Acute Compartment Syndrome
(ACS; Compartment Syndrome, Acute; Volkmann’s Ischemia)
Sheets of connective tissue called fascia are located under the skin of the arms and legs. These wrap around groups of muscles, nerves, and blood vessels to create a unit called a compartment. When pressure builds up in these enclosed spaces, it is redirected into the compartment. When pressure reaches a certain point, it disrupts blood flow. Blood vessels may fail and tissue dies. Acute compartment syndrome (ACS) can affect the arms, hands, legs, feet, and buttocks.
Compartment Syndrome in Lower Leg
Common causes include:
- Vein obstructions in the extremities
- Complication of surgery
These factors increase your chance of developing ACS:
- Pre-existing condition that could lead to fatal bleeding in cases of trauma, such as:
- Taking anticoagulants
- Having a bleeding disorder such as hemophilia
- Participation in certain collision or contact sports such as football
- Bandages or casts that are worn too tightly or worn for too long
- Recent injury to the area
- Swelling of tissues under the skin
Symptoms may include:
- Severe pain
- Feeling of tightness or fullness of muscles
- Swollen, pale, shiny skin over affected area
- Numbness or tingling
Symptoms can develop within 30 minutes to two hours. In other cases, it may take days.
ACS is an emergency. Get medical help right away. Damage can result in serious injury or even death.
You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be taken of your bodily structures. This can be done with:
The pressure inside your compartments will be measured. This can be done with:
- Slit catheter
- Near-infrared spectroscopy
Your bodily fluids will be tested. This can be done with blood tests.
Surgery to relieve pressure, called fasciotomy, must be done right away to prevent permanent damage. The doctor makes a long cut into the fascia to open the envelope of tissue and relieve pressure.
ACS is difficult to prevent because there are many causes. But there are some steps you can take to reduce your risk of injury, such as:
- Wearing proper equipment when playing sports
- Making sure that your medical records mention if you have used anticoagulants or if you have blood diseases
- Being aware of the risk of ACS when you are wearing a bandage or cast
American Academy of Orthopaedic Surgeons
National Institutes of Arthritis and Musculoskeletal and Skin Diseases
Canadian Orthopaedic Foundation
Canadian Physiotherapy Association
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Last reviewed November 2013 by John C. Keel, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.