invaluable in the diagnosis of compartment syndrome. […] Traditionally, an intramuscular compartment pressure of 30 mm Hg was used as a diagnostic threshold for diagnosing compartment syndrome, although the absolute pressure value has been debated. […] Tissue perfusion pressure, or delta pressure, which is calculated as diastolic blood pressure minus the compartment pressure, has been studied as an alternative trigger for compartment release.

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

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

  A delay in the diagnosis of acute compartment syndrome can have devastating consequences for the patient. Early suspicion of the disease should invoke an immediate response. […] The classic signs of acute compartment syndrome include the 6 Ps: pain, paresthesia, poikilothermia, pallor, paralysis, and pulselessness. Pain is usually the initial complaint and should trigger the workup of acute compartment syndrome. […] For both evaluable and non-evaluable patients, pressure measurement is invaluable in the diagnosis of compartment syndrome. […] Traditionally, an intramuscular compartment pressure of 30 mm Hg was used as a diagnostic threshold for diagnosing compartment syndrome, although the absolute pressure value has been debated. […] Tissue perfusion pressure, or delta pressure, which is calculated as diastolic blood pressure minus the compartment pressure, has been studied as an alternative trigger for compartment release.

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

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

  A delay in the diagnosis of acute compartment syndrome can have devastating consequences for the patient. Early suspicion of the disease should invoke an immediate response. […] The classic signs of acute compartment syndrome include the 6 Ps: pain, paresthesia, poikilothermia, pallor, paralysis, and pulselessness. Pain is usually the initial complaint and should trigger the workup of acute compartment syndrome. […] For both evaluable and non-evaluable patients, pressure measurement is invaluable in the diagnosis of compartment syndrome. […] Traditionally, an intramuscular compartment pressure of 30 mm Hg was used as a diagnostic threshold for diagnosing compartment syndrome, although the absolute pressure value has been debated. […] Tissue perfusion pressure, or delta pressure, which is calculated as diastolic blood pressure minus the compartment pressure, has been studied as an alternative trigger for compartment release.

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

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

  Continuous compartment pressure monitoring has been suggested as an alternative to spot compartment pressure checks. […] The traditional treatment for lower extremity compartment syndrome is a two-incision, four-compartment fasciotomy and has been well described in the literature. […] A missed compartment is a critical technical error as irreversible muscle and nerve may damage occur. […] Rhabdomyolysis may result from the muscle necrosis secondary to compartment syndrome, with ischemic cellular contents spilling into the circulation. […] Loss of limb is, arguably, the most devastating complication of compartment syndrome. The reported amputation rate after compartment syndrome is 5.7% to 12.9%. […] Vigilance is key when evaluating and treating patients with lower extremity compartment syndrome. The classic signs of compartment syndrome, the 6 Ps can be deceiving. If there is any concern for compartment syndrome, especially when a patient has pain out of proportion to an injured extremity, compartment pressures should be checked immediately.

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

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

  Acute compartment syndrome usually develops over a few hours after a serious injury to an arm or leg. […] Abdominal compartment syndrome almost always develops after a severe injury or surgery, or during critical illness. As the pressure in the abdominal compartment rises, blood flow to and from the abdominal organs is reduced. The liver, bowels, kidneys, and other organs may be injured or permanently damaged. […] Treatments for compartment syndrome focus on reducing the dangerous pressure in the body compartment. Most people with acute compartment syndrome require immediate surgery to reduce the compartment pressure. A surgeon makes long incisions through the skin and the fascia layer underneath (fasciotomy), releasing excessive pressure.

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

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

  Acute compartment syndrome usually develops over a few hours after a serious injury to an arm or leg. […] Abdominal compartment syndrome almost always develops after a severe injury or surgery, or during critical illness. As the pressure in the abdominal compartment rises, blood flow to and from the abdominal organs is reduced. The liver, bowels, kidneys, and other organs may be injured or permanently damaged. […] Treatments for compartment syndrome focus on reducing the dangerous pressure in the body compartment. Most people with acute compartment syndrome require immediate surgery to reduce the compartment pressure. A surgeon makes long incisions through the skin and the fascia layer underneath (fasciotomy), releasing excessive pressure.

