Definitions and terminology of compartment syndrome and Volkmann's ischemic contracture of the upper extremity

Abstract

Increased tissue pressure within the confines of a nondistensible anatomic compartment increases venous pressure, causes vascular compression, decreases the arteriovenous gradient, and results in a compartment syndrome. The decreased blood flow and hypoxia result in cellular damage of muscles, nerves, and vascular endothelium. Richard von Volkmann's legacy has taught us that a patient's overall status must be monitored to follow the systemic determinants of peripheral blood flow and oxygen transport. Limbs must also be monitored with vigilance. A high index of suspicion must always be present, and compartment pressures can be measured directly to aid in clinical decision making regarding the status of a compartment. The remaining articles in this issue describe and explore von Volkmann's syndrome using the terms and concepts introduced here.