The diagnosis of acute compartment syndrome: a review

Delay in the diagnosis of acute compartment syndrome (ACS) has serious and sometimes catastrophic consequences for the outcome of injury, and has been recognised as one of the primary causes of a poor outcome. This article reviews the evidence for the use of clinical findings and intra-compartmental...

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Bibliographic Details
Published in:European journal of trauma and emergency surgery (Munich : 2007) 2014-10, Vol.40 (5), p.521-528
Main Authors: McQueen, M. M., Duckworth, A. D.
Format: Article
Language:English
Subjects:
Critical Care Medicine
Emergency Medicine
Intensive
Medical diagnosis
Medical disorders
Medicine
Medicine & Public Health
Muscular system
Review Article
Risk factors
Sports Medicine
Surgery
Surgical Orthopedics
Traumatic Surgery
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Summary:Delay in the diagnosis of acute compartment syndrome (ACS) has serious and sometimes catastrophic consequences for the outcome of injury, and has been recognised as one of the primary causes of a poor outcome. This article reviews the evidence for the use of clinical findings and intra-compartmental pressure (ICP) monitoring in making a prompt diagnosis of ACS. Clinical findings have poor sensitivities (13–64 %) compared to ICP monitoring (94 %) using a differential pressure threshold of less than 30 mmHg for more than 2 h. The specificities of clinical findings range from 63 to 98 % compared to a value of 98 % for ICP monitoring. Patients at risk of ACS or at risk of a delayed diagnosis are defined, and it is recommended that these patients undergo ICP monitoring. It is recommended that decompression is carried out primarily on the basis of the differential pressure being less than 30 mmHg for more than 2 h as this results in a reduced time to definitive treatment when compared to waiting for the development of clinical symptoms and signs.
ISSN:1863-9933
1863-9941
DOI:10.1007/s00068-014-0414-7