• #89 Compartment Syndrome – Core EM

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

  Increased compartment pressure – increased venous pressure – compromised local circulation and hypoxia […] Three general etiologies: Increased compartment contents (bleeding, infiltrated infusion), Decreased compartment volume, External pressure […] Tissue threshold for ischemia: Muscle 4 hours, Nerve 8 hours, Fat 12 hours, Skin 24 hours, Bone 72-96 hours […] Optimal therapeutic approach is immediate fasciotomy in the operating room. Delay of surgical intervention can result in irreversible muscle damage, nerve death and bone infarction […] Indications: Clinical signs of acute compartment syndrome, Absolute compartment pressure 30 mm Hg, Perfusion pressure 30 mm Hg.

• #90 Compartment Syndrome – Core EM

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

  Increased compartment pressure – increased venous pressure – compromised local circulation and hypoxia […] Three general etiologies: Increased compartment contents (bleeding, infiltrated infusion), Decreased compartment volume, External pressure […] Tissue threshold for ischemia: Muscle 4 hours, Nerve 8 hours, Fat 12 hours, Skin 24 hours, Bone 72-96 hours […] Optimal therapeutic approach is immediate fasciotomy in the operating room. Delay of surgical intervention can result in irreversible muscle damage, nerve death and bone infarction […] Indications: Clinical signs of acute compartment syndrome, Absolute compartment pressure 30 mm Hg, Perfusion pressure 30 mm Hg.

• #91 Pathophysiology and Management of Limb Compartment Syndromes | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-43683-4_20

  The pathophysiology of acute extremity compartment syndrome involves external compression or internal expansion within the compartment leading to increased tissue pressure, reduced capillary blood flow, tissue hypoxia and necrosis. […] Acute limb compartment syndrome in vascular surgery is mostly related to ischemia-reperfusion injury associated with acute ischemia or vascular trauma. […] When fasciotomy is performed within 6 h of onset, the majority of extremities return to normal function but later fasciotomy is associated with significant complications including neuromuscular dysfunction and amputation.

• #92 Pathophysiology of an adolescent with compartment syndrome: a case report and review of the literature | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-025-05189-z

  The diagnosis of compartment syndrome with this unusual combination of myonecrosis, high CK level, atraumatic, and isolated compartment syndrome is challenging and can often go undiagnosed, given the atypicality of such a presentation. […] Compartment syndrome is primarily a clinical diagnosis and requires a high index of suspicion, based on history and examination. Intracompartmental pressure measurement is the gold standard for diagnosis and can be used to aid in diagnosis when uncertain. […] Immediate surgical fasciotomy is required to reduce ICP and prevent irreparable ischemic damage to muscles and peripheral nerves. Fasciotomy is not recommended 36 hours after injury, and ideally, it should be performed within 6 hours of injury.

• #93 Pathophysiology of an adolescent with compartment syndrome: a case report and review of the literature | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-025-05189-z

  The diagnosis of compartment syndrome with this unusual combination of myonecrosis, high CK level, atraumatic, and isolated compartment syndrome is challenging and can often go undiagnosed, given the atypicality of such a presentation. […] Compartment syndrome is primarily a clinical diagnosis and requires a high index of suspicion, based on history and examination. Intracompartmental pressure measurement is the gold standard for diagnosis and can be used to aid in diagnosis when uncertain. […] Immediate surgical fasciotomy is required to reduce ICP and prevent irreparable ischemic damage to muscles and peripheral nerves. Fasciotomy is not recommended 36 hours after injury, and ideally, it should be performed within 6 hours of injury.

