ETIOPATHOGENESIS, DIAGNOSTICS AND TREATMENT OF ACUTE COMPARTMENT SYNDROME – CURRENT STATE OF KNOWLEDGE

Piotr Szwed; Adam Śmietana; Kacper Piotr Urban; Natalia Julia Sojka; Karolina Maria Dubiel; Monika Białowąs; Sandra Balon; Michał Maćkowski; Jakub Jan Magnowski; Weronika Białowąs

doi:10.31435/ijitss.2(50).2026.5404

Authors

Piotr Szwed Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0007-3204-5042
Adam Śmietana Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0005-1834-3815
Kacper Piotr Urban Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0001-7979-5904
Natalia Julia Sojka Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0002-4779-1295
Karolina Maria Dubiel Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0008-2445-3043
Monika Białowąs Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0001-9662-7347
Sandra Balon Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0007-7106-1133
Michał Maćkowski Medical University of Silesia, ul. Poniatowskiego 15, 40-055 Katowice, Poland https://orcid.org/0009-0000-4219-2125
Jakub Jan Magnowski Medical University of Gdansk, ul. M. Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland https://orcid.org/0009-0009-7862-233X
Weronika Białowąs Wroclaw Medical University, wybrzeże Ludwika Pasteura 1, 50-367 Wrocław, Poland https://orcid.org/0009-0005-1785-0321

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5404

Keywords:

Acute Compartment Syndrome, Fasciotomy, Pediatric Compartment Syndrome, Pressure Monitoring

Abstract

Introduction and purpose: Acute compartment syndrome (ACS) is a surgical condition marked by a critical elevation of intracompartmental pressure within a confined osseofascial space, resulting in impaired perfusion and subsequent risk of ischemic tissue injury. This article seeks to present a comprehensive overview of the contemporary understanding of ACS, including its pathophysiology, diagnostic evaluation, and treatment, with particular focus on associated clinical challenges and recent developments.

A brief description of the state of knowledge: Although ACS most frequently occurs secondary to traumatic injury, it may also develop in the absence of trauma, e.g., infections, bites, and prolonged limb compression. While classic clinical manifestations—such as disproportionate pain and swelling—are widely recognized, they lack specificity. Continuous measurement of intracompartmental pressures remains the diagnostic tool of greatest clinical utility. At present, no laboratory biomarker demonstrates adequate sensitivity or specificity to reliably confirm or exclude the diagnosis, though research is ongoing. The extent and duration of ischemia are the primary determinants of functional outcome in ACS. Accordingly, timely recognition and intervention—most critically surgical fasciotomy—are essential to prevent irreversible neuromuscular ischemic injury.

Conclusions: Comprehensive understanding of the risk factors, diagnostic tools, and therapeutic strategies for ACS facilitates prompt evaluation and intervention. Increased clinical vigilance is imperative to mitigate complications and limit irreversible tissue injury.

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