Acute shine compartment syndrome: epidemiology, etiology, pathophysiology, anatomy, diagnostics, treatment, complications and outputs: literature review

Vytautas Matiulevič1

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania,

Abstract

Background. Compartment syndrome is an acute condition that requires urgent care. Patients with traumatic leg injuries need to be considerately monitored since complications associated with late diagnosis and treatment lead to irreversible consequences.

Aim of the study.  Summarize the latest studies and provide information on the relevance, clinical signs, diagnostic and treatment features of compartment syndrome.

Materials and methods. The review of the literature was conducted using the PubMed, ScienceDirect, and ClinicalKey databases. The literature research was conducted using predetermined keywords: acute compartment syndrome, fasciotomy, diagnosis and treatment of compartment syndrome, acute extremity compartment syndrome. Exclusion criteria were applied to articles related to crush syndrome. More than 20 publications were analyzed.

Results. Most of the clinical signs of compartment syndrome are nonspecific. Fasciotomy should be performed after suspicion of compartment syndrome and measuring the differential pressure < 30 mm Hg.

Conclusions. The most common cause of calf compartment syndrome is tibial fractures. Patient complaints are nonspecific. Pain, non-manageable with NSAIDs, and muscle tension are usually present. Diagnosis is based on patient complaints, physical examination, and measurement of differential pressure. Fasciotomy is recommended when the differential pressure is < 30 mm Hg. This is the only effective treatment for compartment syndrome. There are 2 calf fasciotomy techniques: single incision and two incisions. The surgeon chooses the technique based on his experience and the condition of the patient as the results are similar. Untreated, patients develop soft tissue necrosis, resulting in muscle weakness, pain, nerve damage, cosmetic defects, and venous insufficiency.

Keywords: acute compartment syndrome, fasciotomy, diagnosis, treatment.