Acute Compartment Syndrome of the Upper Extremity

Abstract

Acute compartment syndrome of the upper extremity is a rare but serious condition of elevated intracompartmental pressures leading to tissue ischemia. Prompt diagnosis and emergent fasciotomy are critical to optimize patient outcomes, and delays to care can result in myonecrosis, contracture, and limb dysfunction. Acute compartment syndrome of the upper extremity most commonly occurs in the forearm but may also affect the arm and the hand. Upper-extremity acute compartment syndrome most commonly occurs following trauma, but nontraumatic etiologies include prolonged decubitus position, bleeding conditions, and reperfusion injury after critical limb ischemia. This review article will provide a general overview of acute compartment syndrome of the upper extremity with specific sections on the prevalence, treatment, and outcomes for each anatomic location. This review will also address management options and current controversies, including the treatment of delayed presentation or missed compartment syndrome as well as discuss recent advancements in diagnosis and management.

Keywords: Compartment syndrome; Volkmann ischemic contracture; fasciotomy; forearm; hand.