Introduction and objective:
Compartment syndrome (CS) is a severe and rapidly progressing condition associated with muscle compartments restricted by fascia. It most commonly affects the lower extremities and develops as a result of bone fractures or soft tissue injuries. The essence is an increased pressure within the compartments which have limited ability to compensate their volumes. The aim of this review paper is to present the complexity of the problem, its pathophysiology and current methods of diagnosis and treatment.

Review methods:
Printed literature,PubMed and Google Scholar databases were searched using key words related to compartment syndrome, fasciotomy, fracture and trauma. Articles and book sections in English were searched and two positions from printed literature in Polish were used. Articles were selected after analyzing abstracts, and those which were incomplete or outdated were excluded. The types of articles included prospective studies, retrospective studies and reviews. The summary was supported by case studies to add imaging and clinical value to the study

Brief description of the state of knowledge:
From the initial search, 40 articles were retrieved for final analysis. The available data provide the latest information specifically on the diagnosis of compartment syndrome. Intra-compartmental pressure measuring devices currently in use were utilised. Treatment is based on surgical decompression called fasciotomy. The list of symptoms is intended to increase the consciousness in proceeding with this condition. New non-invasive diagnostic and treatment options are currently used in clinical research and provide a hopeful future in the described disease.

Compartment syndrome is a relatively uncommon trauma-related condition, and if untreated can lead to severe complications or even limb amputation. Management is urgent and strictly surgical

