Compartment syndrome is a pathological condition characterised by elevated interstitial pressure in a closed osteofascial compartment that results in microvascular compromise (restriction of capillary blood flow).

The compartments most commonly involved are those with relatively non-compliant osseous or fascial structures, such as the anterior and deep posterior compartments of the leg and the volar compartment of the forearm.

Risk factors:

• Trauma - Acute compartment syndrome
• Bleeding disorder
• Compression support (e.g. tight casts)
• Thermal injury (burns)
• Intense muscular activity (e.g. long distance runners) - More likely chronic compartment syndrome

PC

*Presence of R/F

• Pain - Disproportionate to the underlying injury - worse with passive stretching of muscles
  • stretch of the EDL is a very sensitive test
• Parasthesia
• Pressure (muscle tightness)

Later signs:

• Pallor
• Pale
• Paralysis (late and worrying feature)

*the presence of a pulse does not rule out compartment syndrome as necrosis occurs due to MICROVASCULAR compromise