Compartmentsyndrome Causes

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:

• 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