Year: 2026 | Month: March | Volume: 13 | Issue: 3 | Pages: 400-407
DOI: https://doi.org/10.52403/ijrr.20260345
Compartment Syndrome: A Literature Review
Triharto Banjaran Sakti1, Komang Septian Sandiwidayat2
1Resident of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Prof Ngoerah Hospital, Bali, Indonesia
2Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Prof Ngoerah Hospital, Bali, Indonesia
Corresponding Author: Triharto Banjaran Sakti
ABSTRACT
Background: Compartment syndrome is a limb-threatening orthopedic emergency characterized by increased pressure within an osteofascial compartment, leading to impaired tissue perfusion and potential irreversible necrosis. Although most frequently associated with tibial fractures, it can also occur in the hand, foot, forearm, and paraspinal muscles.
Methods: This review synthesizes current evidence on the definition, epidemiology, pathophysiology, clinical features, and diagnostic approach to compartment syndrome. Literature was systematically searched across PubMed, Scopus, Web of Science, and Cochrane Library using Boolean operators. Risk of bias was assessed with the Cochrane Risk of Bias tool for randomized trials and the Newcastle-Ottawa Scale for observational studies.
Results: Approximately 69% of compartment syndrome cases are associated with fractures, with 30% involving the tibia. Pathophysiological mechanisms are explained by the arterio-venous gradient theory and ischemia-reperfusion syndrome, both of which describe a vicious cycle of reduced capillary perfusion, metabolic deficit, ischemia, and necrosis. Clinically, the condition presents with severe pain disproportionate to injury, pain on passive stretch, paresthesia, and tense swelling, summarized by the “6 Ps.” Diagnosis remains primarily clinical, but adjunctive investigations such as radiography can identify underlying fractures, while compartment pressure measurement provides objective confirmation in equivocal cases.
Conclusion: Early recognition and timely diagnosis are critical in preventing irreversible damage in acute compartment syndrome. While clinical evaluation remains the cornerstone of diagnosis, adjunctive tools such as imaging and pressure monitoring may assist in difficult cases. Prompt surgical intervention with fasciotomy offers the best chance of preserving limb function.
Keywords: Acute compartment syndrome, Intracompartmental pressure, Fasciotomy, Tibial fracture, Diagnosis, Near-infrared spectroscopy.
[PDF Full Text]