Compartmentsyndrome Causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;


Overview

Any internal or external event that increases pressure within a compartment can cause compartment syndrome. Thus, increased fluid content or decreased compartment size can lead to the condition.

Causes

Common causes of CS. 

Increased fluid content can be caused by the following [1][2][3][4][5][6][7][8][9]:

  • Hemorrhage (commonly due to the Fractures or gunshot wounds. specifically from a large vessel injury) 
  • Surgery
  • Intensive muscle use (eg, tetany, vigorous exercise, seizures) 
  • Everyday exercise activities (eg, stationary bicycle use, horseback riding)
  • Burns
  • Envenomation
  • Decreased serum osmolarity (eg, nephrotic syndrome)
  • Postischemic swelling
  • Drug/alcohol abuse and coma
  • Rhabdomyolysis 
  • Gastrocnemius or peroneus muscle tear (lower extremity)
  • Ruptured Baker cyst
  • Influenza myositis 
  • Autoimmune vasculitis
  • Androgen abuse/muscle hypertrophy
  • Deep venous thrombosis 
  • hemorrhage (due to the Fractures or gunshot wounds)
  • Upper extremity fractures

Iatrogenic causes

Iatrogenic causes of compartment syndrome include the following:

  • Military antishock trousers 
  • Tight splints, casts, dressings 
  • Lithotomy position (lower extremity cases) 
  • Malfunctioning sequential compression devices
  • Intramuscular, intra-arterial, or intracompartmental injection 
  • Intraosseous infusion
  • Massive hypertonic IV fluid infusion
  • Pressurized intravenous (IV) infusion of parenteral hypertonic contrast agent
  • Attempts at cannulating veins and arteries of the arm in patients on systemic anticoagulants or patients treated with thrombolytic drugs
  • Intraoperative use of a pressurized pulsatile irrigation system
  • Use of a pump for infusion of fluids into the joint during an arthroscopic procedure
  • Chemotherapy drugs

References

  1. Godon B, Crielaard JM (February 2005). "[Compartment syndrome and sport traumatology]". Rev Med Liege (in French). 60 (2): 109–16. PMID 15819374.
  2. Mars M, Hadley GP (July 1998). "Raised intracompartmental pressure and compartment syndromes". Injury. 29 (6): 403–11. PMID 9813693.
  3. Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S (April 2010). "Compartment syndrome of the lower leg and foot". Clin. Orthop. Relat. Res. 468 (4): 940–50. doi:10.1007/s11999-009-0891-x. PMC 2835588. PMID 19472025.
  4. McDonald S, Bearcroft P (June 2010). "Compartment syndromes". Semin Musculoskelet Radiol. 14 (2): 236–44. doi:10.1055/s-0030-1253164. PMID 20486031.
  5. Johnston-Walker E, Hardcastle J (2011). "Neurovascular assessment in the critically ill patient". Nurs Crit Care. 16 (4): 170–7. doi:10.1111/j.1478-5153.2011.00431.x. PMID 21651657.
  6. Suzuki T, Moirmura N, Kawai K, Sugiyama M (January 2005). "Arterial injury associated with acute compartment syndrome of the thigh following blunt trauma". Injury. 36 (1): 151–9. doi:10.1016/j.injury.2004.03.022. PMID 15589934.
  7. Alexander W, Low N, Pratt G (January 2018). "Acute lumbar paraspinal compartment syndrome: a systematic review". ANZ J Surg. doi:10.1111/ans.14342. PMID 29316189.
  8. Thati S, Carlson C, Maskill JD, Anderson JG, Bohay DR (June 2008). "Tibial compartment syndrome and the cavovarus foot". Foot Ankle Clin. 13 (2): 275–305, vii. doi:10.1016/j.fcl.2008.02.001. PMID 18457774.
  9. Fulkerson E, Razi A, Tejwani N (February 2003). "Review: acute compartment syndrome of the foot". Foot Ankle Int. 24 (2): 180–7. doi:10.1177/107110070302400214. PMID 12627629.