The surgeon must have a high index of suspicion. An open fracture does not necessarily decompress the compartments and in fact, because of the high energy associated with the injury, may increase the risk of such a syndrome. The classic findings of pain, paralysis, pulselessness, and paresthesia usually present is too late to successfully intervene. Patients with significant trauma, who have been treated and splinted but continue to have unremitting pain in the involved extremity, particularly with passive motion of the digits, should be considered to have a compartment syndrome until proven otherwise. Compartment syndromes are progressive problems that may develop insidiously, thereby requiring repetitive examinations of the extremity.
Diagnosis is clinical and the treatment is decompression, i.e., surgical fasciotomy.
Appropriately-timed fasciotomy makes the difference between amputation and a viable extremity. The University of Iowa. All rights reserved.