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Acute Compartment Syndrome of the Lower Leg: A Review

Published:November 21, 2015DOI:https://doi.org/10.1016/j.nurpra.2015.10.013

      Highlights

      • Acute compartment syndrome (ACS) of the lower leg is a time-sensitive, limb-threatening surgical emergency.
      • Late findings of ACS can lead to limb amputation, contractures, paralysis, multiorgan failure, and death.
      • Diagnosis is based on clinical suspicion, assessment of the 6 P’s (pain, poikilothermia, pallor, paresthesia, pulselessness, and paralysis), and intracompartmental pressure (ICP).
      • ICP measurement above 30 mm Hg requires emergent surgical decompression.
      • The gold standard of ACS treatment is full fasciotomy.

      Abstract

      Acute compartment syndrome (ACS) of the lower leg is a time-sensitive orthopedic emergency that relies heavily on precise clinical findings. Late findings of ACS can lead to limb amputation, contractures, paralysis, multiorgan failure, and death. Hallmark symptoms of ACS include the 6 P's: pain, poikilothermia, pallor, paresthesia, pulselessness, and paralysis. Suspicion of ACS is confirmed by measurement of intracompartmental pressure of the affected compartment. The definitive treatment of ACS is timely fasciotomy. We review the pathophysiology, common causes, diagnosis, and treatment of this potentially devastating condition.

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      Biography

      Joanne Pechar, MSN, AGACNP-BC, ANP-C, is an acute care nurse practitioner with the Department of Penn Orthopedics at Pennsylvania Hospital in Philadelphia and can be reached at [email protected].

      Biography

      M. Melanie Lyons, PhD, MSN, ACNP-BC, is a National Institutes of Health T32 postdoctoral research fellow at the Center for Sleep and Circadian Neurobiology at Perelman School of Medicine and School of Nursing, University of Pennsylvania.