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Compartment Syndrome: Introduction Acute Compartment Syndrome: occures when pressure rises in a compartment,resulting in a critical reduction of blood flow to the tissue. Volkmann`s ischemic contracture Is the end stage of neglected acute compartment syndrom with irreversible muscle necrosis leading to ischemic contractures. The crush syndrome: The systeic result of muscle necrosis caused by prolonged external compression of an Extremity. Epidemiology The underlying condition causing it : MOST COMMONLY: a fracture 2nd most common cause: Soft tissue injury (crush type injury) Effects of raised tissue pressure on: Muscles Nerve Bone Reperfusion injury: Is a group of complications following reestablishment of blood flow to the ischemic tissue. Can occur after fasciatomy & restoration of muscle blood flow. Clinical DX: Pain Paresthesia Paralysis of limb & hyposthesia Swelling Absence of peripheral pulses Parasis & paralysis Compartment pressure monitoring: Needle manometer method The wick catheter The slit catheter Timing: Time factors are also important in making the decision to proceed to faciotomy. Treatment: The single most effective treatment for acute compartment syndrome is: Fasciotomy ( single/ double incision) Management of Fasciotomy wounds: Incisions must never be closed primarily because this may result in persistent elevation of ICP. 48h after, a” 2nd look “ procedure should be undertaken to ensure the viability of all muscles. The wounds may then be closed by delayed primary closure if possible. Complications list for Compartment Syndrome: Muscle contracture Muscle weakness Sensory loss Infection fractures Late diagnosis: Delay in Dx has been cited as the single reason for failure in the management of acute compartment syndrome. Delay to fasciotomy of more than 6hs is likely to cause significant complications.