Introduction

Acute compartment syndrome (ACS) is a surgical emergency produced by increased pressure within a closed osteofascial compartment, resulting in progressive impairment of tissue perfusion and ultimately irreversible muscle and nerve damage.

Fractures are the commonest cause, and tibial shaft fractures are among the most important injuries associated with ACS.

Definition

Acute compartment syndrome is a condition in which raised pressure within a closed fascial compartment compromises the microcirculation to the muscles and nerves contained within that compartment.

Untreated ACS causes:

↑ COMPARTMENT PRESSURE
        ↓
↓ MICROVASCULAR PERFUSION
        ↓
TISSUE ISCHAEMIA
        ↓
CAPILLARY LEAK + OEDEMA
        ↓
FURTHER ↑ PRESSURE
        ↓
MUSCLE + NERVE NECROSIS

Causes of Acute Compartment Syndrome

ACS develops either because the contents of the compartment increase or because the size of the compartment decreases.