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

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

  In general, longer periods of compartment syndrome and ischemia correlate with worse outcomes. Tissue ischemia of only 1 hour is associated with reversible neuropraxia, whereas ischemia of 4 hours can induce irreversible axonotmesis. Ischemia of up to 6 hours is associated with irreversible necrosis and more likely to produce functional impairment. […] Compartment syndrome can occur in any area of the body with closed compartments. […] 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. […] 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.

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

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

  In general, longer periods of compartment syndrome and ischemia correlate with worse outcomes. Tissue ischemia of only 1 hour is associated with reversible neuropraxia, whereas ischemia of 4 hours can induce irreversible axonotmesis. Ischemia of up to 6 hours is associated with irreversible necrosis and more likely to produce functional impairment. […] Compartment syndrome can occur in any area of the body with closed compartments. […] 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. […] 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.

• #96 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. […] 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. […] In acute compartment syndrome, unless the pressure is relieved quickly, permanent disability and tissue death may result. This does not usually happen in chronic (exertional) compartment syndrome.

• #97 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. […] 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. […] In acute compartment syndrome, unless the pressure is relieved quickly, permanent disability and tissue death may result. This does not usually happen in chronic (exertional) compartment syndrome.

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

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

  Acute compartment syndrome is a potentially devastating condition. Return of normal function and minimizing injury depends upon quick recognition of the situation and prompt surgical fasciotomy to resolve the increased pressure. […] Left unrecognized or untreated, the complications of acute compartment syndrome are irreversible. As swelling increases and the muscle loses its blood supply, cells eventually die and muscle necrosis occurs.

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

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

  Acute compartment syndrome is a potentially devastating condition. Return of normal function and minimizing injury depends upon quick recognition of the situation and prompt surgical fasciotomy to resolve the increased pressure. […] Left unrecognized or untreated, the complications of acute compartment syndrome are irreversible. As swelling increases and the muscle loses its blood supply, cells eventually die and muscle necrosis occurs.

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

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

  In general, longer periods of compartment syndrome and ischemia correlate with worse outcomes. Tissue ischemia of only 1 hour is associated with reversible neuropraxia, whereas ischemia of 4 hours can induce irreversible axonotmesis. Ischemia of up to 6 hours is associated with irreversible necrosis and more likely to produce functional impairment. […] Compartment syndrome can occur in any area of the body with closed compartments. […] 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. […] 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.

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

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

  Continuous compartment pressure monitoring has been suggested as an alternative to spot compartment pressure checks. […] The traditional treatment for lower extremity compartment syndrome is a two-incision, four-compartment fasciotomy and has been well described in the literature. […] A missed compartment is a critical technical error as irreversible muscle and nerve may damage occur. […] Rhabdomyolysis may result from the muscle necrosis secondary to compartment syndrome, with ischemic cellular contents spilling into the circulation. […] Loss of limb is, arguably, the most devastating complication of compartment syndrome. The reported amputation rate after compartment syndrome is 5.7% to 12.9%. […] Vigilance is key when evaluating and treating patients with lower extremity compartment syndrome. The classic signs of compartment syndrome, the 6 Ps can be deceiving. If there is any concern for compartment syndrome, especially when a patient has pain out of proportion to an injured extremity, compartment pressures should be checked immediately.

• #102

  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. […] Diagnosis is made with the presence of severe and progressive leg pain that worsens with passive ankle motion. Firmness and decreased compressibility of the compartments is often present. Needle compartment pressures are diagnostic in cases of inconclusive physical exam findings and in sedated patients. […] Treatment is usually emergent fasciotomies of all 4 compartments. […] Pathophysiology includes a cascade of events that 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.

• #103 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. […] Initial treatment consists of relieving the pressure on the compartment. If compartment syndrome is due to a cast, removal of the cast is indicated. If it is due to increased pressure within the compartment from increased contents, such as bleeding or swelling, surgery to cut the fascia is necessary. This is an emergency, because damage to the muscles and nerves is irreversible after 8 to 12 hours and may lead to kidney failure or death.

