Acute compartment syndrome of the lower extremity: an update

Acute Compartment Syndrome (ACS) represents a limb threatening condition characterised by increased intracompartmental pressure and decreased tissue perfusion leading to cellular anoxia, muscle ischemia, and death. Musculoskeletal trauma, as well as other medical conditions, initiate this syndrome. Most commonly the lower leg is involved. Basic science data shows the involvement of reactive oxygen metabolites in the development of this clinical entity. Diagnosis is principally clinical, reportedly delayed by certain anaesthetic techniques, such as nerve blocks and other forms of regional and epidural anaesthesia. Measurement of the intracompartmental pressure is required for the confirmation of the syndrome. Complete fasciotomy of all compartments involved is mandatory to reinstate perfusion to the affected tissues. Recognising a compartment syndrome requires a high index of suspicion, accurate evaluation. Early treatment.prevents irreversible damage and subsequent disability as well as avoiding medico-legal problems.