Compartment syndrome (CS) results when there is increased pressure within a closed osteofascial compartment, compromising local circulation. This condition is a surgical emergency that can lead to tissue ischemia and necrosis if it is not tackled urgently.
Definition and diagnosis: (1) Acute CS results from increased pressure within a muscle compartment, often following trauma; (2) clinical signs alone may not be sufficient for diagnosis, so serial monitoring of intracompartmental pressure is crucial; (3) a threshold of intracompartmental pressure >30 mm Hg aids in diagnosing acute CS; (4) invasive intracompartmental pressure monitoring is a quick and safe procedure; (5) fasciotomy (surgical release of the fascia) is necessary when intracompartmental pressure exceeds 30 mm Hg or when the delta pressure (difference between compartmental pressure and diastolic pressure) is <30 mm Hg.
Importance of timely intervention: (1) Delayed diagnosis of CS can lead to limb gangrene and an increased risk of amputation; (2) the study aims to evaluate serial monitoring of intracompartmental pressure for early detection and timely intervention through fasciotomy in cases of acute limb ischemia.
Materials and methods: (1) A prospective study was conducted at Mahatma Gandhi Memorial Government Hospital in Trichy, Tamil Nadu; (2) we recruited 224 patients with acute limb ischemia due to trauma or nontraumatic causes (e.g., snake bites, cellulitis, diabetic cellulitis, chronic kidney disease); (3) serial compartmental pressure monitoring using a Stryker intracompartmental pressure monitor was performed at 0, 12, 24, and 48 hours.
Results: Among 224 patients with lower limb pathology: (1) 178 (79.5%) were males; (2) 46 (20.5%) were females; (3) the age-group ranged from 2 to 72 years, with 44.1% falling within the 20–40 years age-group; (4) the most common etiology was snake bite cellulitis; (5) compartmental pressure measurements were taken at different time intervals; (6) patients with elevated compartmental pressure (>30 mm Hg) or when the delta pressure (difference between compartmental pressure and diastolic pressure) was <30 mm Hg underwent fasciotomy, while others were managed conservatively.
Early diagnosis and prompt treatment are crucial for preventing complications associated with CS.
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