In this episode, we review compartment syndrome, a limb-threatening orthopedic emergency caused by increased pressure within a closed muscle compartment that compromises tissue perfusion. We discuss the underlying pathophysiology of rising intracompartmental pressure leading to ischemia, cellular hypoxia, and potential muscle and nerve damage. The episode highlights common causes such as fractures, crush injuries, burns, vascular trauma, and reperfusion injuries, along with nontraumatic triggers like intense physical exertion or prolonged immobilization. Key clinical features—including severe pain out of proportion to exam, pain with passive stretch, paresthesias, and tense compartments—are emphasized to aid early recognition. We also review diagnostic considerations, the role of compartment pressure measurement, and the urgent treatment of emergent fasciotomy to prevent devastating complications such as permanent nerve damage, rhabdomyolysis, amputation, or death.

References

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