Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity

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