• #104

  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. […] Diagnosis is made with the presence of severe and progressive leg pain that worsens with passive ankle motion. Firmness and decreased compressibility of the compartments is often present. Needle compartment pressures are diagnostic in cases of inconclusive physical exam findings and in sedated patients. […] Treatment is usually emergent fasciotomies of all 4 compartments. […] Pathophysiology includes a cascade of events that 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.

• #105

  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. […] Diagnosis is made with the presence of severe and progressive leg pain that worsens with passive ankle motion. Firmness and decreased compressibility of the compartments is often present. Needle compartment pressures are diagnostic in cases of inconclusive physical exam findings and in sedated patients. […] Treatment is usually emergent fasciotomies of all 4 compartments. […] Pathophysiology includes a cascade of events that 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.

• #106 Compartment Syndrome | Thoracic Key

  https://thoracickey.com/compartment-syndrome-2/

  Compartment syndrome may affect any myofascial compartment. […] Although less common than the lower leg, compartment syndromes have been described in the upper extremity, hand, thigh, foot, and buttock. […] A variety of adjuncts have been proposed to mitigate muscle swelling and prevent the development of compartment syndrome. […] The most common approach has been pharmacologic therapy to blunt the IR phenomenon. […] The decision to proceed to fasciotomy may be dictated on clinical grounds with or without ICP measurements.

• #107 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. […] Initial treatment consists of relieving the pressure on the compartment. If compartment syndrome is due to a cast, removal of the cast is indicated. If it is due to increased pressure within the compartment from increased contents, such as bleeding or swelling, surgery to cut the fascia is necessary. This is an emergency, because damage to the muscles and nerves is irreversible after 8 to 12 hours and may lead to kidney failure or death.

• #108 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 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. […] After an injury, the affected area may swell, and blood or fluid resulting from inflammation or injury can accumulate in the compartment, causing edema. The tough walls of fascia can’t easily expand to make room for the swelling or fluid build-up, and compartment pressure rises. When this happens, tissues inside the compartment don’t get sufficient blood flow. It also puts pressure on the nerves and muscles in the compartment. This can cause tissues in the area to die leading to damage of the organs or muscles, loss of function, or even death.

• #109 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 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. […] After an injury, the affected area may swell, and blood or fluid resulting from inflammation or injury can accumulate in the compartment, causing edema. The tough walls of fascia can’t easily expand to make room for the swelling or fluid build-up, and compartment pressure rises. When this happens, tissues inside the compartment don’t get sufficient blood flow. It also puts pressure on the nerves and muscles in the compartment. This can cause tissues in the area to die leading to damage of the organs or muscles, loss of function, or even death.

• #110 Compartment Syndrome | Thoracic Key

  https://thoracickey.com/compartment-syndrome-2/

  Compartment syndrome may affect any myofascial compartment. […] Although less common than the lower leg, compartment syndromes have been described in the upper extremity, hand, thigh, foot, and buttock. […] A variety of adjuncts have been proposed to mitigate muscle swelling and prevent the development of compartment syndrome. […] The most common approach has been pharmacologic therapy to blunt the IR phenomenon. […] The decision to proceed to fasciotomy may be dictated on clinical grounds with or without ICP measurements.

• #111 Abdominal Compartment Syndrome: pathophysiology and definitions | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Full Text

  https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-17-10

  Hepatic artery, hepatic vein, and portal vein blood flow are all reduced by the presence of IAH. […] Cerebral perfusion and function are also directly affected by the presence of IAH. […] IAH can induce similar increases in ICP, but these elevations are sustained as long as the IAH is present and can result in significant reductions in cerebral perfusion pressure (CPP). […] The abdominal wall is also subject to the effects of elevated IAP. Visceral edema, abdominal packs, and free intraperitoneal fluid all distend the abdomen and reduce abdominal wall compliance. […] The WSACS defines ACS as a sustained IAP 20 mmHg (with or without an APP 60 mmHg) that is associated with new organ dysfunction or failure.

