Acute compartment syndrome (ACS) is a serious condition characterized by increased pressure within a closed anatomical space, such as a limb compartment, leading to reduced tissue perfusion and potential tissue necrosis
Risk factors
Several risk factors have been identified for ACS:
- Trauma: Penetrating trauma resulting in arterial injury can cause ACS, particularly in the forearm
- Fractures: Long bone fractures, especially of the femur, are associated with ACS
- Surgical interventions: Certain surgical interventions, such as damage control surgery and surgeries requiring packing and planned reoperation, can increase the risk of ACS
- Resuscitation: Large-volume crystalloid resuscitation is a common risk factor for ACS
- Obesity and sepsis: These conditions have been identified as risk factors for intra-abdominal hypertension and ACS in critically ill patients
Prognosis
The prognosis of ACS largely depends on the timing of diagnosis and intervention. Early diagnosis and prompt surgical decompression are crucial determinants of good outcomes
. However, delayed recognition and treatment can lead to serious complications, including permanent muscle and nerve damage, limb loss, and even death
- Functional outcome: Long-term functional deficits are common in patients with ACS, particularly in the thigh. Factors such as high injury severity scores, ipsilateral femoral fracture, prolonged intervals to decompression, the presence of myonecrosis at the time of fasciotomy, and an age of more than thirty years are associated with increased long-term functional deficits and worse functional outcome scores
In conclusion, ACS is a serious condition with several risk factors, and its prognosis largely depends on the timing of diagnosis and intervention. Early recognition and prompt treatment are crucial to prevent serious complications and improve functional outcomes.