ΔP – delta pressure; ACS – acute compartment syndrome; ATP – adenosine triphosphate; CECS – chronic exertional compartment syndrome; CS – compartment syndrome; HBO – hyperbaric oxygen therapy; ICP – intracompartmental pressure; IMA – ischaemia-modified albumin; NPWT – negative pressure wound therapy
Via AG, Oliva F, Spoliti M, et al. Acute compartment syndrome. Muscles Ligaments Tendons J. 2015;5(1):18–22.
Garner MR, Taylor SA, Gausden E, et al. Compartment syndrome: diagnosis, management, and unique concerns in the twenty-first century. HSS J. 2014;10(2):143–152.
van der Kraats AM, Winkes M, Janzing HMJ, et al. Review of Reliable and Valid Noninvasive Tools for the Diagnosis of Chronic Exertional Compartment Syndrome. Orthop J Sports Med. 2023;11(1).
Guo J, Yin Y, Jin L, et al. Acute compartment syndrome: Cause, diagnosis, and new viewpoint. Medicine (Baltimore). 2019;98(27):e16260.
von Volkmann R. Ischaemic muscle paralyses and contractures. 1881. Clin Orthop Relat Res. 2007;456:20–21.
Torlincasi AM, Lopez RA, Waseem M. Acute Compartment Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing LLC 2022.
Taylor RM, Sullivan MP, Mehta S. Acute compartment syndrome: obtaining diagnosis, providing treatment, and minimizing medicolegal risk. Curr Rev Musculoskelet Med. 2012;5(3):206–213.
Jones G, Thompson K, Johnson M. Acute compartment syndrome after minor trauma in a patient with undiagnosed mild haemophilia B. Lancet. 2013;382(9905):1678.
Amado FC, Noversa C, Moura A, et al. Necrotizing Fasciitis Causing Acute Compartment Syndrome after Radial Artery Catheterization. Eur J Case Rep Intern Med. 2020;7(4).
Edigin E, Shaka H. Idiopathic Acute Compartment Syndrome of the Leg with Incidental Deep Venous Thrombosis: A Case Report. Cureus. 2019;11(7):e5130.
Lutter C, Schöffl V, Hotfiel T, et al. Compartment Syndrome of the Foot: An Evidence-Based Review. J Foot Ankle Surg. 2019;58(4):632–640.
Ilyas H, Fagan C, Roser F, et al. Lumbar Paraspinal Compartment Syndrome: Case Report and Critical Evaluation of the Literature. Clin Spine Surg. 2022;35(7):301–309.
Marin AC, Hechter S, Prasad A, et al. Abdominal Compartment Syndrome (ACS) With Sigmoid Volvulus (SV): Lost Hours Are Lost Lives. Cureus. 2023;15(1):e33741.
Benns M, Miller K, Harbrecht B, et al. Heroin-Related Compartment Syndrome: An Increasing Problem for Acute Care Surgeons. Am Surg. 2017;83(9):962–965.
Tiwari A, Haq AI, Myint F, et al. Acute compartment syndromes. Br J Surg. 2002;89(4):397–412.
Novak M, Penhaker M, Raska P, et al. Extremity compartment syndrome: A review with a focus on non-invasive methods of diagnosis. Front Bioeng Biotechnol. 2022;10:801586.
Turner J, Thies KC. Intra-osseous-access-associated lower limb compartment syndrome in a critically injured paediatric patient. Eur J Anaesthesiol. 2018;35(12):981–983.
Bochenek A, Reicher M. Anatomia Człowieka. Vol I. Warszawa: PZWL; 2019. p. 911–913.
Mostafa E, Graefe SB, Varacallo M. Anatomy, Bony Pelvis and Lower Limb, Leg Posterior Compartment. In: StatPearls. Treasure Island (FL): StatPearls Publishing LLC; 2022.
Wilke J, Schleip R, Yucesoy CA, et al. Not merely a protective packing organ? A review of fascia and its force transmission capacity. J Appl Physiol (1985). 2018;124(1):234–244.
Benjamin M. The fascia of the limbs and back--a review. J Anat. 2009;214(1):1–18.
Oliver JD. Acute Traumatic Compartment Syndrome of the Forearm: Literature Review and Unfavorable Outcomes Risk Analysis of Fasciotomy Treatment. Plast Surg Nurs. 2019;39(1):10–13.
Schellenberg M, Chong V, Cone J, et al. Extremity compartment syndrome. Curr Probl Surg. 2018;55(7):256–273.
McMillan TE, Gardner WT, Schmidt AH, et al. Diagnosing acute compartment syndrome-where have we got to? Int Orthop. 2019;43(11):2429–2435.
Cone J, Inaba K. Lower extremity compartment syndrome. Trauma Surg Acute Care Open. 2017;2(1).
A comparison of pressure measurement devices used in the acute compartment syndrome of the limbs – Scientific Figure on ResearchGate. (access: 2023.03.31).
McQueen MM, Duckworth AD. The diagnosis of acute compartment syndrome: a review. Eur J Trauma Emerg Surg. 2014;40(5):521–528.
Coccolini F, Improta M, Picetti E, et al. Timing of surgical intervention for compartment syndrome in different body region: systematic review of the literature. World J Emerg Surg. 2020;15(1):60.
Ellison CE, Zollinger RM. Zollinger Atlas Zabiegów Chirurgicznych. Wrocław: Edra Urban & Partner; 2019. p. 638–639.
Lower Leg Compartment Syndrome after Appendicectomy. (access: 2023.03.31).
Jeong JG, Choi SH, Kim AR, et al. Gluteal Compartment Syndrome and Rhabdomyolysis after Prolonged Laparoscopic Nephroureterectomy and Treatment Strategies Including Rehabilitation: A Case Report. Healthcare (Basel). 2021;10(1):47.
Tsai WH, Huang ST, Liu WC, et al. High risk of rhabdomyolysis and acute kidney injury after traumatic limb compartment syndrome. Ann Plast Surg. 2015;74(2):158–161.
Lollo L, Grabinsky A. Clinical and functional outcomes of acute lower extremity compartment syndrome at a Major Trauma Hospital. Int J Crit Illn Inj Sci. 2016;6(3):133–142.
Wang T, Long Y, Ma L, et al. Single-cell RNA-seq reveals cellular heterogeneity from deep fascia in patients with acute compartment syndrome. Front Immunol. 2023;13. fimmu.2022.1062479.
Buerba RA, Fretes NF, Devana SK, et al. Chronic exertional compartment syndrome: current management strategies. Open Access J Sports Med. 2019;10:71–79.
Houston A, Cosma G, Turner P, et al. Predicting surgical outcomes for chronic exertional compartment syndrome using a machine learning framework with embedded trust by interrogation strategies. Sci Rep. 2021;11(1):24281.
Charvin M, Orta C, Davy L, et al. Botulinum Toxin A for Chronic Exertional Compartment Syndrome: A Retrospective Study of 16 Upperand Lower-Limb Cases. Clin J Sport Med. 2022;32(4):436–440. https://
Robles EL, Pache KM, Gluck JS. Acute compartment syndrome of the leg caused by cocaine use, creatine supplementation and vigorous exercise. J Surg Case Rep. 2022;2022(11).
AlShammari H, AlDuwaisan W, Akbar Z, et al. Compartment syndrome secondary to intra-operative IV methylene blue extravasation to detect ureteral injury. Urol Case Rep. 2023;47:102340. eucr.2023.102340.
Chouhan D, Phansopkar P, Chitale NV, et al. Physiotherapy Rehabilitation in an Above-Knee Amputee Following Compartment Syndrome in Post-tibial Plateau Fracture: A Case Report. Cureus. 2022;14(12).
van Zantvoort APM, de Bruijn JA, Hundscheid HPH, et al. Fasciotomy for Lateral Lower-leg Chronic Exertional Compartment Syndrome. Int J Sports Med. 2018;39(14):1081–1087.
Compartment Syndrome. (access: 2023.03.31).
Hammerberg EM. Acute compartment syndrome of the extremities. In: UpToDate. Post TW, editor. UpToDate: Waltham (MA): UpToDate Inc. 2023.
Ipaktchi K, Wingfield J, Colakoglu S. Fasciotomy: Upper Extremity. In: Mauffrey C, Hak DJ, Martin III MP, editors. Compartment Syndrome: A Guide to Diagnosis and Management. Springer; 2019. p. 59–66. https://
Lee DH, Desai MJ, Gauger EM. Electrical Injuries of the Hand and Upper Extremity. J Am Acad Orthop Surg. 2019;27(1):e1-e8. https://
Merchan N, Ingalls B, Garcia J, et al. Factors Associated With Surgical Site Infections After Fasciotomy in Patients With Compartment Syndrome. J Am Acad Orthop Surg Glob Res Rev. 2022;6(2):e22.00002.
Mirza TM, Taqi M. Volkmann Contracture. In: StatPearls. Treasure Island (FL): StatPearls Publishing LLC 2022.