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

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

  Lower limb exertional compartment syndrome (LLECS), also known as chronic exertional compartment syndrome (CECS), is an overuse syndrome characterized by exercise-induced elevation of intramuscular pressures (IMP) that results in reproducible transient pain, paresthesias, and neuromuscular dysfunction. […] The exact mechanism that causes exertional compartment syndrome is unknown. The increased intra-compartmental pressures are thought to impede tissue perfusion, create a relative oxygen debt, and result in symptom onset. The exact mechanism by which this occurs remains unclear. […] It has been recently suggested that venous outflow occlusion may play a significant role in increased compartment pressures and symptom development. […] Functional muscular compression and associated occlusion of vasculature has been proposed to create elevated hydrostatic pressures and fluid accumulation within the compartments, thereby explaining the elevated IMPs and common findings on imaging modalities.

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

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

  Lower limb exertional compartment syndrome (LLECS), also known as chronic exertional compartment syndrome (CECS), is an overuse syndrome characterized by exercise-induced elevation of intramuscular pressures (IMP) that results in reproducible transient pain, paresthesias, and neuromuscular dysfunction. […] The exact mechanism that causes exertional compartment syndrome is unknown. The increased intra-compartmental pressures are thought to impede tissue perfusion, create a relative oxygen debt, and result in symptom onset. The exact mechanism by which this occurs remains unclear. […] It has been recently suggested that venous outflow occlusion may play a significant role in increased compartment pressures and symptom development. […] Functional muscular compression and associated occlusion of vasculature has been proposed to create elevated hydrostatic pressures and fluid accumulation within the compartments, thereby explaining the elevated IMPs and common findings on imaging modalities.

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

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

  Lower limb exertional compartment syndrome (LLECS), also known as chronic exertional compartment syndrome (CECS), is an overuse syndrome characterized by exercise-induced elevation of intramuscular pressures (IMP) that results in reproducible transient pain, paresthesias, and neuromuscular dysfunction. […] The exact mechanism that causes exertional compartment syndrome is unknown. The increased intra-compartmental pressures are thought to impede tissue perfusion, create a relative oxygen debt, and result in symptom onset. The exact mechanism by which this occurs remains unclear. […] It has been recently suggested that venous outflow occlusion may play a significant role in increased compartment pressures and symptom development. […] Functional muscular compression and associated occlusion of vasculature has been proposed to create elevated hydrostatic pressures and fluid accumulation within the compartments, thereby explaining the elevated IMPs and common findings on imaging modalities.

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

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

  Lower limb exertional compartment syndrome (LLECS), also known as chronic exertional compartment syndrome (CECS), is an overuse syndrome characterized by exercise-induced elevation of intramuscular pressures (IMP) that results in reproducible transient pain, paresthesias, and neuromuscular dysfunction. […] The exact mechanism that causes exertional compartment syndrome is unknown. The increased intra-compartmental pressures are thought to impede tissue perfusion, create a relative oxygen debt, and result in symptom onset. The exact mechanism by which this occurs remains unclear. […] It has been recently suggested that venous outflow occlusion may play a significant role in increased compartment pressures and symptom development. […] Functional muscular compression and associated occlusion of vasculature has been proposed to create elevated hydrostatic pressures and fluid accumulation within the compartments, thereby explaining the elevated IMPs and common findings on imaging modalities.

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

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

  Elevation of IMP is believed to occur in response to physiologic and pathologic changes, including muscle hypertrophy, intracompartmental fluid, and fascial thickening, whose effect is enhanced by a 20% muscle volume increase during strenuous physical activity. […] At a population level, involvement of the various compartments may follow different patterns. While they can present in isolation, a portion of patients may have multiple compartments contributing to their symptoms. […] These presentations more commonly affect bilateral lower extremities, while deep posterior compartment involvement may be more common in a unilateral presentation.

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