title: Acute compartment syndrome.
abstract: BACKGROUND
  acute compartment syndrome (ACS) is one of the few true emergencies in orthopedics and traumatology. It is a painful condition caused by the increase interstitial pressure (intracompart-mental pressure - ICP) within a closed osteofascial compartment which impair local circulation. It occurs most often in the legs, but it can affects also the arms, hands, feet, and buttocks. It usually develops after a severe injury such as fractures or crush injury, but it can also occurs after a relatively minor injury and it may be iatrogenic. Uncommon causes of ACS have been also described, that suggest surgeons to pay great attention to this serious complication. Diagnosing ACS is difficult in clinical practice, even among expert surgeons. Currently, the diagnosis is made on the basis of physical examination and repeated ICP measures. ICP higher than 30 mmHg of diastolic blood pressure is significant of compartment syndrome. Once diagnosis is made, fasciotomy to release the affected compartment should be performed as early as possible because delayed decompression would lead to irreversible ischemic damage to muscles and peripheral nerves.
  
  
  CONCLUSIONS
  acute compartment syndrome is a surgical emergency. There is still little consensus among authors about diagnosis and treatment of these serious condition, in particular about the ICP at which fasciotomy is absolutely indicated and the timing of wound closure. New investigations are needed in order to improve diagnosis and treatment of ACS.
authors: Department of Orthopaedic and Traumatology, University of Rome "Tor Vergata", School of Medicine, Rome, Italy.
authors: Alessio Giai
authors: AG
authors: Via
authors: Department of Orthopaedic and Traumatology, University of Rome "Tor Vergata", School of Medicine, Rome, Italy.
authors: Francesco
authors: F
authors: Oliva
authors: Department of Orthopaedics and Traumatology, San Camillo-Forlanini Hospital, Rome, Italy.
authors: Marco
authors: M
authors: Spoliti
authors: Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Italy; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, London, England.
authors: Nicola
authors: N
authors: Maffulli
keywords: acute compartment syndrome; complications; fasciotomy; fracture; intracompartmental pressure; myofascial compartment