Compartment syndrome occurs when fascial compartment pressure exceeds perfusion pressure, resulting in decreased compartment perfusion, ischemia, and ultimately necrosis of the contained muscles and nerves. The syndrome can occur anywhere that there is skeletal muscle surrounded by fascia. Pain out of proportion to injury is most important physical finding; compartments may feel firm and tense.

Fractures account for 75% of cases of acute compartment syndrome. Other injuries to tissue that can cause the condition include crush injuries, burn injuries, contusions, overly constrictive bandages, and gunshot wounds. Burns, envenomation injuries, intravenous (IV) extravasation, and bleeding diathesis / vascular disorders are other non-traumatic causes.

• Tibial fractures (eg, tibial shaft fractures) are most common cause for compartment syndrome of lower leg.
• Lower leg is the most common place to develop compartment syndrome, followed by forearm, thigh, and upper arm.
• For the forearm, distal radius fractures in adults are most common; in pediatrics, the most common cause is supracondylar humerus fractures.
• Compartment syndrome may also occur in the hand secondary to intravenous medication / fluid extravasation.

The majority of cases (91%) occur in men (average age 32 years); however, the condition can affect anyone.

Early diagnosis, pressure monitoring, and fasciotomy can preserve function. If not treated immediately, damage to nerves and muscles may be irreversible. When muscle has become necrotic, amputation may be required.