MAST-associated compartment syndrome (MACS): a review

Compartment syndromes occur following lower extremity injuries and have been associated with the use of pneumatic or "medical" antishock trousers (MAST). Review of 12 previously reported cases and 15 new cases suggests that lower extremity trauma and systemic hypotension are cofactors responsible for the development of compartment syndrome but MAST use also contributes to the process by prolonging muscle ischemia. Complications of lower limb compartment hypertension may be averted by early recognition and fasciotomy. Associated amputations and mortality are directly related to the severity of injury, or indirectly to delay in diagnosis and treatment of the compartment syndrome and its complications.