This describes threatened tissue ischaemia and necrosis due to increased swelling within an unyielding osteofascial compartment in the arm or leg. It may result from a fracture, from infection, from prolonged immobilisation in a tight plaster cast or from muscle hypertrophy in athletes; arterial damage is not necessary.
Untreated, a vicious circle soon arises in which tissue swelling results in reduced tissue perfusion and in turn, tissue ischaemia. This results in further swelling, a further increase in pressure, and a further reduction in capillary blood flow. Necrosis develops within about 12 hours - nerve function may be recoverable in time but infarcted muscle is damaged permanently. Eventually, the dead muscle fibroses and shortens, and an ischaemic contracture results.
Note that a compartment syndrome may complicate up to 15% of open fractures.
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