title: Diagnosis and treatment of acute extremity compartment syndrome.
abstract: Acute compartment syndrome of the extremities is well known, but diagnosis can be challenging. Ineffective treatment can have devastating consequences, such as permanent dysaesthesia, ischaemic contractures, muscle dysfunction, loss of limb, and even loss of life. Despite many studies, there is no consensus about the way in which acute extremity compartment syndromes should be diagnosed. Many surgeons suggest continuous monitoring of intracompartmental pressure for all patients who have high-risk extremity injuries, whereas others suggest aggressive surgical intervention if acute compartment syndrome is even suspected. Although surgical fasciotomy might reduce intracompartmental pressure, this procedure also carries the risk of long-term complications. In this paper in The Lancet Series about emergency surgery we summarise the available data on acute extremity compartment syndrome of the upper and lower extremities in adults and children, discuss the underlying pathophysiology, and propose a clinical guideline based on the available data.
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA. Electronic address: avonkeudell@mgh.harvard.edu.
authors.forename: Arvind G
authors.initials: AG
authors.lastname: von Keudell
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Weaver
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Beth Israel Deaconess Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Appleton
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Donald S
authors.initials: DS
authors.lastname: Bae
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: George S M
authors.initials: GSM
authors.lastname: Dyer
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Heng
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Jupiter
authors.affiliation: Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Vrahas
mesh_terms: D000208:Acute Disease; D000328:Adult; D001132:Arm / Q000098:blood supply / Q000601:surgery; D002648:Child; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery