[Compartment syndrome. Principles of therapy]

Area of Science:

• Orthopedics
• Trauma Surgery
• Vascular Surgery

Background:

• Compartment syndrome is a surgical emergency characterized by elevated intracompartmental pressure.
• It can be classified as imminent or manifest, with distinct clinical presentations and tissue compromise.
• Prompt diagnosis and intervention are crucial to prevent irreversible tissue damage.

Purpose of the Study:

• To outline the diagnostic criteria for imminent and manifest compartment syndrome.
• To detail the surgical management strategies for both classifications of compartment syndrome.
• To address the specific challenges in managing compartment syndrome in the foot.

Main Methods:

• Review of classification criteria for compartment syndrome.
• Description of surgical interventions: subcutaneous fasciotomy for imminent, therapeutic fasciotomy for manifest.
• Discussion of wound management, including delayed closure and secondary procedures.
• Consideration of foot-specific surgical techniques.

Main Results:

• Imminent compartment syndrome management involves subcutaneous fasciotomy with possible skin closure.
• Manifest compartment syndrome requires extensive fasciotomy, débridement, and delayed wound closure to avoid rebound syndrome.
• Foot compartment syndrome necessitates opening pedal muscle compartments and adequate skin release.

Conclusions:

• Timely surgical decompression is essential for compartment syndrome.
• Management strategies differ significantly between imminent and manifest presentations.
• Specialized approaches are needed for complex cases, such as those involving the foot.