The diagnosis of acute compartment syndrome: a review

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Margaret M McQueen, Andrew D Duckworth

Abstract

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.

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Citations

May 10, 2016·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Karina Sovik-Correia, Kathryn Cullinane Whalen
Jan 26, 2018·JBJS Case Connector·Wesley Zhang YangSeth Robert Yarboro
May 17, 2018·Trauma Surgery & Acute Care Open·Jennifer Cone, Kenji Inaba
Jun 6, 2019·JBJS Case Connector·Matthew C DeWolfRakesh R Veerareddy
Apr 3, 2019·The Journal of Trauma and Acute Care Surgery·Thomas J WaltersKathy L Ryan
Mar 29, 2019·Biomechanics and Modeling in Mechanobiology·Iftah NudelGal deBotton
Mar 28, 2020·Aesthetic Surgery Journal·Katarina AndjelkovRamon Llull
Jul 18, 2020·Journal of Orthopaedic Trauma·Samuel A MacKenzieAndrew D Duckworth
May 3, 2018·Vascular and Endovascular Surgery·Charlotte Wesslén, Carl-Magnus Wahlgren
Jun 28, 2019·The Journal of Trauma and Acute Care Surgery·Thomas J WaltersKathy L Ryan
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Aug 28, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Elliott L WoodwardJames G Ramsay
Aug 18, 2021·Journal of Orthopaedic Surgery and Research·Xiangtian DengYingze Zhang

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