Compartment syndrome

Compartment syndrome is raised pressure within a closed fascial space leading to vascular compromise and muscle death. It can occur after any significant limb trauma, particularly after crush injuries or surgeries, or limb in tight casts

Early diagnosis is key to preventing severe limb-threatening complications.

Suspicious signs and symptoms include

• Pain out of proportion to injury

• Unrelenting pain despite analgesia

• Pain on passive stretch of the muscles in that compartment

• tense and swollen compartment

• pale, cool, pulseless limb with paraesthesia or paralysis are late signs

Acute A&E management

• release any tight constricting devices (e.g. cast/bandages)

• elevate limb

• assess and document neurovascular status

• refer to Ortho oncall for urgent assessment